Inspection on 24/04/06 for Graceland Care Home

This inspection was carried out on 24th April 2006.

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

The inspector found there to be outstanding requirements from the previous inspection report. These are things the inspector asked to be changed, but found they had not done. The inspector also made 9 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Graceland Care Home 28/06/07

Graceland Care Home 05/10/05

Graceland Care Home 19/05/05

Graceland Care Home 24/01/05

Graceland Care Home 30/07/04

Similar services:

Ashlong House

Norbury Crescent (30)

Edenvale

Wadham Avenue

Chatsworth Care - Dawson House

Cowden Road, 52 - 54

Chatsworth Care - Tudor Lodge

Foxley Lane (121a)

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

CARE HOME ADULTS 18-65 Graceland Care Home 113A Parchmore Road Thornton Heath Croydon Surrey CR7 8LZ Lead Inspector Mohammad Peerbux Key Unannounced Inspection 24th April 2006 9:15am Graceland Care Home DS0000025785.V291234.R01.S.doc Version 5.1 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 Graceland Care Home DS0000025785.V291234.R01.S.doc Version 5.1 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Adults 18-65. 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. Graceland Care Home DS0000025785.V291234.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Graceland Care Home Address 113A Parchmore Road Thornton Heath Croydon Surrey CR7 8LZ 020 8771 5691 020 8768 1445 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) Graceland Care Home Limited Mrs Grace Basoah Care Home 2 Category(ies) of Learning disability (2) registration, with number of places Graceland Care Home DS0000025785.V291234.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 5th October 2005 Brief Description of the Service: Graceland is registered as a care home to provide a service for up to two young adults between the ages of 18 to 65 years, under the category of learning disabilities. There are two Registered Providers, one of whom manages the home on a day-to-day basis. The home is positioned on a main road in Thornton Heath, with the town centre and local transport links within easy reach. Due to the good location, service users benefit from being able to access a variety of community resources. The home comprises of a lounge/ dining area, small kitchen, two large bedrooms, one smaller bedroom, upstairs bathroom/ toilet and ground floor toilet/ shower room, with laundry facilities outside. Entry to the premises is via the rear of the building as the proprietors’ business office is at the front. There is no garden but a good- sized paved yard for service users to utilize in the summer months. The range of weekly fees is between £400 and £666 and this information was gathered on the day of the inspection (24/04/06). Graceland Care Home DS0000025785.V291234.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was the home’s first inspection for the year 2006/07. It was an unannounced inspection and took place over four hours. Some times were spent looking at the policies and procedures, talking to staff, manager and to one of service users. A tour of the building was also carried out. Service user spoken to stated that she was happy with the care being provided. Overall the inspection confirmed that the home provides a good level of care for the service users who live there. What the service does well: What has improved since the last inspection? The service users’ care plans and risk assessments have been reviewed and updated accordingly. The home now ensures that the hot water temperature is always within recommended level and has met all the recommendations with regards to fire safety. The Registered Provider has developed a business plan demonstrating that the home is financially viable for the purpose of achieving the aims and objectives set out in the Statement of Purpose. Graceland Care Home DS0000025785.V291234.R01.S.doc Version 5.1 Page 6 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. Graceland Care Home DS0000025785.V291234.R01.S.doc Version 5.1 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Graceland Care Home DS0000025785.V291234.R01.S.doc Version 5.1 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 2 Quality in this outcome area is good. This judgement has been made from evidence gathered both during and before the visit to this service. All prospective service users have their needs assessed prior to admission to ensure that the home and staff are aware of their assessed needs. EVIDENCE: The manager indicated that service users are only admitted to the home after a full assessment of their needs has been carried out by the home and the Placing Authority for individuals referred through Care Management, involving the prospective service user/recognised representative. There has been a service user who has recently been admitted to the home and it was positively noted that the home carried out a very comprehensive needs assessment. Graceland Care Home DS0000025785.V291234.R01.S.doc Version 5.1 Page 9 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6,7 and 9 Quality in this outcome area is adequate. This judgement has been made from evidence gathered both during and before the visit to this service. Service user’s care plans are comprehensive and include detailed information about their needs and personal goals. However these care plans will have far greater authority if service users were involved where possible in their development. EVIDENCE: It was previously required that the registered manager must ensure that all service users have a care plan in place that sets out in detail the action which needs to be taken by care staff to ensure that all aspects of the health, personal and social care needs of the service user are met. Both service users’ care plans were sampled, it was noted that they were all up to date and well maintained. Overall, the plans demonstrated a thorough needs assessment, which clearly set out how current and anticipated needs would be met. The plans checked established individualised procedures for service users likely to challenge the service, focusing on positive management strategies. However it was noted that none of the care plans were drawn up with the involvement of the service user together with their family, friends and/or advocate as Graceland Care Home DS0000025785.V291234.R01.S.doc Version 5.1 Page 10 appropriate, and relevant other agencies/specialists. The registered person must ensure that service users care plans are drawn up after consultation with the service user, family, friends and an advocate where appropriate. The care plan must also be made available in a language and format that the service user can understand and is held by the service user unless there are clear and recorded reasons not to do so. The rights of service users to make decisions about their own lives is central to the ethos of the home, support and guidance is given in all areas to ensure that service users are making decisions which are in their best interests. From discussion with service user and staff no evidence of restrictions on service users were found. Risk assessments for service users were examined. Potential risks are identified covering all aspects of their daily living both inside and outside the home. The risk assessments give details to what action is required to minimise identified risks and hazards. The risk assessments have been updated in line with requirement made at the last inspection. Again the registered manager must ensure that service users risk assessments are drawn up after consultation with the service user, family, friends and an advocate where appropriate. Graceland Care Home DS0000025785.V291234.R01.S.doc Version 5.1 Page 11 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,15,16 and 17 Quality in this outcome area is good. This judgement has been made from evidence gathered both during and before the visit to this service. Service users are encouraged to explore opportunities to enhance their quality of life as well as maintain and participate with friends and the local community, with the aim of maximum integration. The daily routines and house rules promote service users’ rights, and ensure equality and that all rights are enjoyed by service users. Dietary needs are well catered for and a well balanced diet is provided, to ensure health and enjoyment of food. EVIDENCE: The home is very well situated for local shops and public transport - which enables participation and integration into the local community. The staff reported that they accompany and support service users in undertaking a wide range of facilities, including shopping, going on day trips, bowling, etc. Graceland Care Home DS0000025785.V291234.R01.S.doc Version 5.1 Page 12 The service users are clearly all able to express their social / leisure needs and interests. Staff support service users in pursuing these activities if and when necessary / requested. Service users take part in a range of local leisure activities. Service users are actively encouraged to maintain links with their families and friends. The home has an ‘open’ visitor’s policy and simply recommends that visitor’s telephone to say they are coming to ensure there loved one will be available. Service user, who was at home at the time of this inspection, appeared to enjoy some level of independence. Routines can be very flexible and are well observed to take into account all the service users individual needs. All service users have a key to their bedrooms. The daily routines at Graceland clearly promote opportunities for service users to maintain, or further develop their personal skills in areas such as money / household management and personal relationships. Activities such as cooking, cleaning and self-care are a normal part of the daily life for service users in this home. The home promotes service users health and well being by ensuring the supply of nutritious, varied and balanced meals in a congenial setting and at flexible times. Service users are offered a choice of suitable menus, which meet their dietary and cultural needs, and which respect their individual preferences. Graceland Care Home DS0000025785.V291234.R01.S.doc Version 5.1 Page 13 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 18,19 and 20 Quality in this outcome area is good. This judgement has been made from evidence gathered both during and before the visit to this service. Service users’ personal, physical and emotional health needs are being appropriately met and reviewed. This ensures that the service users’ physical and emotional health is well maintained and therefore the quality of life experienced is also maximised. EVIDENCE: Staff provide sensitive and flexible personal support to maximise service users’ privacy, dignity, independence and control over their lives. The manager stated that where needed, guidance and support regarding personal hygiene is provided. Times for getting up/going to bed, baths, meals and other activities are flexible. The service users are all registered with a local General Practitioner. Records checked indicate that GP’s and other community based medical/health care professionals are contacted on an as needed basis. It was evident that records of all medical/health appointment/visits were being maintained. The home has a medication policy and procedure. The current service users are not on any medications. Graceland Care Home DS0000025785.V291234.R01.S.doc Version 5.1 Page 14 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 22 and 23 Quality in this outcome area is adequate. This judgement has been made from evidence gathered both during and before the visit to this service. Complaints are generally managed well, which should ensure that service users’ and relatives’ concerns are listened to. Generally the home’s policies and procedures help protect service users from abuse and help staff if they need to tell someone about any bad care practice they may observe. EVIDENCE: The current complaints procedure is a good and gives clear step-by-step guide of how to make a complaint. It is also available in pictoral format. There have been no complaints since the last inspection. The home has its own protection of vulnerable adults policy in place. The home should also have a copy of the Croydon adult protection policy, guidelines and procedures. The manager stated that all staff have attended the “Abuse Awareness” training however not all the attendance certificates were available so it was difficult to ascertain who attended the training. The manager must make suitable arrangements by training staff to prevent service user’s being harmed or suffering abuse or being placed at risk of harm and/or abuse. Graceland Care Home DS0000025785.V291234.R01.S.doc Version 5.1 Page 15 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 24 and 30 Quality in this outcome area is good. This judgement has been made from evidence gathered both during and before the visit to this service. The home is generally hygienic and clean, homely and comfortable; this environment therefore facilitates the service users’ health and emotional wellbeing. EVIDENCE: The home is suitable for its stated purpose. It is accessible, meet service users’ individual and collective needs in a comfortable and homely way. Service users’ bedroom are personalised to reflect their individual needs, and personalities. Overall the home was decorated to a reasonably good standard throughout and appeared to be very comfortable, bright and warm. To ensure that the premises comply with the requirements of the local fire brigade (LFEPA), the Registered Provider was previously required to arrange for a safety inspection to be carried out by the fire service with a report made available to inspection. The London Fire and Emergency Planning Authority visited the home in November 2005 and made 6 recommendations. The home has met all of them at the time of this inspection. Graceland Care Home DS0000025785.V291234.R01.S.doc Version 5.1 Page 16 The home is kept very clean and hygienic and free from offensive odours throughout. Systems are in place to control infection in accordance with relevant legislation and published professional guidance. Graceland Care Home DS0000025785.V291234.R01.S.doc Version 5.1 Page 17 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 34,35 and 36 Quality in this outcome area is adequate. This judgement has been made from evidence gathered both during and before the visit to this service. Generally staff are recruited appropriately and employed in sufficient numbers to meet the health and social needs of their service users. However care staff are not receiving supervision on a regular basis, which could have an impact on the standards of care being provided to service users. EVIDENCE: It was previously required that the manager must ensure that staff files must contain all relevant documentations as per schedule 2 of the revised Care Homes Regulations 2001.At the time of this inspection recruitment procedures seemed appropriate. Three staff files were examined at random and found to contain all the information required by the Care Homes Regulations 2001 including a completed job application, terms and conditions of employment, an enhanced CRB check and proof of their identity. From the staff training records, it was noted that they were not always up to date and there are gaps in mandatory training. It was very difficult to ascertain if the staff were up to date with their training. The registered manager must ensure that there is a staff training and development programme which meets Sector Skills Council workforce training targets and ensures staff fulfil the aims of the home and meet the changing needs of service users. The registered Graceland Care Home DS0000025785.V291234.R01.S.doc Version 5.1 Page 18 manager must also ensure that a training needs assessment is carried out for the staff team as a whole, and an impact assessment of all staff development is undertaken to identify the benefits for service users and to inform future planning. From staff supervision records it seems that not all staff are having at least six sessions per year. This was a requirement made at the last inspection and would be repeated. The registered provider must ensure that formal supervision sessions are held with all care staff at least six times a year, and that these sessions are recorded and signed by both the supervisor and supervisee. It is also recommended that staff have an annual appraisal in order to review staff performances against their job descriptions and agree career development plans. Graceland Care Home DS0000025785.V291234.R01.S.doc Version 5.1 Page 19 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. 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 are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 37,39,42 and 43 Quality in this outcome area is adequate. This judgement has been made from evidence gathered both during and before the visit to this service. The home management generally provides leadership, guidance and direction to staff to ensure service users receive consistent quality care. However an annual quality development plan still needs to be developed. EVIDENCE: Throughout the course of the inspection the manager demonstrated a good competent management skills and appears to have created a skilled, positive and enthusiastic workforce. She has experience of working with this client group and displayed an insight into the relevant issues. The home has a satisfaction questionnaire for service users and their relatives to gain feedback on the services being provided. The manager explained that an annual quality development plan still needs to be developed for the home and this requirement therefore still stands. Graceland Care Home DS0000025785.V291234.R01.S.doc Version 5.1 Page 20 The inspector examined certificates relating to health and safety. Up to date servicing certificates were in place. Risk assessments covering safe working practices have yet to be completed for the premises and the former requirement therefore still stands. The Registered Provider has developed a business plan, demonstrating that the home is financially viable for the purpose of achieving the aims and objectives set out in the Statement of Purpose. This is in line with requirement made at the last inspection. Graceland Care Home DS0000025785.V291234.R01.S.doc Version 5.1 Page 21 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 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 X 2 3 3 X 4 X 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 2 ENVIRONMENT Standard No Score 24 3 25 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 X 33 X 34 3 35 2 36 2 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 2 3 X 2 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 X 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 3 X 2 X X 2 3 Graceland Care Home DS0000025785.V291234.R01.S.doc Version 5.1 Page 22 Are there any outstanding requirements from the last inspection? YES 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 YA6 Regulation 15(1) Requirement The registered person must ensure that service users care plans are drawn up after consultation with the service user, family, friends and an advocate where appropriate. Service user’s care plans must be made available in a language and format that the service user can understand and is held by the service user unless there are clear and recorded reasons not to do so. The registered manager must ensure that service users risk assessments are drawn up after consultation with the service user, family, friends and an advocate where appropriate. Timescale for action 31/07/06 2. YA6 15(2) 31/07/06 3. YA9 15(1) 31/07/06 4. YA23 13(6) The manager must make 31/07/06 suitable arrangements by training staff to prevent service user’s being harmed or suffering abuse or being placed at risk of harm and/or abuse. Graceland Care Home DS0000025785.V291234.R01.S.doc Version 5.1 Page 23 6. YA35 18(1)(C) The registered manager must ensure that there is a staff training and development programme which meets Sector Skills Council workforce training targets and ensures staff fulfil the aims of the home and meet the changing needs of service users. The registered manager must ensure that a training needs assessment is carried out for the staff team as a whole, and an impact assessment of all staff development is undertaken to identify the benefits for service users and to inform future planning. The Registered Provider must ensure that all care staff have regular, recorded supervision. (Timescale of 19/05/05 and 15/12/05 not met) 31/07/06 7. YA35 18(1)(C) 31/07/06 8. YA36 17(2) 18(2) 31/07/06 9. YA39 21(2) The home must produce a 24(1)(a)(b) written record of an annual quality development plan. (Timescale of 31/07/05 and 15/12/05 not met) 13(4) 15(1) Sch.3, 3q The home must ensure that environmental risk assessments are completed for all safe working practices as listed in standards 42.2 and 42.3. (Timescale of 31/07/05 and 15/12/05 not met) 31/07/06 10. YA42 31/07/06 Graceland Care Home DS0000025785.V291234.R01.S.doc Version 5.1 Page 24 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 YA36 Good Practice Recommendations It is also recommended that staff have an annual appraisal in order to review staff performances against their job descriptions and agree career development plans. Graceland Care Home DS0000025785.V291234.R01.S.doc Version 5.1 Page 25 Commission for Social Care Inspection Croydon, Sutton & Kingston Office 8th Floor Grosvenor House 125 High Street Croydon CR0 9XP 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 Graceland Care Home DS0000025785.V291234.R01.S.doc Version 5.1 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. 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