Inspection on 27/07/06 for Graceland Care Home

This inspection was carried out on 27th July 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 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

Graceland Care Home 12/12/05

Graceland Care Home 23/06/05

Graceland Care Home 08/02/05

Graceland Care Home 11/05/04

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

CARE HOMES FOR OLDER PEOPLE Graceland Care Home Belmangate Guisborough TS14 7BB Lead Inspector Julia Connor Key Unannounced Inspection 27th July 2006 10:15 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 Graceland Care Home DS0000000169.V304492.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. Graceland Care Home DS0000000169.V304492.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Graceland Care Home Address Belmangate Guisborough TS14 7BB 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) 01287 639351 01287 635647 Paramount Agency Services Limited Mrs Joan Parvin Care Home 53 Category(ies) of Dementia (0), Dementia - over 65 years of age registration, with number (0) of places Graceland Care Home DS0000000169.V304492.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. Age category for individuals with dementia is age 60 One named individual who is under the age category is allowed to reside in the home. 12th December 2005 Date of last inspection Brief Description of the Service: Graceland is a care home providing nursing and personal care for older people with mental health needs. It is a two-storey purpose built home providing single and double accommodation for 53 Residents; the 31 single bedrooms are a minimum of 10 sq.m. The 11 double bedrooms are a minimum of 16 sq.m. There is a passenger lift giving access to the upper floor. There are a selection of lounges and three dining rooms, one on the first floor and one on the ground floor. The home is close to local shops and amenities with a car park at the front of the home. Graceland Care Home DS0000000169.V304492.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection carried out by two Inspectors’ commenced at 10.15 a.m. and concluded at 3.15 p.m. Two visitors’ and two members’ of staff were spoken to during the inspection. Due to their confusion the Residents’ were unable to give the Inspectors’ any information about living at Graceland. However the Inspectors’ observed that interaction between the Residents’ and staff was kind and respectful. No relatives’ returned the Commission for Social Care Inspection comment cards. The current fees structure is £356.00 to £494.00 a week depending on the level of care required. What the service does well: What has improved since the last inspection? The Inspectors’ were informed that the home had employed a care manager who is responsible for the care documentation and has implemented the key worker system. 80 of the staff have an NVQ in care. Policies and procedures have been reviewed and updated where necessary. Bedrooms and corridors have been decorated and some new lounge chairs have been purchased. Graceland Care Home DS0000000169.V304492.R01.S.doc Version 5.2 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 DS0000000169.V304492.R01.S.doc Version 5.2 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 Graceland Care Home DS0000000169.V304492.R01.S.doc Version 5.2 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 Quality in this outcome area is Good. This judgement has been made using available evidence including a visit to this service. Residents have their needs assessed prior to their admission to the home. EVIDENCE: Five sets of Residents’ were audited and had evidence that the Resident had been assessed by the appropriate professional prior to being admitted to the home. Graceland Care Home DS0000000169.V304492.R01.S.doc Version 5.2 Page 9 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 and 10 Quality in this outcome area is Good. This judgement has been made using available evidence including a visit to this service. The Residents’ health, personal and social needs are recorded in an individual plan of care and their health care needs are met. Family members feel their relatives are treated with respect and dignity. Medication is dispensed appropriately and Residents’ are protected by the home’s policies and procedures for dealing with medication. EVIDENCE: New care documentation is currently being introduced. Five sets of Residents’ care files were audited and all contained an adequate amount of information. There was evidence that the Residents’ representative had had access to their files and agreed the plans of care. The Inspector spoke with one Resident whose notes she had audited; unfortunately he was unable to give any information regarding the care he received. Graceland Care Home DS0000000169.V304492.R01.S.doc Version 5.2 Page 10 There was evidence in the care documentation that the Residents’ had access to out side health professionals e.g. Doctor, District Nurse, Dentist and Optician. There is a policy and procedure for the receipt, recording, storage, handling, administration and disposal of medicines. The Residents’, which the Inspector came into contact with, were appropriately dressed for their gender and the weather. The interaction observed between the staff and the Residents’ was kind and respectful. Both of the visitors’ who spoke to the Inspector stated that they felt that their relative was cared for with respect and dignity. Graceland Care Home DS0000000169.V304492.R01.S.doc Version 5.2 Page 11 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 and 15 Quality in this outcome area is Good. This judgement has been made using available evidence including a visit to this service. Activities take place within the home on a regular basis and appear to be varied. Residents’ maintain contact with family and friends and are encouraged to make choices in their every day lives. The Residents’ receive a wholesome and well balanced diet. EVIDENCE: There is an activities organiser in post. There was a photo album available which showed the Residents’ enjoying activities. There was a vase of artificial flowers on the reception desk, which the Residents’ had arranged. There were visitors’ in the home on the day of the inspection. Both visitors’ stated that they were always made welcome. One visitor who spoke to the Inspector takes his friend out for a ride in his car, which he states she enjoys. Graceland Care Home DS0000000169.V304492.R01.S.doc Version 5.2 Page 12 A visit to the Kitchen showed there was a good stock of food both fresh and dried, including fresh fruit and vegetables. The visitors’ to the home stated that the meals always looked nice. On the day of the inspection there were sufficient staff to give assistance to those Residents’ who required it Graceland Care Home DS0000000169.V304492.R01.S.doc Version 5.2 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 and 18 Quality in this outcome area is Good. This judgement has been made using available evidence including a visit to this service. Family members’ are confident that their complaints will be listened to seriously and action taken. There are polices and procedures in place to follow should abuse be reported. EVIDENCE: There is a complaints policy and procedure in place, which outlines the stages the complainant should take to make a formal or informal complaint. Complaints are recorded appropriately and are available for inspection. There have been two complaints in the last twelve months; both of which were investigated appropriately. The visitors’ to the home were confident that should they need to make a complaint it would be dealt with appropriately. Policies and procedures are in place in relation to adult protection and prevention of abuse. The home has a copy of the Teeswide No Secrets Protection of Vulnerable Adults Guidance. The Manager informed the Inspectors’ that staff was currently working through a workbook regarding the protection of vulnerable adults, which the staff confirmed during discussion with the Inspector. Graceland Care Home DS0000000169.V304492.R01.S.doc Version 5.2 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 and 26 Quality in this outcome area is Good. This judgement has been made using available evidence including a visit to this service. The home is well maintained and Residents’ have access to safe and comfortable outdoor communal facilities and bedrooms’ are made comfortable and familiar by family members personalising them. On the day of the inspection the home was clean, pleasant and hygienic. EVIDENCE: The Inspector was informed that there is currently a decorating programme in place. The patio area at the back of the home was pleasant and safe for the Residents’ and families to use. On the day of the inspection a Resident was sat out on the patio with family members’. Graceland Care Home DS0000000169.V304492.R01.S.doc Version 5.2 Page 15 A good deal of work had taken place in regards to decorating and renewing furnishings for example bedrooms and corridors have been decorated and many lounge chairs have been replaced. The Inspector was informed that new cushion covers had been ordered. The Residents’ bedrooms had been personalised by the Resident and their family members’. On the day of the inspection the home was clean and hygienic. Graceland Care Home DS0000000169.V304492.R01.S.doc Version 5.2 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): 27, 28, 29 and 30 Quality in this outcome area is Good. This judgement has been made using available evidence including a visit to this service. The duty rota indicated the appropriate number of staff where present in the home on the day of the inspection. Staff are being trained to NVQ level 2 which should ensure that they can meet the Residents’ needs. The Residents’ are protected by the home’s recruitment practices and staff receive training to enable them to care for the Residents’. EVIDENCE: An audit of the duty rota showed that there were two qualified nurses’ and seven care assistants’ on duty for the day shift, two qualified nurses’ and six care assistants’ on duty for the evening shift, and two qualified nurses’ and three care assistants’ on duty on a night shift. The Manager recorded in the pre-inspection questionnaire that 80 of the care staff had an NVQ level 2 or 3 in care, which is an increase of 15 since June 2005. An audit of three personnel files showed that the home complied with the requirements stipulated in Schedule 2 of the Care Home Regulations 2001. Graceland Care Home DS0000000169.V304492.R01.S.doc Version 5.2 Page 17 Five training files were audited and showed that training had taken place, for example diabetes, wound care, manual handling and infection control. Staff who spoke to the Inspector confirmed that training takes place. Graceland Care Home DS0000000169.V304492.R01.S.doc Version 5.2 Page 18 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35 and 38 Quality in this outcome area is Good. This judgement has been made using available evidence including a visit to this service. The Manager is a registered psychiatric nurse with many years experience of working in the care home setting. There was evidence that quality assurance and quality monitoring takes place. The Residents’ personal finances are safeguarded and there are polices and procedures in place for the staff to access EVIDENCE: The visitors’ and staff spoke well of the Manager. There is a quality assurance and quality monitoring system in place within the home. The audits cover the different departments within the home e.g. Residents care documentation, the kitchen and the environment. Graceland Care Home DS0000000169.V304492.R01.S.doc Version 5.2 Page 19 The Inspector was informed that the Residents’ families take care of financial matters for their relative. The home has Health and Safety policies and procedures in place. The Manager recorded in the Pre-inspection questionnaire that equipment was maintained as required, for example the hoists’ were serviced in May 2006 and the emergency lighting was inspected in April 2006. Graceland Care Home DS0000000169.V304492.R01.S.doc Version 5.2 Page 20 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 X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 3 X X X 3 X 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X X 3 Graceland Care Home DS0000000169.V304492.R01.S.doc Version 5.2 Page 21 Are there any outstanding requirements from the last inspection? NO STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Graceland Care Home DS0000000169.V304492.R01.S.doc Version 5.2 Page 22 Commission for Social Care Inspection Tees Valley Area Office Advance St. Marks Court Teesdale Stockton-on-Tees TS17 6QX 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 DS0000000169.V304492.R01.S.doc Version 5.2 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. 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!