Inspection on 28/06/07 for Graceland Care Home

This inspection was carried out on 28th June 2007.

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 no outstanding requirements from the previous inspection report, but made 4 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Graceland Care Home 24/04/06

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 28th June 2007 9:00am Graceland Care Home DS0000025785.V339664.R01.S.doc Version 5.2 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.V339664.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 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.V339664.R01.S.doc Version 5.2 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.V339664.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 24th April 2006 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 £420 and £680 and this information was gathered on the day of the inspection (28/06/07). Graceland Care Home DS0000025785.V339664.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced visit to the home was undertaken as a part of the inspection process for the year 2007/2008. In writing the report consideration has also been given to information received throughout the year such as comments from people who use the service, reports of incidents and complaints. Some times were spent looking at the policies and procedures, records, talking to the residents and the registered manager. A tour of the building was also carried out. They are all thanked for their time and all of those who provided feedback for their support in the inspection process. What the service does well: What has improved since the last inspection? In general the staff training and development programme is kept up to date to ensure that staff fulfil the aims of the home and meet the changing needs of service users. Graceland Care Home DS0000025785.V339664.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. The summary of this inspection report can be made available in other formats on request. Graceland Care Home DS0000025785.V339664.R01.S.doc Version 5.2 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.V339664.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 2 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home has its own assessment plan to ensure that any new resident’s needs are fully assessed prior to their admission and that staff are aware of how to support them. EVIDENCE: Admissions are not made to the home until a full needs assessment has been undertaken. The home consults the assessment information to see if they can meet the prospective individual’s needs before they make the decision to accept the application for admission and offer a placement. Evidence suggests that prospective people who use services have a needs assessment carried out before they are admitted to the home. The home has received copies of the summary, and care plans, from those assessments carried out through care management arrangements for most of the residents. The assessments are generally undertaken satisfactorily. Graceland Care Home DS0000025785.V339664.R01.S.doc Version 5.2 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. 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 using available evidence including a visit to this service. Generally residents’ care plans include detailed information about their needs and personal goals. This helps staff to know the residents’ needs and how to meet them. EVIDENCE: Each resident has a care plan but practice of involving people who use the service in the development and review of the plan is variable. The plan includes basic information necessary to deliver the resident’s care but is not detailed or person centred. The home must ensure that care plans cover all aspects of personal and social support and healthcare needs of the residents. Graceland Care Home DS0000025785.V339664.R01.S.doc Version 5.2 Page 10 The home recognises the right of individuals to take control of their lives and to make their own decisions and choices. There is some evidence that individuals are involved in some decision making about the home, such as day to day living and social activities. Risk assessments are completed but these are basic and mainly focus on keeping people who use the service safe. Where limitations are in place, there is some evidence that decisions are agreed with the individual but this is not consistent. The home must ensure that residents’ risk assessments are comprehensive and staff have good information on which to base decisions, within the context of the resident’s individual plan and of the home’s risk assessment and risk management strategies. Graceland Care Home DS0000025785.V339664.R01.S.doc Version 5.2 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. 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 using available evidence including a visit to this service. Residents 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. EVIDENCE: The home has a strong commitment to enabling people who use services to develop their skills, including social, emotional, communication, and independent living skills. Individuals are supported to identify their goals, and work to achieve them. Graceland Care Home DS0000025785.V339664.R01.S.doc Version 5.2 Page 12 People using the service are given the opportunity to take part in a variety of activities both within the home and in the community. The registered manager stated that where possible staff gather information on community based events and try to make individual arrangements for people to attend. All the residents are registered to vote. The service is committed to the principles of inclusion and promotes, and fosters good relationships with neighbours and other members of the community. The practice of staff promotes individual rights and choice, but also considers protection of individuals, supporting people to make informed choices. People who use the service are actively encouraged to maintain links with their families and friends. The registered manager stated that the home has an ‘open’ visitor’s policy and simply recommends that visitors telephone to say they are coming to ensure there loved ones will be available. Residents, who were at home at the time of this inspection, appeared to enjoy some level of independence. Routines can be flexible and are well observed to take into account all the residents’ individual needs. The home tries to be flexible and attempts to provide a service that is as individual as possible using its staff and resources effectively. The meals are balanced and nutritional and cater for the dietary needs of the individuals using the service. Mealtimes are flexible and relaxed, staff are patient and helpful, and allow individuals the time they needed to finish their meal comfortably. Opportunities are available for residents to be involved in food shopping, the preparation of meals and menu planning. Graceland Care Home DS0000025785.V339664.R01.S.doc Version 5.2 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. 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 using available evidence including a visit to this service. Overall the arrangement for health care needs of the residents is good and they receive personal support in the way they prefer. EVIDENCE: The delivery of personal care is individual and flexible. Staff respect the privacy and dignity of the residents and are sensitive to their changing needs. Where needed, guidance and support is provided. Times for getting up/going to bed, baths, meals and other activities are flexible. People who use services are supported and helped to be independent and can take responsibility for their personal care needs. Staff listen to people who use services and take account of what is important to them. People who use services have access to health care services both within the home and in the local community. The people who use services are able to Graceland Care Home DS0000025785.V339664.R01.S.doc Version 5.2 Page 14 choose their own GP and attend local dentists, opticians and other community services. The home has an efficient medication policy supported by procedures and practice guidance, which staff understand and follow. Medication records are fully completed, contain required entries, and are signed by appropriate staff. An assessment has been carried out to ensure each member of staff is competent to handle, record and administer medication properly. Graceland Care Home DS0000025785.V339664.R01.S.doc Version 5.2 Page 15 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. JUDGEMENT – we looked at outcomes for the following standard(s): 22 and 23 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Complaints are generally managed well, which should ensure that residents’ and relatives’ concerns are listened to. EVIDENCE: The ethos of the home is that it welcomes complaints and suggestions about the service, uses these positively and learns from them. The home has a complaints procedure that is clearly written and easy to understand. The home has an open culture that allows residents to express their views, and concerns Residents who were spoken to stated that they are happy with the service provision and feel well supported. Policies and procedures for safeguarding people who use the service are in place. However the home must ensure that staff are familiar with the guidance. The Commission will monitor this as there has been a concern raised in another home that is run by the same provider. Graceland Care Home DS0000025785.V339664.R01.S.doc Version 5.2 Page 16 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. 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 using available evidence including a visit to this service. The home is generally hygienic and clean, homely and comfortable; this environment therefore facilitates the residents’ health and emotional wellbeing. EVIDENCE: The home is suitable for its stated purpose. It is accessible, meet residents’ individual and collective needs in a comfortable and homely way. Residents’ bedrooms are personalised to reflect their individual needs, and personalities. The home is comfortable, and has a programme to improve the decoration, fixtures and fittings. People who use services are encouraged to personalise their bedrooms. Graceland Care Home DS0000025785.V339664.R01.S.doc Version 5.2 Page 17 The home is kept 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.V339664.R01.S.doc Version 5.2 Page 18 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. JUDGEMENT – we looked at outcomes for the following standard(s): 32,33,34,35 and 36 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The completion of staff training within Sector Skills Council training specifications is not being met satisfactorily, and without improvement this could affect the staffs ability to consistently meet all residents’ needs. EVIDENCE: The registered manager informed that three staff have NVQ level 2 in care. Following a recent incident at another home which is run by the same provider and staff team, it was noted that not all staff working between the two homes have the skills and experience necessary for the tasks they are expected to do. This was discussed again with the registered manager during this inspection. The home has a staff team with sufficient numbers to support residents’ assessed needs. However the registered manager must ensure that staffing rotas take into account the needs and routines of the people using the service Graceland Care Home DS0000025785.V339664.R01.S.doc Version 5.2 Page 19 especially when the registered provider and registered manager are away on leave abroad. As part of the inspection process staff records were sampled for references, criminal record checks, application forms and copies of identification. One staff file did not contain all the relevant documentation. The registered provider must ensure that staff files contain all relevant documentations as per schedule 2 of the revised Care Homes Regulations 2001. The home recognises the importance of training, and tries to delivers a programme that meets any statutory requirements and the National Minimum Standards. The registered manager is aware that there are some gaps in the training programme. The home must ensure that all staff receive relevant training that is focussed on delivering improved outcomes for people using the service. From staff files sampled at random there were evidence that care workers are being supervised on a regular basis. Graceland Care Home DS0000025785.V339664.R01.S.doc Version 5.2 Page 20 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. JUDGEMENT – we looked at outcomes for the following standard(s): 37,39 and 42 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is generally managed well however the manager must access to a mentor or another professional for support in relation to her professional practice. EVIDENCE: The manager is qualified and has the necessary experience to run the home. She is aware of the need to keep up to date with practice and continuously develop management skills. It is recommended that the registered manager have access to a mentor or another professional for support in relation to her Graceland Care Home DS0000025785.V339664.R01.S.doc Version 5.2 Page 21 professional practice. All professionals need an element of support and supervision, including managers and owners. The home has an effective quality assurance and quality monitoring systems, based on seeking the views of service users, to measure success in achieving the aims, objectives and statement of purpose of the home. The home has a health and safety policy that generally meets health and safety requirements and legislation. It is aware of the areas where they need to make improvements and has an action plan for undertaking the work. Certificates relating to health and safety were up to date servicing certificates. Records are of a good standard and are routinely completed. Graceland Care Home DS0000025785.V339664.R01.S.doc Version 5.2 Page 22 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 3 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 2 33 3 34 2 35 2 36 3 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 3 X X 3 X Graceland Care Home DS0000025785.V339664.R01.S.doc Version 5.2 Page 23 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 YA6 Regulation 15(1) Requirement The home must ensure that care plans cover all aspects of personal and social support and healthcare needs of the residents. The home must ensure that residents’ risk assessments are comprehensive and staff have good information on which to base decisions, within the context of the resident’s individual plan and of the home’s risk assessment and risk management strategies. The home must ensure that all staff receive relevant training that is focussed on delivering improved outcomes for people using the service. Staff personnel files must contain all relevant documentations as per schedule 2 of the revised Care Homes Regulations 2001 for the protection of residents. Timescale for action 28/08/07 2. YA9 13(4) 28/08/07 3. YA35 18(1) 28/08/07 4. YA34 19 28/06/07 Graceland Care Home DS0000025785.V339664.R01.S.doc Version 5.2 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 YA37 Good Practice Recommendations It is recommended that the registered manager have access to a mentor or another professional for support in relation to her professional practice. Graceland Care Home DS0000025785.V339664.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Croydon, Sutton & Kingston Office 8th Floor Grosvenor House 125 High Street Croydon CR0 9XP National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Graceland Care Home DS0000025785.V339664.R01.S.doc Version 5.2 Page 26 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!