Inspection on 06/07/05 for Gracelands

This inspection was carried out on 6th July 2005.

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

The inspector found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Gracelands 23/09/08

Gracelands 26/09/07

Gracelands 09/08/06

Gracelands 30/11/05

Gracelands 09/11/04

Gracelands 30/04/04

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

CARE HOMES FOR OLDER PEOPLE Gracelands 443 Fishponds Road Fishponds Bristol BS16 3AP Lead Inspector Sandra Jones Unannounced 06 July 2005 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 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. Gracelands D56_D05_S26506_Gracelands_V219515_060705_ Stage4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Gracelands Address 443 Fishponds Road, Fishponds, Bristol, BS16 3AP Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) 0117 9653019 Rosie@hancock443.fsnet.co.uk Mrs Rosemarie J Hancock Mrs Rosemarie J Hancock CRH 6 Category(ies) of OP,5MD(E),1 registration, with number of places Gracelands D56_D05_S26506_Gracelands_V219515_060705_ Stage4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: MD(E) for one named person. Will revert to all OP when she leaves.May accommodate up to 6 persons aged 65 years and over requiring personal care only. Date of last inspection 9-Nov-2004 Brief Description of the Service: Gracelands is operated by Ms Hancock and registered as a care home for six older adults. The property is situated on the Fishponds Rd, in close proximity of shops, amenities and bus routes. It has the appearance of a domestic dwelling, which blends well with its environment. The accommodation is arranged over two floors with communal areas on the ground floor and bedrooms on both floors. Gracelands D56_D05_S26506_Gracelands_V219515_060705_ Stage4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. Gracelands D56_D05_S26506_Gracelands_V219515_060705_ Stage4.doc Version 1.40 Page 6 This is an overview of what the inspector found during the inspection. This inspection was conducted on an unannounced basis in July2005 and the first inspection for this financial year. The interaction between staff and residents was directly and indirectly observed. Records, policies and procedures were used to assess compliance with the requirements of the legislation. Four residents agreed to give feedback on the standards of care at the home. What the service does well: What has improved since the last inspection? What they could do better: Requirements made following this inspection are based on certificates to be displayed, fire safety systems checks and training. Please contact the provider for advice of actions taken in response to this Gracelands Version 1.10 Page 7 inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Gracelands D56_D05_S26506_Gracelands_V219515_060705_ Stage4.doc Version 1.40 Page 8 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 Standards Statutory Requirements Identified During the Inspection Gracelands D56_D05_S26506_Gracelands_V219515_060705_ Stage4.doc Version 1.40 Page 9 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 standard(s) This standard remains unchanged since the last inspection. For this reason these standards were not examined. EVIDENCE: Gracelands D56_D05_S26506_Gracelands_V219515_060705_ Stage4.doc Version 1.40 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 standard(s) 8, 9 & 10 Residents are registered with a GP, access NHS community facilities and where necessary are referred for specialist support from the primary healthcare trust. Safe systems for the administration, recording and storage of medications exist at the home. The staff employed at the home respect residents right to privacy and dignity. EVIDENCE: Residents are currently registered with a local GP. Documentation held within case records evidenced that residents are referred by GPs for specialist services at the hospital. Care plans describe the individual’s physical care needs, with the assistance needed. Incorporating the persons likes, dislikes and preferred routines. Gracelands D56_D05_S26506_Gracelands_V219515_060705_ Stage4.doc Version 1.40 Page 11 It was understood from the service provider that one frail resident was provided with equipment to relieve the potential of a pressure sore. All other residents are not at risk of pressure sores. Manual handling risk assessments are completed for each resident and described are the person’s capabilities and equipment needed for safe lifting. Currently one person requires assistance from the staff with standing and transferring. The service provider arranges regular home chiropodist and optician visits and as required from the dentist. Medications that staff administer are through a monitored dosage system and the records of administration were consistent with the medication held within the system. To indicate receipt of the medications no longer required at the home, the pharmacist countersigns the record of medications. Individual profiles that include information leaflets are in place and describe the purpose of the prescribed medications, side effects and compatible homely remedies. The service provider explained the arrangements in place for respecting residents right to privacy and dignity. The service provider reported that policies in place established the intended standard with the accommodation and facilities. Locks on bathroom and toilet doors with lockable private personal space ensuring privacy. Visits arranged from GPs and other NHS professionals take place in bedrooms, further evidencing that standards of care ensure residents rights are respected. Mail is handed to residents unopened, although staff assist with reading the letters to the person where necessary. Gracelands D56_D05_S26506_Gracelands_V219515_060705_ Stage4.doc Version 1.40 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 standard(s) 12, 13 & 14 Residents make choices about their daily activities in terms of leisure and routines for daily living. Visitors to the home are welcome by the staff and visits can take place in the lounge or bedrooms. Residents are supported to have control over their lives. EVIDENCE: The residents at home during the inspection described their daily lives at the home. One resident explained that as community-based activities were arranged before admission to the home, the arrangements had continued. Other residents stay at home and generally watch television, read and pursue hobbies. Other comments made about their abilities to make choices included times to rise, retire, eating their meals and whether to stay in their bedrooms or socialise in the lounge. Residents confirmed that their visitors are welcome at anytime and visits can be conduct in the shared space or in bedrooms. Gracelands D56_D05_S26506_Gracelands_V219515_060705_ Stage4.doc Version 1.40 Page 13 One resident commented about the recent redecoration of the bedrooms. The resident was happy with the redecoration and felt it made the environment brighter. Other residents confirmed that their bedrooms contained a combination of their personal belongings and home’s furniture. Residents described staff’s practices which evidenced the standards of care regarding their right to privacy and dignity. Knocking on their bedroom doors and waiting for an invitation to enter, conducting personal care in private and using the person’s preferred mode of address were the examples used by residents. Gracelands D56_D05_S26506_Gracelands_V219515_060705_ Stage4.doc Version 1.40 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 standard(s) 16 & 17 Residents are confident that staff would take their concerns seriously and act upon them. Residents rights as citizens are promoted. EVIDENCE: There were no complaints received at the home and CSCI for investigation since the last inspection in November 2004. Residents confirmed that feedback is welcome by the service provider. It was further stated that members of staff take their concerns seriously and act upon them. The residents are registered on the electoral roll, which is their right as citizens. Two residents exercised their right to vote at a recent election. Gracelands D56_D05_S26506_Gracelands_V219515_060705_ Stage4.doc Version 1.40 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 standard(s) These standards were not examined at this inspection. EVIDENCE: Gracelands D56_D05_S26506_Gracelands_V219515_060705_ Stage4.doc Version 1.40 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 considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 28 & 30 The service provider and partner undertake “hands-on” care with two staff employed to maintain the staffing levels. Vocational training is available although staff are reluctant to commit to this training. EVIDENCE: The service provider and partner undertake “hand-on” care with two care assistants employed to maintain the staffing levels. These staff have worked at the home for a minimum of ten years and with one exception are related to the service provider. Training is available although staff are reluctant to commit to vocational training. Gracelands D56_D05_S26506_Gracelands_V219515_060705_ Stage4.doc Version 1.40 Page 17 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31, 34, 35, 36, 37 & 38 The service provider is taking steps to keep in touch with good practice guidelines. Records of fees are up to date and accurate. With the exception of fire alarm systems checks, the service provider ensures that residents and staff’s health and safety is promoted at the home. The staff must conduct fire safety systems checks weekly. EVIDENCE: The service provider is a qualified nurse and will consider updating her qualification. Since the last inspection in November 2004, the service provider Gracelands D56_D05_S26506_Gracelands_V219515_060705_ Stage4.doc Version 1.40 Page 18 has undertaken medication update, managing stress and assertiveness training. The service provider explained to the inspector that periodicals and other information sent to the home ensures good practice guidelines are followed. Staff are encouraged to read the information ensuring that they are kept abreast of good practice. The certificate of employer’s liability insurance on display is out of date. The service provider was able to evidence that payment for the cover was purchased. The service provider must display the correct certificate, evidencing valid cover. Facilities for the safekeeping of cash exist at the home and the residents currently accommodated manage their own finances. Maintaining consistency of care was discussed with the service provider. Day to day observation of the interaction between staff and residents and monthly meetings are the means by which the service provider ensures standards of care are maintained. Records of monthly meetings indicated that training and re-decoration was discussed at the last meeting. An Environmental Health Officer recently visited the home and good standards were the findings on the report. In terms of statutory training, in-house videos on Food Hygiene, Fire and First Aid are used by the members of staff as refresher training. It was understood from the service provider that infection control measures are in place. Gloves are purchased for members of staff to use. The records that relate to fire safety policies, procedures, checks and practices were examined. From the records weekly fire systems checks are out of date, while practices and other checks were conducted at the required frequencies. The staff at the home must conduct fire safety systems checks weekly. The Local Authority contributes towards four residents fees and two people self fund their placements. For residents placed by the Local Authority, individual schedules that denote the source which contribute to the fees are in place. Records indicate that fees range from £339.00 - £366.00 per week for the placements at the home. Gracelands D56_D05_S26506_Gracelands_V219515_060705_ Stage4.doc Version 1.40 Page 19 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score x x x x x x HEALTH AND PERSONAL CARE Standard No Score 7 x 8 3 9 3 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 x COMPLAINTS AND PROTECTION x x x x x x x x STAFFING Standard No Score 27 x 28 3 29 x 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 3 x 2 x x x x x 3 2 Gracelands D56_D05_S26506_Gracelands_V219515_060705_ Stage4.doc Version 1.40 Page 20 yes Are there any outstanding requirements from the last inspection? 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. 2. Standard 38 34 Regulation 17(2) 4(14) 25(2e) Requirement A record the weekly fire safey systems checks conducted must be mainatied. A current employerss liability insurance certificate must be sought. Timescale for action 30/06/05 30/08/05 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. Refer to Standard Good Practice Recommendations Gracelands D56_D05_S26506_Gracelands_V219515_060705_ Stage4.doc Version 1.40 Page 21 Commission for Social Care Inspection 300 Aztec West Almondsbury South Gloucesterdshire BS32 4RG 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 Gracelands D56_D05_S26506_Gracelands_V219515_060705_ Stage4.doc Version 1.40 Page 22 - 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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