Inspection on 21/06/07 for Grafton House

This inspection was carried out on 21st 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 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

Grafton House 05/02/10

Grafton House 27/10/09

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

CARE HOMES FOR OLDER PEOPLE Grafton House 157 Ashby Road Scunthorpe North Lincolnshire DN16 2AQ Lead Inspector Theresa Bryson Unannounced Inspection 21st June 2007 09:00 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 Grafton House DS0000068320.V310711.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. Grafton House DS0000068320.V310711.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Grafton House Address 157 Ashby Road Scunthorpe North Lincolnshire DN16 2AQ 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) 01724 289000 Mrs Saima Munir Raja Mr Sami Ullah Position Vacant Care Home 26 Category(ies) of Dementia - over 65 years of age (15), Old age, registration, with number not falling within any other category (26) of places Grafton House DS0000068320.V310711.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 30th August 2006 Brief Description of the Service: Grafton House is set in the centre of the industrial town of Scunthorpe, with easy access to all local amenities and near to pubic transport. The home is a two-storey building with stairs and a lift joining the two floors. The service users rooms are a combination of single and shared rooms, with some en-suite facilities. There are a selection of different sitting rooms and dining room areas. The home has adequate bathrooms and toilets. There are gardens areas surrounding the home and a secluded piece at the back of the property. Each person is registered locally with a GP service and the home liaises closely with the local district nursing service and other health care professionals. It has a robust system of recruitment and training of staff to deliver the care to each individual. The statement of purpose and service users guide is on display in the main entrance and is given to each prospective service user. The home will take service users funded by the local authority and those privately funded. Grafton House DS0000068320.V310711.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection site visit took place one day in June 2007. Prior to the visit 10 surveys were sent out to relatives, of which 4 were returned. 12 sent to staff and 3 returned. 5 service users were spoken to on the day and 4 relatives. 1 relative was telephoned prior to the site visit. 8 staff were spoken to on the day. The event history for the home was also tracked prior to the visit. A variety of records to ensure the home was safe to live and work in and a number of staff files were tracked to ensure a safe system was in place to prevent people from being harmed were also checked. The Acting manager and deputy manager accompanied the inspector during the course of the site visit. What the service does well: A robust system is in place to ensure that staff are safe to work with service users prior to commencement of employment. They are then trained to do their jobs to give them an adequate knowledge base to tackle the needs of people living in the home. Comprehensive documentation is provided to ensure people wishing to use the services of the home can make informed decision as to whether the home can meet their needs. A holistic assessment is completed on each person and this is used to plan their admission and prepare staff. Care plan documentation is accurate and well presented, giving staff clear guidance on how to look after the needs of each individual in the home. This is updated and evaluated regularly, with the help of each individual and sometimes family members, where appropriate. A variety of social activities are on offer to meet the expectations and requests of people living in the home. They are encouraged to keep contact with the local community and events in the near by town. A varied menu is on offer and special diets can be catered for. Portion sizes are tailored to meet people’s needs and desires, and a watchful record kept on weights and food and fluid in take. Meals are prepared in a clean and safe environment. The environment is clean and tidy and a number of regular checks made to ensure it is safe to live and work in. People living in the home are consulted Grafton House DS0000068320.V310711.R01.S.doc Version 5.2 Page 6 about their surroundings and can bring in personal items to help them settle into the home. A number of quality checks are completed each month and the home has been awarded the Gold standard of the local authority’s quality assurance scheme. This ensures that the home has an open and transparent method of monitoring the delivery of care, maintaining the home to a high standard and ensuring staff are safe to work there. What has improved since the last inspection? 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. Grafton House DS0000068320.V310711.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 Grafton House DS0000068320.V310711.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. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users are given comprehensive information about the service prior to admission to allow them to make informed decision. EVIDENCE: During the course of this inspection Standards 1,2,3 and 6 were checked. The comprehensive documents of the statement of purpose and service users guide were on display in the main entrance and these are also given to prospective service users prior to admission to allow them to make informed choice about the services provided. Prior to admission the manager, her deputy and sometimes a senior care assistant assess the prospective service users to see if the home can meet Grafton House DS0000068320.V310711.R01.S.doc Version 5.2 Page 9 their needs. This holistic tool is then used to help staff prepare for a person’s admission. The home does not provide intermediate care so Standard 6 is not applicable. Grafton House DS0000068320.V310711.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Accurate records are kept on each service user to ensure their current needs are being met and these are evaluated regularly. EVIDENCE: During the course of this inspection Standards 7,8,9 and 10 were checked. Prior to the inspection 10 survey forms were sent to relatives and 4 returned. At the site visit 4 service users files were tracked and 5 service users spoken to and 4 relatives and 1 relative spoken to by telephone. The majority of people gave very positive comments to the inspector about the care provided saying staff are “friendly” and “I feel I don’t have to worry any more” and “I wouldn’t like to be any where else”. Staff should be commended for the precise way they keep the care plan documentation up to date. After a holistic assessment the care plans are then Grafton House DS0000068320.V310711.R01.S.doc Version 5.2 Page 11 written with goals for each need and using supplementary documents, ensure that these are up dated on a regular basis. The Acting Manager was in the process of auditing all care plans at the time of the site visit. Staff stated they found them useful and not difficult to complete. These records ensure that each individual’s needs are being meet at all times and constantly updated. Staff were observed giving personal care to individuals and also assisting service users at meal times. Each task was completed in a relaxed manner with respect given to each individual. Since the last inspection the home has revised its policy on the way service users are observed who wish to self medicate. At the time of the site visit, no one was using this system. The deputy manager went over the drug administration records and storage facilities with the inspector and appeared to have a good working knowledge of each service users needs and how the administration system works. The home has a robust system in place for administration of drugs, which limits the risk service users, will be put at for receiving their correct medication. Grafton House DS0000068320.V310711.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Varied programmes of activities are in place to ensure service users expectations are met. A balanced diet is prepared in a clean and safe kitchen environment. EVIDENCE: During the course of this inspection Standards 12,13,14 and 15 were checked. The deputy manager and cook escorted the inspector on a tour of the kitchen. This was a clean environment, with records kept of all safety checks. The local environmental health officer had visited 3 weeks before but the report had not been seen yet, but positive comments were made on the day. The storerooms were neat and tidy and there was ample evidence of fresh fruit and vegetables and home baking being used. The kitchen offers a varied 4-week cycle of menus and can cater for special diets. At the time of the site visit this was only for diabetics. Service users spoken to were very complimentary about the diet, saying such as “I get Grafton House DS0000068320.V310711.R01.S.doc Version 5.2 Page 13 plenty to eat” and “I can have more if I need it but the portions are so large I don’t” and relatives saying they are offered tea and biscuits. The home employs an activities organiser for 16 hours each week. This person keeps records on each event, which takes place. These identify the event, people involved and what level of participation they had. There appeared to be a wider range of activates which had taken place and many more planned for the rest of the year. They varied from one to one sessions such as reading and hopping trips to games, caking making and entertainers. Care is also taken to ensure that people living in the home can take part in local community events such as local fetes and religious events. The activities organiser works alongside the key workers who ensure the social needs assessments are kept up to date. The combination of the two also make sure that peoples needs and expectations are maintained at all times. One person stated “ I love the bingo sessions” and another “I wouldn’t like to be anywhere else, I can take part when I want to and stay in my room if I wish” and another “I like the cake making”. Grafton House DS0000068320.V310711.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Service users feel confident that their concerns will be addressed quickly and in a professional manner and feel they are free from harm. EVIDENCE: During the course of this inspection Standards 16 and 18 were checked. A complaints log showed there had been no concerns raised since May 2006 and those received directly to CSCI in the last year had been satisfactorily dealt with and outcomes recorded. No issues remained outstanding when the event history for the home was tracked. The majority of relatives and service users also stated that they had confidence in the new management team that concerns would be addressed promptly and in confidence. This was also reiterated in the interviews with 8 staff members. The home has a robust system in place for recruiting staff and ensuring safety checks are completed prior to commencement of employment. Training has been completed in the last year and currently being updated for some staff in their knowledge base about safe guarding adults. This ensures that people are safe from harm and staff are aware of how to report events promptly should they occur. Grafton House DS0000068320.V310711.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users live in a safe and clean environment suitable to their needs. EVIDENCE: During the course of this inspection Standards 19 and 26 were checked. The Acting Manager and deputy accompanied the inspector on a tour of the building. All bathrooms, toilets and communal areas were seen and a selection of bedrooms. All areas were very clean and tidy and the programme for the near future shows that some corridors will be painted and a new corridor carpet fitted. At the time of the site visit the home’s full electrical system was being checked for its 5-year service. Each dining area was tidy and a relaxed environment in which to eat. Grafton House DS0000068320.V310711.R01.S.doc Version 5.2 Page 16 Service users stated how comforting it was to bring in some of their personal belongings to the home and this had helped them, settle into the home. There was ample evidence in the rooms seen that service users rooms had been arranged to suit their needs and individual tastes. One person stated how they liked to “do a bit of dusting, the girls will do it, but I like to do a little each day”. The laundry assistant showed the inspector around the laundry. All equipment was in working order and there was a system for distributing clean clothing to rooms. A couple of families identified some concerns about missing items of clothing, but appeared satisfied about the way the Acting Manager was dealing with the issue. This area was clean and tidy and free from hazards. The linen and towels supplies were ample and in a good state of repair, of those seen in storage cupboards and in use on beds and in rooms. There are small garden areas around the home, but a more secluded area to the back of the property. A small amount of off road parking for vehicles is provided. The garden was in the process of being planted with more colourful shrubs and flowers, but was free from hazards. The home appeared to be well maintained and a safe and clean environment in which to live in work. Grafton House DS0000068320.V310711.R01.S.doc Version 5.2 Page 17 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home has a robust system in place to ensure staff are safe to work with service users prior to commencement of employment and are trained to do their jobs. EVIDENCE: During the course of this inspection Standards 27,28,29 and 30 were checked. Prior to the site visit 12 staff surveys were sent out of which 3 were returned. 8 staff were spoken to at the time of the site visit. There appeared to be adequate staff on duty to ensure the needs of the service users were being met. Individual concerns raised by a couple of service users were fed back to the Acting Manager. The home uses a verifiable dependency tool to calculate the staffing hours against the dependency needs of the service users, which staff stated does work and they felt there were sufficient staff on duty to met service users needs. Service users spoken to stated “they treat me with respect” and “ they are friendly and do every thing I want them to do”. Grafton House DS0000068320.V310711.R01.S.doc Version 5.2 Page 18 Apart from care staff the home also employs laundry, domestic, kitchen, activities and maintenance staff. All receive safety checks prior to employment and this also includes one volunteer. 6 personal files were tracked during the site visit and found to have all the necessary information contained within them. The Company head office gives the Acting Manager support in administration issues. Half of the staff have completed their NVQ level 2 awards and 4 were commencing their awards. Alongside this staff are encouraged to attend other training courses since as dementia training, health and safety and palliative care. The new Acting Manager still has to complete the staffing matrix, which will help to keep abreast of all mandatory training and service specific training to ensure they have the knowledge to do their jobs. Grafton House DS0000068320.V310711.R01.S.doc Version 5.2 Page 19 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The service users live in a safe and comfortable environment where they are consulted about the running of the home and the home is audited regularly. EVIDENCE: During the course of the inspection Standards 31,33,35 and 38 were checked. The home has an Acting Manager at the time of the site visit and all parties surveyed spoke highly of how this person was running the home and managing the staff team. This person is now looking to CSCI to become the Registered Manager for this establishment. Grafton House DS0000068320.V310711.R01.S.doc Version 5.2 Page 20 The home currently has the highest standard awarded by the Local Authority Quality Assurance scheme – the Gold Award. A reassessment has taken place and a follow up visit is due before the final new verification, but on the letter seen this was a very favourable visit. The staff maintain extensive records to ensure they are monitoring the running of the home and also consult not only service users but other stakeholders. Minutes were seen of the Quality circle from January to May 2007, where a number of topics were discussed. This ensures that every one is consulted and their views taken into consideration about many aspects of the home. A cross section of records were also seen that confirmed the management team are ensuring the home is safe to live and work in. these included accident records, health and safety audits, the policy and procudre manual, fire checks and certificates on equipment. 3 service users personal allowance records were also checked and found to be accurate. Grafton House DS0000068320.V310711.R01.S.doc Version 5.2 Page 21 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 3 3 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 4 8 4 9 3 10 4 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 4 13 4 14 4 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 4 17 X 18 4 3 X X X X X X 3 STAFFING Standard No Score 27 3 28 3 29 3 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 4 X 4 X X 4 Grafton House DS0000068320.V310711.R01.S.doc Version 5.2 Page 22 Are there any outstanding requirements from the last inspection? No STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1 Standard OP30 Regulation 18.1.c.i. Requirement A training matrix must be produce to ensure that all mandatory training and service specific training is completed through the year, to enable staff to do heir jobs. Timescale for action 30/09/07 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 Grafton House DS0000068320.V310711.R01.S.doc Version 5.2 Page 23 Commission for Social Care Inspection Hessle Area Office First Floor, Unit 3 Hesslewood Country Office Park Ferriby Road Hessle HU13 0QF 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 Grafton House DS0000068320.V310711.R01.S.doc Version 5.2 Page 24 - 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. 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