Inspection on 16/01/06 for Grafton Lodge

This inspection was carried out on 16th January 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

Grafton Lodge 06/03/07

Grafton Lodge 12/09/05

Grafton Lodge 18/02/05

Grafton Lodge 11/10/04

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

CARE HOMES FOR OLDER PEOPLE Grafton Lodge 40 Goddington Road Strood Rochester Kent ME2 3DE Lead Inspector Sue McGrath Unannounced Inspection 16th January 2006 10:00 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 Lodge DS0000028885.V277934.R01.S.doc Version 5.1 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for 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 Lodge DS0000028885.V277934.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Grafton Lodge Address 40 Goddington Road Strood Rochester Kent ME2 3DE 01474 833531 Telephone number Fax number Email address Provider Web address Name of registered provider(s)/company (if applicable) Mr Lee James Boyson Mrs Lavinia Mary Boyson, Mrs Lesley Ann Boyson, Mrs Sharon Rosemarie Boyson, Mrs Jo Ann Weston, Mr Rickie Michael Boyson, Mr William James Boyson Miss Anne Carmel Perkins Care Home 20 Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Category(ies) of Old age, not falling within any other category registration, with number (20) of places Grafton Lodge DS0000028885.V277934.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 12th September 2005 Brief Description of the Service: Grafton Lodge is a large house, which accommodates twenty older people. The home has a shaft lift to the first floor, plus stair lifts to the first and second floors. There are steps to the front entrance, but wheelchair access is possible via the driveway to the rear. The home has a large garden, which includes sitting areas. It is located on a hill close to the town centre with access to local amenities and public transport. Grafton Lodge DS0000028885.V277934.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced inspection under the terms of the Care Standards Act 2000 and took place on the 16th January 2006 between 11.00 and 14.30. One inspector was in the home and the main focus of the inspection was on the progress of the home in meeting with requirements made at the last inspection, the general environment and the well being of the residents. During the inspection documentation and records were read. A tour of the building was undertaken and many of the residents were spoken with. Time was also spent talking to staff and members of the management team. As this report was made following an unannounced visit and may not cover the standards in sufficient depth for the reader to make a judgment about the home, it is recommended that a copy of the last announced inspection report dated 12th September 2005 be also obtained. What the service does well: What has improved since the last inspection? The coded lock on the office door has now been fitted. Some new carpets had been provided in a few bedrooms, some curtains and some net curtains had also been replaced. The refurbishment of the kitchen had been completed and new colour coded chopping boards purchased. The lift and the bath hoists had been serviced as required from the last inspection. Grafton Lodge DS0000028885.V277934.R01.S.doc Version 5.1 Page 6 What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Grafton Lodge DS0000028885.V277934.R01.S.doc Version 5.1 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 Lodge DS0000028885.V277934.R01.S.doc Version 5.1 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): 1&2 Prospective residents are provided with the information they need to make an informed choice about moving into the home. EVIDENCE: The manager had provided CSCI with a copy of the new updated Statement of Purpose and new Service User Guide. It had been read prior to the inspection and had been found to meet all of the requirements of the regulations. It was well presented and comprehensive. The residents’ contracts were currently being updated and would be assessed at the next inspection. The remaining standards were met at the last inspection. Grafton Lodge DS0000028885.V277934.R01.S.doc Version 5.1 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): Not inspected Judgement for the previous inspection. Residents benefit from having clear and in-depth care plans that identify their individual needs and give clear guidance to staff. Residents can be confident that their care plans are regularly updated to ensure changes are recorded and acted upon. Residents can be confident that their health needs are met and that they have full access to all professional health care services as required. Residents are protected by the home’s policies and procedures for dealing with medicines and also benefit from having the issue of illness and ageing dealt with sensitively. EVIDENCE: These standards were assessed as met at the last inspection. Grafton Lodge DS0000028885.V277934.R01.S.doc Version 5.1 Page 10 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 The other standards were assessed as met at the last inspection. Residents have limited scope for social activities and stimulation. EVIDENCE: The home still did not have a designated activities co-ordinator and staff continue to try to fit some activities in with their normal care work. Limited activities were taking place and only some residents went on days out. It remains a recommendation that a more structured approach to activities be taken, with the residents being involved with deciding what activities be made available and how often. Activities should be recorded to evidence that they do actually take placed on a regular basis. The manager had concerns over names of residents being recorded and advice was given that only the activities need to be recorded, this would evidence that activities were actually taking place. The home would benefit greatly with designated staff time being allowed for activities. The manager did explain that she had advertised for activity staff but had difficulty finding the right person. It had been suggested that extra care hours be offered with special responsibilities for activities. The menu board recommended in the last report was in place but residents spoken to said they could not read it and still did not know what was for dinner. It is advised that residents are made aware of the daily menus. Grafton Lodge DS0000028885.V277934.R01.S.doc Version 5.1 Page 11 Grafton Lodge DS0000028885.V277934.R01.S.doc Version 5.1 Page 12 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): 16,17 and 18 Residents are protected by a robust complaints system and service users and relatives feel their views are listened to and acted upon. The home’s Adult Protection Policy and procedures protect residents from abuse. Residents’ legal rights are protected. EVIDENCE: The home had a written complaints procedure in place that staff were aware of. The home had no recorded complaints. The home had adopted the Multi Agency Adult Protection Policy for Kent and Medway and staff spoken to were able to demonstrate a good awareness and understanding of the policies. The Manager confirmed that all residents were registered for postal voting should they wish to vote in any local or general election. Grafton Lodge DS0000028885.V277934.R01.S.doc Version 5.1 Page 13 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): 22, 23, 24, 26 Residents benefit from living in a clean, safe and fairly well-maintained environment. They had safe access to comfortable indoor communal areas although the rear garden is in need of attention. Whilst residents’ rooms are homely and comfortable not all benefit from living in rooms that meet the requirements for space. EVIDENCE: The homes maintenance plan had not been developed for this year and work was in hand to produce one. The home was also still waiting for an Occupational Therapy assessment to be completed to ensure a safe environment was being maintained, however baths hoists were in place, as were some grab rails and some handrails. Five of the rooms were shared and some were below the required size but residents all seemed happy with their rooms. Some of the rooms were unable to contain all of the furniture required by regulation due to their size, but again the residents were happy with this arrangement. Some extension leads were Grafton Lodge DS0000028885.V277934.R01.S.doc Version 5.1 Page 14 noted and it is advised that where they are needed permanent electric sockets be installed. Each bedroom should have at least two double accessible sockets. All of the bedrooms had a hand washbasin. The bathroom on the lower floor would benefit from refurbishment. The pond in the rear garden had not been cleared or reinstated. This work needs to be completed before the summer to ensure residents can safely access the rear gardens. The Infection Control Nurse had visited the home as advised at the last inspection. Several recommendations were made including the installation of a sluice. It was agreed that the disused shower room was the best place in which to site the sluice. The owners were currently looking into having this work completed. Hand washing facilities in the toilet on the upper floor need to be installed urgently. Discussion took place about the storage of clean clothing as this had also been highlighted in the infection control report. It was advised that an action plan be drawn up and sent to the Nurse to ensure the home was taking the correct action. The refurbishment in the kitchen had been completed and new chopping boards purchased. Grafton Lodge DS0000028885.V277934.R01.S.doc Version 5.1 Page 15 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): 29 Residents benefit from being cared for by staff who have a good understanding of their needs and who receive regular supervision. Residents are protected by the home’s robust recruitment procedures. EVIDENCE: The home had one full time vacancy that was currently being advertised. The recruitment and selection policy and procedure was assessed and was comprehensive and ensured residents were protected. Other standards were assessed as met at the last inspection. Grafton Lodge DS0000028885.V277934.R01.S.doc Version 5.1 Page 16 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): 33,34,35 and 38 The Residents benefit from living in a home where the manager is competent, enthusiastic and experienced with the care of older people and has a clear vision for the home. The health and safety of residents is put at risk because of the identified shortfalls in the home’s practice in this area. EVIDENCE: The manager had completed her NVQ 4 in Management and NVQ 3 in Care and was currently applying to complete her Registered Managers Award. There had been some issues with the company being used for verification but this had now been resolved and the manager was hoping to complete her award in the very near future. Throughout the inspection she demonstrated the necessary skills to manage the home in a competent and compassionate way. Staff Grafton Lodge DS0000028885.V277934.R01.S.doc Version 5.1 Page 17 stated they felt well supported and benefited from regular structured supervision. Residents also commented that they felt happy to discuss anything with the manager and that she was approachable and friendly. The records kept in the home were accessible and also secure. The manager and owners were still developing this year’s development plan. The home also had some residents’ surveys but was advised to develop this system to ensure effective quality assurance and quality monitoring is in place to fully comply with standard 33. Some individual allowances were maintained in the home and two accounts were audited. Both balanced and were accurate and well maintained. The manager stated that they rarely keep valuables in the home and preferred families to take charge of any such items. Appropriate insurance cover was in place. The requirement from the last inspection regarding the lock on the office had been actioned. The lift had recently been serviced, as had the bath hoists as required from the last inspection. The home had a Health and Safety assessment completed by an external company and several recommendations were made. It is advised that these recommendations be carried out. The intumescent strips around the fire doors were still painted over. It will be a requirement that this work is completed as soon as possible, as the paint makes the fire doors ineffective. Grafton Lodge DS0000028885.V277934.R01.S.doc Version 5.1 Page 18 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 2 3 3 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 3 18 3 3 3 3 2 2 2 3 2 STAFFING Standard No Score 27 3 28 4 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 2 3 3 3 3 2 Grafton Lodge DS0000028885.V277934.R01.S.doc Version 5.1 Page 19 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 OP38 Regulation 23 Requirement Timescale for action 28/02/06 2. OP38 23 3. OP21 23 The registered person shall having regard to the number and needs of the residents ensure that the premises used as a the care home meet the needs of the residents in that the intumescent strips on the fire doors be replaced. Action plan required. The registered person shall 28/02/06 having regard to the number and needs of the residents ensure that the premises used as a the care home meet the needs of the residents in that further permanent electric sockets are fitted where required. Action plan required. The registered person shall 28/02/06 having regard to the number and needs of the residents ensure that the premises used as a the care home meet the needs of the residents in that hand washing facilities are fitted in the toilet. Action plan required. Grafton Lodge DS0000028885.V277934.R01.S.doc Version 5.1 Page 20 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. 2. 3. 4. 5. Refer to Standard OP19 OP12 OP15 OP26 OP33 Good Practice Recommendations It is recommended that the garden pond is either repaired or replaced It is strongly recommended that more opportunities for stimulation through leisure and recreational activities inside and outside the home be provided. It is recommended that daily menus are displayed in a suitable format for the residents to see and they are given a daily choice of food. It is recommended that a sluicing facility be installed as recommended by the infection control nurse. It is recommended that the quality assurance questionnaires be developed to meet all of the requirements of this standard. Grafton Lodge DS0000028885.V277934.R01.S.doc Version 5.1 Page 21 Commission for Social Care Inspection Maidstone Local Office The Oast Hermitage Court Hermitage Lane Maidstone ME16 9NT 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 Grafton Lodge DS0000028885.V277934.R01.S.doc Version 5.1 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. 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