Inspection on 18/07/07 for Grafton Lodge

This inspection was carried out on 18th July 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 there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Grafton Lodge 06/01/07

Grafton Lodge 11/02/06

Grafton Lodge 09/09/05

Grafton Lodge 03/02/05

Grafton Lodge 09/08/04

Grafton Lodge 25/02/04

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

CARE HOMES FOR OLDER PEOPLE Grafton Lodge Grafton Road Oldbury West Midlands B68 8BJ Lead Inspector Deirdre Nash Key Unannounced Inspection 18th July 2007 12:00 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 DS0000034140.V337417.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 Lodge DS0000034140.V337417.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Grafton Lodge Address Grafton Road Oldbury West Midlands B68 8BJ 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) 0121 559 3889 0121 559 0708 Sandwell Metropolitan Borough Council vacant post Care Home 36 Category(ies) of Dementia - over 65 years of age (36) registration, with number of places Grafton Lodge DS0000034140.V337417.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. All requirements contained within the pre-registration report of 13 January 2003 are met within the timescales contained within the action plan agreed between Sandwell Metropolitan Borough Council and the National Care Standards. Day care provision must not encroach on the facilities, staffing and services provided to residential service users One service user accommodated at the home may be DE. This will remain until such time that the service users placement is terminated. 6th January 2007 2. 3. Date of last inspection Brief Description of the Service: Grafton Lodge is owned by Sandwell Metropolitan Borough Council and aims to provide an individual approach to care for older people with mental health needs, the majority being with moderate to severe forms of dementia. The home is situated 2 miles from Oldbury and within easy access of Blackheath, Dudley and Birmingham and approximately 2 miles from the M5, junction 2. Rowley railway station is within walking distance and a number of bus routes (449, 88, 123) frequently pass the unit in Grafton Road. Local amenities are within walking distance of Grafton Lodge, these include a church, shops, post office, take away food outlets, golf course, public house, restaurants and a doctors surgery. Grafton Lodge has 36 single bedrooms, (including one ensuite room) set out in two 18 bedded units, one on each floor. Five beds are for respite care on the upstairs unit. There is a passenger lift, and various aids and adaptations. To the rear of the property is a patio and garden, which provides residents with an outdoor area. Car parking space is available at the side of the building. The home has its own transport. A range of services are available at Grafton Lodge, which are detailed in the homes Service User Guide. Fees for 2007/8 are £467:00 per week Grafton Lodge DS0000034140.V337417.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. We looked at all of the information that we have received about the home since it was last inspected. The Inspector arrived without notice at the end of a morning, looked around the home, talked to four residents, the manager and four staff members and looked at records. We had already sent out some comment cards and six were returned to us from relatives and residents and the views expressed in them are also included in this report. The manager filled out a detailed questionnaire to bring us up to date with facts and figures about the home and how it is improving its service. This was returned to us in good time and was useful in planning our visit. We closely followed the care of two ‘sample’ residents to see if they are getting looked after as they should be. All of the residents in the home looked well taken care of and comfortable with the staff. What the service does well: All residents are well groomed and cared for including those who are frail and staff are kind and interested in them. Pre admission information and needs assessment is generally good so that the home does not invite people to live there if it cannot look after them properly. The home is developing a good system for producing written care plans for individuals and these include risk assessments for most areas of everyday life so that people can live as ordinary life as possible. Risks involved in everyday living for individuals are managed through their care plans. Residents are helped to remain in as much control of their lives as they can be. Medication is well managed and people’s health, including their weight is monitored. The manager is experienced and listens and acts when residents and other people with an interest raise any concerns or offer suggestions for improvement. Staff are carefully recruited, are trained and supervised and clear about their duty to report any concerns about residents safety to their manager The home is large and spacious and has a garden and its own mini bus and is competently run in the best interests of its residents. Grafton Lodge DS0000034140.V337417.R01.S.doc Version 5.2 Page 6 One relative said, ‘On the whole staff are very helpful and always try to fulfil our wishes.’ What has improved since the last inspection? What they could do better: The manager should be registered with us. Day to day social opportunities for residents remain a challenge for the home. Although some outings are arranged residents have little to do to occupy them each day and keep them mentally alert. One comment card returned to us by a relative says there are ‘not enough daily activities ‘ in the home. Care assistants do not read the care plans for individuals and this could lead to people with confusion being looked after differently by different members of staff. Although the large patio garden has tables, chairs and parasols there is little for the residents to look at and enjoy outside by way of shrubs and seasonal planting. This should be improved to encourage people out of doors. Food is well served and residents are offered a choice but one relative told us that she would like to see a better balanced diet offered with less refined foods. The main lounge and dining room is large and the conservatory can get very hot on a warm day. Corridors are not well lit and they all look the same. Grafton Lodge DS0000034140.V337417.R01.S.doc Version 5.2 Page 7 These environmental things are important to get right for people who have some confusion so they can feel comfortable and in control. 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 Lodge DS0000034140.V337417.R01.S.doc Version 5.2 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 Outcomes Statutory Requirements Identified During the Inspection Grafton Lodge DS0000034140.V337417.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. 1, 2, 3, 4 This judgement has been made using available evidence including a visit to this service. Pre admission information and needs assessment is generally good. Staff have the training to meet residents needs. People moving into the home can be confident that it can properly look after them. EVIDENCE: The home has updated and improved the content of its statement of purpose and service user guide. This will help prospective residents and their carers and funding authorities to make a fully informed decision about the home. We looked at the care files of two residents as a sample. One was recently admitted from hospital. Her file contains a social services and NHS assessment of her care needs dated two weeks before her admission and a Grafton Lodge DS0000034140.V337417.R01.S.doc Version 5.2 Page 10 ‘pre admission fact finder’ document compiled by the home. This however is incomplete, undated and unsigned. These documents should be checked by managers for their quality. The other resident was admitted in 2004 and has a less full social services community care plan. We looked at the training records of a key worker to both of these residents and saw certificates of training that meet their assessed needs including an NVQ Award at level 2 in Health and Social Care and a recent dementia awareness training course. This is very positive. Both files have written terms and conditions for care and accommodation at the home including the fees. The statement made in the Quality Assurance Assessment (AQAA) completed by the manager ahead of this inspection identifies that improvements around admissions to the home could be made by encouraging more trial visits and getting feedback from people who decide against moving into the home. Grafton Lodge DS0000034140.V337417.R01.S.doc Version 5.2 Page 11 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): 7, 8, 9, 10 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home manages risk for individuals through their care plans. Residents are well looked after and helped to remain in as much control of their lives as they can be. EVIDENCE: Written plans of care in both residents file support what the manager told us in the AQQA. The format for the care plan has been improved and risk assessment and risk management are integral to it. This is very good practice. Both showed evidence of regular review. The care plan for the resident recently admitted follows some but not all of the identified areas of need and service provision set out in her social services assessment. Areas such as ‘supervise mobility’ and ‘increase social opportunities’ have no written day-to-day plan by the home. Supervision of Grafton Lodge DS0000034140.V337417.R01.S.doc Version 5.2 Page 12 mobility is particularly relevant as this lady was admitted to hospital after a fall. We met this resident and she seemed confident moving around the home. This resident has some confusion but there is no written agreed plan for managing this. Staff that we spoke to about her care attended dementia care training last year but say they do not feel comfortable with the ‘reality orientation’ approach that this training seems to promote as it distresses individuals so they use their own ‘common sense’ approach. We saw short episodes of emotional distress from two residents during the time that we were there and staff responded kindly. However without an agreed approach other staff may respond differently and this could cause residents further confusion. All other residents that we saw and spoke to appeared happy. We talked to the manager about the content of the training provided and the importance of staff taking a consistent and agreed approach to residents with cognitive dysfunction to promote their psychological well being. All of the residents in the home have some confusion and the home must get its approach to this right. The AQAA identifies that the home could do better by developing links with professionals from old age psychiatry to advise on best support for individuals. The manager told us that she is pursuing this although the link is difficult to achieve. We saw nutritional risk assessments and weight charts in both residents files and a full list of medications for each individual. There are also routine and specialist health appointment records. We saw that medication is securely stored in locked walk in cupboards. Although we saw an introduction to administration of medication certificate in the key workers file that we looked at, the manager reports that the policy is that only management staff deal with residents medication. Grafton Lodge DS0000034140.V337417.R01.S.doc Version 5.2 Page 13 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): 12, 13, 14, 15 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Residents have a comfortable but limited life style with little to occupy them daily. Steps taken to improve this are still in early stages. EVIDENCE: Referred to above there is no plan of care for the ‘increased social opportunities’ identified as a need by social services for one of the individuals in our sample. Staff report that the other resident is taken out by staff to watch football matches on occasion. The home has its own transport and we saw some photographs of a day trip out made last summer. There is no other evidence of the recent outings described to us by staff. There is no indication whether the annual monthly schedule of community contact events that we saw on the office notice board has been provided or an evaluation made of enjoyment value for individuals. Grafton Lodge DS0000034140.V337417.R01.S.doc Version 5.2 Page 14 One comment card returned by a relative says there are ‘not enough daily activities ‘ in the home. We saw residents sitting with nothing in their hands to do. There was nothing around for them to pick up and occupy themselves with. One resident told us that he always sees the daily newspaper. The AQAA reports improvement against this outcome in the last twelve months with a staff training programme looking at interaction, stimulation and activities. There are plans to create a reminiscence shop and implement life history boxes. We saw a piece of high quality art work on the wall that the manager told us was painted by a resident. There is some evidence that a gardening project had started but stalled. Little of the summer bedding is thriving remaining as it is in seedling pots and the borders are sparse. Although the large patio garden has tables, chairs and parasols there is little for the residents to look at and enjoy outside. This should be improved to stimulate people and encourage them out of doors. We had lunch with some residents and saw individuals being visually offered a choice of dishes by staff. This is good practice. One of our sample residents is on risk assessment for weight loss. Her assessments say that she needs to be prompted and supervised to make sure that she takes an adequate diet. Her care plan says that she is not to be offered ‘big dinners’ as this puts her off food and she will not eat them. It also says that she dislikes fish. We had lunch with her and saw staff offer her a choice of two ‘big dinners’ one of which was fish, which she accepted and then didn’t eat. Care staff clearly do not always read the care plans. Staff did offer her a sandwich and she ate that. Records show that she has gained weight since she was admitted to the home in January however. We saw fresh fruit in the kitchenette. The lunch that we saw residents eat looked hot and appetising but one relative that returned a comment card said, ‘As a nutritional therapist I would like to see more effort put into balancing of nutrition within the meals. For example the reduction of refined foods such as crisps, biscuits and Angel Delight and the increase of whole grains including wholemeal bread, brown rice, beans and pulses…’. Grafton Lodge DS0000034140.V337417.R01.S.doc Version 5.2 Page 15 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): 16, 18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The manager listens and acts when residents and other stakeholders raise concerns or give feedback on the service. Residents are protected by good policy and procedure and staff training. EVIDENCE: We have heard of no complaints about the home since it was last inspected. The AQAA reports that the home has received 6 complaints in the last six months and all were resolved within 28 days. The manager reports that most of these were about lost items of clothing or possessions. There have been three safeguarding adults referrals by the home to social services through the agreed procedure. Staff that we spoke to, including a new starter are very clear about their responsibility to report any concerns, suspicions or allegation of abuse of a resident to a manager regardless of the circumstances. The key worker training file that we looked at showed training in Adult Protection, Working with Violence and Aggression and the Value Base of Social Care. Grafton Lodge DS0000034140.V337417.R01.S.doc Version 5.2 Page 16 Grafton Lodge DS0000034140.V337417.R01.S.doc Version 5.2 Page 17 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): 19, 20, 21, 22, 25, 26 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The home was not designed for people with dementia and some residents find the layout confusing. EVIDENCE: The building was purpose built thirty years ago for more able people and although it functions as two Units the design and layout is not enabling for people with cognitive dysfunction. Some decoration has taken place since the last inspection and signage on doors has improved but the long corridors remain poorly lit and the layout remains potentially confusing. We saw one resident hesitate at a junction and then turn her head to the sound of voices before she was confident enough to turn left into the public Grafton Lodge DS0000034140.V337417.R01.S.doc Version 5.2 Page 18 rooms. We have raised this before. The AQAA acknowledges that the home could do better by improving signage. The Unit that we looked at has a large conservatory off the open plan dining room and lounge leading out to a patio garden. The conservatory was hot on this very warm day and we saw one resident going around all of the chairs and feeling the seats with her hand saying ‘its hot’ until she found one that she said was cool and then sat in it. Corridors are not brightly lit and this is likely to undermine people’s confidence in moving around the home independently. We have remarked before on the unsuitability of large open plan space for people with cognitive dysfunction. The noise and general business can be disorienting. The Unit does have a smaller public room with a television and a dining table. We refer the provider to the considerable body of knowledge appearing in the professional journals about creating an ‘enabling’ rather than further disabling environment for people with cognitive impairment through décor and contrast of colour and consistent association of colour with room function. In the meantime areas or junctions of corridors and toilets could be more creatively identified relatively cheaply. The home was clean and tidy and the laundry well ordered and staff that we asked are clear about good infection control procedure. We have remarked on the garden already but one relative that returned a comment card said that although the inside of the home is always fresh and clean, the garden (one weekend at the beginning of June) was untidy with cigarette ends over the floor, very long grass and weeds that had grown tall and strong indicating neglect for some time. It is important that residents, especially those who need to keep on the move, have an attractive outdoor space to walk and sit in. There are assisted baths and showers. Resident have keys to their bedrooms on risk assessment and we saw some personal possessions in each of the bedrooms of our sample residents. Bedding was clean and residents said that their beds are comfortable. We saw sensors for alerting night staff if residents leave their room. These are accounted for in care plans and risk assessments. Each Unit has its own kitchenette and the main kitchen for the home and day centre is undergoing complete refurbishment. Grafton Lodge DS0000034140.V337417.R01.S.doc Version 5.2 Page 19 Grafton Lodge DS0000034140.V337417.R01.S.doc Version 5.2 Page 20 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): 27, 28, 29, 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Staffing levels are adequate to meet resident’s care needs in the home and staff are safely recruited, trained and supervised. A professional team committed to their welfare looks after residents. EVIDENCE: The home has 31 permanent residents and up to six more on a short stay basis. It is divided in half into Units. There are six care staff, a deputy manager, a team leader and a senior care assistant on duty for each day time shift and the manager is in the home during office hours at least. Team leaders and senior carers also undertake the personal care of residents along with supervision and management duties. We saw this level of staffing on duty when we arrived. This is adequate for the needs of current residents while they are at home. We saw that residents got care attention whenever they needed it but we have remarked above on the need to help individuals to occupy themselves during the day and this could be improved with higher staffing levels. We have raised this before. One relative that returned a comment cards said the home ‘could do with more staff, not just the minimum requirement’. A Grafton Lodge DS0000034140.V337417.R01.S.doc Version 5.2 Page 21 resident who returned a comment card said, ‘they [staff] are pretty good but its impossible to be around all the time with the amount of residents to care for all their needs’ Another relative said, ‘On the whole the staff are very helpful and always try to fulfil our wishes.’ The AQAA reports that 50 of staff at the home are qualified at NVQ Level 2. We spoke to a new recruit who confirms that she is about to attend a five day mandatory induction course. We saw the personnel file for the key worker of our sample residents and it contains all of the proofs and documents required to establish suitability to work with vulnerable people. We also saw records of three 1:1 supervision sessions with a manager since last December, a learning plan and a development plan. This shows that staff are developed and encouraged to learn. Staff that we saw and met were kind and interested in residents and well dressed and professional in appearance. Grafton Lodge DS0000034140.V337417.R01.S.doc Version 5.2 Page 22 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): 31, 32, 33, 36, 37, 38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The management and administration of the home is strong and reliable. Residents live in a home that is run in their best interests. EVIDENCE: The manager is experienced but not yet registered with us. She told us that she is in the process of applying now that her ‘permanent’ posting at the home has been confirmed. When we arrived a manager from another care home within the provider organisation was undertaking a routine ‘peer’ quality audit of parts of the service provided by this home. We are told that this is a reciprocal quality assurance arrangement. This is very positive. Most of the records that we saw are complete and legible but some routine admission documents used by the home and referred to above are incomplete and others lack a date. These will be of little value historically. Grafton Lodge DS0000034140.V337417.R01.S.doc Version 5.2 Page 23 We saw a manual handling risk assessment for bathing only in the file of one sample resident. When we spoke to him and he agreed to show us his bedroom, a staff member helped him up from his sitting position on the sofa by pulling from one hand. This is not safe moving and handling practice and could cause injury to the resident and the worker. This must improve. There are certificates for training in basic food hygiene, first aid and manual handling in the file of the key worker that we looked at. This worker has no training in infection control or fire safety however. This is important safe working training and must be kept up to date for the safety of residents. The AQAA document was well completed and returned to us in good time. It shows a clear awareness of where the home needs to improve its service. We saw an up to date certificate for sufficient insurance cover in the foyer and also the homes registration certificate on conspicuous display. Most requirements made at previous inspections have been complied with by the manager and we have been notified of any incidents in the home as we should be. This local authority run home does have more to do to improve the specialist service that it holds itself out to offer. It has been slow to respond to the environmental improvements that we have asked for and are important for helping residents with confusion. Grafton Lodge DS0000034140.V337417.R01.S.doc Version 5.2 Page 24 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 3 x x HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 2 14 3 15 2 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 x 18 3 2 2 3 2 3 3 x 3 STAFFING Standard No Score 27 2 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 3 x x 3 2 2 Grafton Lodge DS0000034140.V337417.R01.S.doc Version 5.2 Page 25 Are there any outstanding requirements from the last inspection? yes 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 13 Requirement Residents must be confident that they are moved and handled safely by staff. Provide all care staff with up to date manual handling training. Residents must be protected from practices that could spread infection around the home. Provide all care staff with up to date training in infection control. Residents must be protected from the dangers of fire in the home. Provide up to date training in fire safety for all staff. Timescale for action 01/11/07 2. OP38 13 01/11/07 3. OP38 13 01/11/07 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard OP4 Good Practice Recommendations So that residents are receiving the same approach to their care from each member of staff, evaluate the recent dementia care training and find out what staff have learned from it. DS0000034140.V337417.R01.S.doc Version 5.2 Page 26 Grafton Lodge 2. OP4 3. 4. 5. 6. 7. 8. 9. 10. OP7 OP12 OP17 OP15 OP19 OP27 OP26 OP37 To make sure that individuals are receiving all of the care that social services have said they need, written day to day care plans should follow each ‘objective’ in their Community Care Assessment and Care Plan. To protect residents a more in-depth assessment of falls should be undertaken using a recognised assessment tool. Work on how the home can provide day to day stimulation, interest and occupation for people indoors and in the garden to keep them alert. To keep alert and prevent social isolation residents should be given the opportunity to access the local community on a regular basis Take good advice on improving the nutritional balance of food and meals to keep residents fit and alert. So that residents with confusion can feel confident and comfortable about living in and getting around the home improve the interior design. So that residents can have some occupation during the day to keep them well and alert, review staffing levels to give some individual attention. For good infection control keep the laundry in a good state of repair. Date all records clearly so that individuals or their representatives can see how the home has managed and planned their care. Grafton Lodge DS0000034140.V337417.R01.S.doc Version 5.2 Page 27 Commission for Social Care Inspection Halesowen Record Management Unit Mucklow Office Park, West Point, Ground Floor Mucklow Hill Halesowen West Midlands B62 8DA 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 Lodge DS0000034140.V337417.R01.S.doc Version 5.2 Page 28 - 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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