Inspection on 01/12/05 for Grafton Manor Head Injury & Rehabilitation Unit

This inspection was carried out on 1st December 2005.

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 Manor Head Injury &... 23/12/08

Grafton Manor Head Injury &... 18/04/07

Grafton Manor Head Injury &... 13/07/05

Grafton Manor Head Injury &... 22/11/04

Grafton Manor Head Injury &... 29/04/04

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

CARE HOME ADULTS 18-65 Grafton Manor Head Injury & Rehabilitation Unit Grafton Regis Manor Nursing Home Bozenham Mill Lane Grafton Regis Towcester Northants NN12 7SS Lead Inspector Mrs Linda Preen Unannounced Inspection 10:00 1 December 2005 st Grafton Manor Head Injury & Rehabilitation Unit DS0000012618.V271271.R01.S.doc Version 5.0 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 Manor Head Injury & Rehabilitation Unit DS0000012618.V271271.R01.S.doc Version 5.0 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Grafton Manor Head Injury & Rehabilitation Unit DS0000012618.V271271.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Grafton Manor Head Injury & Rehabilitation Unit Address 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) Grafton Regis Manor Nursing Home Bozenham Mill Lane Grafton Regis Towcester Northants NN12 7SS 01908 543131 01908 542644 lmarshall@partnershipsincare.co.uk Partnerships In Care Limited Mrs Moira Amos Care Home 26 Category(ies) of Mental disorder, excluding learning disability or registration, with number dementia (26) of places Grafton Manor Head Injury & Rehabilitation Unit DS0000012618.V271271.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. No one falling within the category MD may be admitted into the home where there are 26 service users of this category already accommodated within the home. That one bedroom within the chantry measures 10 square meters with additional en suite as agreed in variaiton application number V000020532 13th July 2005 2. Date of last inspection Brief Description of the Service: Situated halfway between Northampton and Milton Keynes, Grafton Manor is a magnificent building dating back to the 15th Century. Set in 7 acres of landscaped gardens, it provides a relaxing environment for assessment and rehabilitation programmes. The accommodation comprises of 13 single rooms in the main manor house with a further 6 bedrooms in the Chantry along with a cottage, bed-sit and flat offering a choice of accommodation to suit individual needs. There is a range of communal areas within the different units and residents are able to enjoy the garden areas. Grafton Manor Head Injury & Rehabilitation Unit DS0000012618.V271271.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was a statutory unannounced inspection; 1 hour was spent gathering information and planning for the inspection and 2 and a half hours were spent in the home. The care of two service users was reviewed to include their care plans, risk assessments, medication and other records. Owing to their brain injury some of the residents were unable to comment on their care, however a period of observation and discussion with residents was undertaken to ascertain if they were happy in the home. As part of this inspection, a complaint received by the Commission was investigated. This concerned resident care practices and was found to be unfounded. What the service does well: What has improved since the last inspection? Risk assessments and care plans are now in place for those residents who smoke in order to record any restrictions in place. Systems have been put in place to ensure that there is a clear audit trail for medication in the home. Grafton Manor Head Injury & Rehabilitation Unit DS0000012618.V271271.R01.S.doc Version 5.0 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 Manor Head Injury & Rehabilitation Unit DS0000012618.V271271.R01.S.doc Version 5.0 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Grafton Manor Head Injury & Rehabilitation Unit DS0000012618.V271271.R01.S.doc Version 5.0 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 2 Residents needs are fully assessed and information provided to ensure they understand what to expect and for their needs to be met. EVIDENCE: Comprehensive pre-admission assessments were available for the residents chosen to case track. This assessment includes information from the resident, their carers and previous professionals involved in their care. Grafton Manor Head Injury & Rehabilitation Unit DS0000012618.V271271.R01.S.doc Version 5.0 Page 9 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6 and 9 Care plans and risk assessments identify service user needs and the overall care planning system provides a consistent approach. EVIDENCE: Residents have clear care plans in place that are regularly reviewed by the multidisciplinary team in the home. Risk assessments have been completed to ensure that residents are able to regain maximum independence, and these risk assessments are reflected in the daily records in the home. One resident had chosen not to take part in an exercise programme and this had been discontinued. Grafton Manor Head Injury & Rehabilitation Unit DS0000012618.V271271.R01.S.doc Version 5.0 Page 10 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 11,12,13,14 and 17 Social Activities and meals are both well managed, creative and provide daily interest and variation for people living in the home. EVIDENCE: A group of residents in the main house were taking part in a spelling quiz during the inspection. Residents in the Chantry were watching television. One resident spoken to was looking forward to a session at “Riding for the Disabled” that afternoon and one of the residents had just enjoyed a session of Yoga. Another resident had gone out for coffee and a resident from the main house goes to the local gym on a daily basis. The dining room was set for lunch with attractive tables set with napkins and glasses. Lunch was due to be a roast, with Yorkshire pudding and vegetables followed by Bannoffie pie. A choice of jacket potatoes was available for those who did not want the roast. Grafton Manor Head Injury & Rehabilitation Unit DS0000012618.V271271.R01.S.doc Version 5.0 Page 11 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 20 Systems are in place to ensure residents receive their medication in a safe manner. EVIDENCE: New procedures have been put in place to ensure a clear audit trail of medication in the home. This ensures that all medication may be accounted for in order to protect residents from potential harm. Grafton Manor Head Injury & Rehabilitation Unit DS0000012618.V271271.R01.S.doc Version 5.0 Page 12 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 22 The home takes all complaints seriously and residents may be assured that their concerns will be taken seriously. EVIDENCE: A comprehensive complaints procedure is available for residents and relatives. Records of the investigation and action taken in case of complaints were available. The Commission had received one complaint for Social Care Inspection concerning care practices in the home. This was investigated as part of this inspection and was unfounded. Grafton Manor Head Injury & Rehabilitation Unit DS0000012618.V271271.R01.S.doc Version 5.0 Page 13 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 24, 25,28 and 30 Both buildings are maintained and decorated in a homely manner in order for residents to have a pleasant place in which to live. EVIDENCE: A limited tour of the environment was undertaken. This demonstrated that the home was clean and tidy and maintained in a homely manner. Resident rooms showed evidence of personalisation, with personal items on display. Various lounge areas as well as extensive grounds are available for residents use. Grafton Manor Head Injury & Rehabilitation Unit DS0000012618.V271271.R01.S.doc Version 5.0 Page 14 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): These standards were not assessed on this occasion. EVIDENCE: Grafton Manor Head Injury & Rehabilitation Unit DS0000012618.V271271.R01.S.doc Version 5.0 Page 15 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): These standards were not assessed on this occasion. EVIDENCE: Grafton Manor Head Injury & Rehabilitation Unit DS0000012618.V271271.R01.S.doc Version 5.0 Page 16 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score X 3 X X X Standard No 22 23 Score 3 X ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score 3 X X 3 X Standard No 24 25 26 27 28 29 30 STAFFING Score 3 3 X X 3 X 3 LIFESTYLES Standard No Score 11 3 12 3 13 3 14 3 15 X 16 X 17 Standard No 31 32 33 34 35 36 Score X X X X X X CONDUCT AND MANAGEMENT OF THE HOME 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score X X 3 X Standard No 37 38 39 40 41 42 43 Score X X X X X X X Grafton Manor Head Injury & Rehabilitation Unit DS0000012618.V271271.R01.S.doc Version 5.0 Page 17 No 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. Standard Regulation Requirement Timescale for action 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 Manor Head Injury & Rehabilitation Unit DS0000012618.V271271.R01.S.doc Version 5.0 Page 18 Commission for Social Care Inspection Northamptonshire Area Office 1st Floor Newland House Campbell Square Northampton NN1 3EB 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. 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