CARE HOMES FOR OLDER PEOPLE
Grampian House Grampian Drive Peterlee Co Durham SR8 2LR Lead Inspector
Ms Kathy Bell Unannounced Inspection 26th January 2006 10:45 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 Grampian House DS0000031225.V267656.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 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. Grampian House DS0000031225.V267656.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION
Name of service Grampian House Address Grampian Drive Peterlee Co Durham SR8 2LR 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) 0191 5864833 0191 5864776 Durham County Council Mrs Maria Luke Care Home 20 Category(ies) of Old age, not falling within any other category registration, with number (20), Physical disability (10) of places Grampian House DS0000031225.V267656.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION
Conditions of registration: Date of last inspection 15th November 2005 Brief Description of the Service: Grampian House is registered to provide care (by not nursing care) for up to 20 older people. As long as the total number is not more than 20, they can also look after up to 10 people with physical disabilities. 10 beds within the home are within an intermediate care unit which provides care and treatment for people who need to improve their mobility and ability to care for themselves before they can return home, after, for example, a stay in hospital. All the bedrooms are single and are on the first floor of the building. On this floor, each of the two wings has its own lounge and dining room and small serving kitchen. On the ground floor there is a day centre, with large lounge and dining room which can be used by residents. One wing on the ground floor contains the offices used by workers such as physiotherapists, occupational therapists and care managers who provide support to the intermediate care unit and to those who receive similar services in their own homes. The home is in a housing estate near the town centre of Peterlee. The building is pleasantly decorated in a domestic style throughout and appears to be well maintained. Grampian House DS0000031225.V267656.R01.S.doc Version 5.0 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This unannounced inspection took place during one day in January 2006. It was one of the two inspections planned for the year. During the inspection, the inspector spoke with eight residents, two relatives and three staff as well as the manager. She looked around the building and saw some records. Residents and relatives praised the home highly. The staff were described as cheerful and helpful and one resident would give the home a score of 101 . People who had spent time in the intermediate care unit valued the help they had received. What the service does well: What has improved since the last inspection?
Further improvements have been made to the care plans which describe the care each resident needs. These now explain properly the help each person may need to use the toilet. It is important that staff have these clear guidelines so that they can help people stay continent. The care plans also show that staff have assessed whether they should refer any resident to the district nurse for her to assess whether any equipment is necessary to reduce the risk of pressure sores developing. Staff had some concerns that the assessment tool used might be identifying resident’s as at risk when they were
Grampian House DS0000031225.V267656.R01.S.doc Version 5.0 Page 6 not. The manager has agreed that she and staff will discuss this issue with the district nurse. The lack of other improvements is not a bad sign: it shows the generally high standards already in place in this home. 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. Grampian House DS0000031225.V267656.R01.S.doc Version 5.0 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 Grampian House DS0000031225.V267656.R01.S.doc Version 5.0 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): These standards were not assessed during this inspection. EVIDENCE: Grampian House DS0000031225.V267656.R01.S.doc Version 5.0 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): EVIDENCE: Grampian House DS0000031225.V267656.R01.S.doc Version 5.0 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): 14 Residents can have choice and control over their lives. EVIDENCE: Residents can choose whether they want to sit in their rooms or spend time with other people. One resident likes to walk around but is rather unsteady on her feet. The good staffing levels and the layout of the building means that staff are on hand to offer her a steadying arm rather than trying to persuade her not to do what she wants to do. Grampian House DS0000031225.V267656.R01.S.doc Version 5.0 Page 11 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 & 18 Residents were confident that they could talk to staff about anything they werent happy about. The home has done all it can to make sure that people are aware of the complaints procedure so they know what to do if they want to complain. The home has systems in place to make sure that people are protected from financial abuse and all staff have had training to make them aware of how to protect people from abuse. EVIDENCE: The home has a satisfactory complaints procedure and information about this was on display in the area used by residents. Newer residents described how they had been told about this. Residents said that they would feel able to complain if they werent happy about something. A book is also available which people can write in if they want to mention minor things they are dissatisfied with. This is good because it allows people to mention things which they feel are not serious enough to complain about. This then gives the home the chance to respond to their concerns. The home has proper procedures to guide staff if there any concerns about abuse and staff have all received training in this area. There are satisfactory procedures for handling any money belonging to resident’s which protect them from financial abuse. Grampian House DS0000031225.V267656.R01.S.doc Version 5.0 Page 12 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): 19 The home provides a pleasant, comfortable and safe place to live. EVIDENCE: The building is well maintained and is furnished and decorated in a pleasant domestic style. Each of the two wings used by residents has its own lounge and dining room and a small kitchen. All of the rooms are singles and although most are not large, residents have enough space to sit and watch TV or read if they wish. The equipment and facilities in the building are regularly serviced and safety checks are carried out to make sure that the health and safety of residents and staff are protected. Grampian House DS0000031225.V267656.R01.S.doc Version 5.0 Page 13 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): 28, 29 & 30 The home make sure that only suitable people are employed and provides proper training to make sure they have the knowledge and skills to care for residents. More than half the staff have obtained the qualification which shows that they have the skills to work in a care home. EVIDENCE: The home has established procedures for the recruitment of staff which include carrying out Criminal Records Bureau checks and obtaining references. There is a comprehensive training package for staff, covering core subjects such as food hygiene and first aid to make sure that staff are able to look after residents safely. The training department reminds the home when staff are due for refresher training. Training is planned in the near future on customer care and infection control for staff who have not already done this. When agency staff come to work in the home, they receive a proper induction to make sure they have the necessary knowledge of safety procedures etc .An agency worker who was covering a shift on the day of inspection described how he does receive a proper hand over at the beginning of his shift to make sure he is aware of residents needs. Over 70 of the care staff have already achieved NVQ 2 in care which is more than the 50 minimum recommended. This is a commendable achievement. Grampian House DS0000031225.V267656.R01.S.doc Version 5.0 Page 14 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 & 38 Although the management of the home does check that it is providing the service expected by residents, they should develop their systems to make sure that they receive good information back from residents and relatives. This would make sure that they hear about minor concerns, which people may not mention because they are so satisfied with every other aspect of the home. Staff take good care that the home is a safe place to live and work- the only exception was that some regular checks were not carried out when the person normally responsible was on leave. EVIDENCE: Senior staff from outside the home carry out a monthly inspection to check home is operating properly, and seek residents views on these visits. Independent surveys have been carried out in the past and people who use the intermediate care service are asked for feedback. However the home should try and obtain views from all residents, relatives and professionals who visit
Grampian House DS0000031225.V267656.R01.S.doc Version 5.0 Page 15 the home to make sure they obtain as full a picture as possible of how people see the home. This would help them find out if there are minor issues which people dont mention because they are so pleased with the service in general. There are good systems to make sure that the home is running safely. Equipment is serviced regularly and checks of the fire systems, water temperatures etc are carried out regularly. The only exception is that when the Porter/handyman who normally carries out these checks is on leave, no one else does them. Training to staff on fire safety and emergency procedures is of a particularly high standard, with staff receiving individual refresher training twice a year to make sure that everyone is aware of what to do in an emergency. Grampian House DS0000031225.V267656.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 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 X X X X X X HEALTH AND PERSONAL CARE Standard No Score 7 X 8 X 9 X 10 X 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 X 13 X 14 3 15 X COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X X X X X x STAFFING Standard No Score 27 X 28 4 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score X X 3 X X X X 3 Grampian House DS0000031225.V267656.R01.S.doc Version 5.0 Page 17 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 13 Requirement The manager must make sure that regular health and safety checks are carried out even when the person who normally does them is on holiday. Timescale for action 01/02/06 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 OP33 Good Practice Recommendations The home should develop systems for finding out what residents, relatives, care managers etc think of the home. Grampian House DS0000031225.V267656.R01.S.doc Version 5.0 Page 18 Commission for Social Care Inspection Darlington Area Office No. 1 Hopetown Studios Brinkburn Road Darlington DL3 6DS National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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