Inspection on 08/06/06 for Grampian House

This inspection was carried out on 8th June 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

Grampian House 26/01/06

Grampian House 15/11/05

Grampian House 17/09/04

Grampian House 21/05/04

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

CARE HOMES FOR OLDER PEOPLE Grampian House Grampian Drive Peterlee Co Durham SR8 2LR Lead Inspector Mr Leonard Hird Unannounced Inspection 8th June 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 Grampian House DS0000031225.V297208.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. Grampian House DS0000031225.V297208.R01.S.doc Version 5.2 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.V297208.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 26th January 2006 Brief Description of the Service: Grampian House is registered to provide Residential Care (but not nursing care) for up to 20 older people (OP) and up to 10 people in the Category of Physical Disability (PD) who may reside in the intermediate care unit within that overall number. Grampian Houses “intermediate care unit provides short-term care and treatment for up to 10 people in the Category of Physical Disability 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 room, a separate lounge and a dining room that can be used by residents One wing on the ground floor contains the offices used by the integrated care team who provide the professional health services support for the intermediate care unit and local community. Grampian House is located in a housing estate near to the town centre of Peterlee. The building is pleasantly decorated in a domestic style throughout, with garden areas to the front and the building appears to be well maintained. Grampian House DS0000031225.V297208.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced key inspection of Grampian House took place on the 8th June between 10 00 and 1530 hrs as well as the 23rd June between 0930 and 1430 hrs. The inspection process considered all of the Key standard areas as identified by the Commission for Social Care Inspection within the Care Homes for Older People National Minimum Standards. These Key standards are: Choice of Home (NMS3 and 6), Health and Personal Care (NMS 7, 8, 9 and 10), Daily Life and Social Activities (NMS 12, 13, 14 and 15) Complaints and Protection (NMS 16 and 18), Environment (NMS 19 and 26), Staffing (NMS 27, 28, 29, 30,) and Management and Administration (NMS 30, 31, 33, 35 and 38). The Commission for Social Care Inspection received 7 written comments from residents and their relatives as well as verbal comments on the days of inspection from residents, family members, visitors, social workers and visiting health professionals. Comments were also received from the registered manager, members of the care staff team, team manager, integrated care team members and the operational manager for the integrated care team. What the service does well: What has improved since the last inspection? Grampian House DS0000031225.V297208.R01.S.doc Version 5.2 Page 6 The registered manager had addressed the requirements and recommendations made at the last inspection. What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Grampian House DS0000031225.V297208.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Grampian House DS0000031225.V297208.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): NMS 1 NMS3 NMS 6 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Grampian House provided a Statement of Purpose and a Service User Guide that contained sufficient information for prospective residents to make an informed choice about where they were going to live. Grampian House ensured that prior to admission to the intermediate and residential care units, suitably qualified staff including where appropriate occupational therapists, members of the integrated care team and care staff had undertaken a full assessment of the needs of the prospective resident. Residents residing on the intermediate care unit were being actively encouraged to maximise their independence prior to returning home. EVIDENCE: The Statement of Purpose and Service User Guide currently being used at Grampian House contained sufficient information for prospective residents to the intermediate care unit to make informed decisions about the home. The Grampian House DS0000031225.V297208.R01.S.doc Version 5.2 Page 9 documents were easily read and could be made available in different languages and formats if required. Though some information contained in these documents particularly in the areas of fees and the new management structure of integrated care in the home was not fully available. It was confirmed, however, by the Registered Manager, that a review of the documentation was being undertaken to ensure that all of this information would be included in the future. Assessments of needs had been undertaken by suitably qualified and experienced staff of residents before admission to Grampian House. These assessments of needs records were being maintained on individual residents files. Residents spoken with during the inspection process confirmed that they had been assessed before they had entered the home. One resident commented that ‘they had had an assessment carried out by the physiotherapist before coming into the home’ another commented ‘that they had seen a nurse for their assessment’ Comments received from residents residing at Grampian House were very positive about the levels of care they were receiving. One resident commented that ‘the intermediate care unit had given them an opportunity to regain their confidence to get on with their lives’ another commented that ‘I will be able to get back to my own bed when I didnt expect to’ whilst another commented that ‘ it was a nice place and it has worked for me’ Grampian House DS0000031225.V297208.R01.S.doc Version 5.2 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): NM S 7 NMS 8 NMS 9 NMS 10 Quality in this outcome area was excellent. This judgement has been made using available evidence including a visit to this service. Individual residents health, personal and social care needs were being set out in their care plan. Residents were able to make decisions about how they could lead their lives and were treated with respect and dignity. The homes medications policies, procedures, guidance and programme enabled staff to dispense medication to residents safely. EVIDENCE: Residents living at Grampian House had individual plans of care in place and information was being maintained on the individual residents health and personal needs. training Grampian House DS0000031225.V297208.R01.S.doc Version 5.2 Page 11 Assessments of risk were also being included in these care plans. These risk assessments had taken account of individual residents views e.g. whether to self-medicate or not which is important for those residents on the intermediate care unit who were striving for an independent lifestyle. Staff had reviewed individual residents plans of care and where any changes had been identified these had been acted upon. The homes Registered Manager confirmed that a new care plan and recording system were being developed to take account of the changing needs of the service and residents within the intermediate and residential care units. Care staff at Grampian House had access to appropriate policies and procedures for the receipt, recording, storage handling, administration and disposal of medicines. Records were being maintained of the training undertaken by care staff in the safe handling and administration of medication, infection control and first aid. Visiting physiotherapists, occupational therapists and district nurses to the home on the days of the inspection all commented, “that there were good working relationships between themselves and the homes care staff ensuring that there were positive outcomes for the health of the residents on both the intermediate and residential care unit’. A written comment received from a resident stated ‘ I am extremely happy with the care provided by the staff at Grampian house’ A resident verbally commented, “I see a nurse or doctor when I need to and the staff look after me” It was observed during the inspection that all of the homes staff had a very friendly but professional approach to the residents as well as treating them in a respectful and dignified manner. Grampian House DS0000031225.V297208.R01.S.doc Version 5.2 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): NMS 12 NMS 13 NMS 14 and NMS 15 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The routines of daily living and activities available at Grampian House were varied and flexible and generally meeting the needs of the residents. The independence and personal choices of residents at Grampian House were being actively promoted by the home. The dietary needs of residents were well catered for with a balanced and varied selection of food being made available throughout the day. EVIDENCE: It was observed that the daily routines of living were flexible and meeting the needs of both groups of residents. One resident commented in writing, “ I do not take part in activities but thats through my choice.” another commented verbally that ‘they enjoyed the visits of the activity organiser and Create as they did different things’ Residents also commented that they “ that staff did not rush them into getting up but let them do things at their own pace”. Grampian House DS0000031225.V297208.R01.S.doc Version 5.2 Page 13 Relatives visiting the home spoke well of the homes visiting policy and a relative commented, “as visitors they were always made welcome by all of the staff”. Activities were arranged for residents within the home and they had been consulted as to the type of activities they would like to take part in by the home’s Activities organiser who had drawn up a full programme. Records were being maintained of activities undertaken by residents in the home as well as of those organised by the Create program. Menus were being displayed in the home of the different choices of food available and special diets were being catered for where required. Verbal comments received from residents about the food ranged from ‘the meals were good’ ‘meals were always varied’to ‘if I dont like something, there is always a choice’. Records were being maintained of the choice of food being made by residents as well as records of the homes Menus. Records of training undertaken by the catering staff including Food Hygiene were being maintained on their personnel file. Regular residents meetings were being held and the choices of food and activities being made available at home to residents were regularly discussed and minutes of these meetings were kept. Grampian House DS0000031225.V297208.R01.S.doc Version 5.2 Page 14 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): NMS 16 and NMS 18 Quality in this outcome area is good. The judgement has been made using available evidence including a visit to the service. The complaints and adult protection policies and procedures currently being used in Grampian House provide for a safe environment for residents to live in. EVIDENCE: Grampian House had appropriate policies and procedures available for the Protection of Vulnerable Adults. From discussions with staff it was confirmed that they were aware of the importance of acting quickly in cases of suspected abuse and that they would follow the homes policy and procedures if necessary. Staff had received training on how to deal with the Protection of Vulnerable Adults and records were being maintained of this training. Staff confirmed that they had received training in how to deal with the Protection of the Vulnerable Adult. Grampian House had appropriate policies and procedures in place for residents and their families on how and who to complain to if they needed. Information on how to complain was being displayed on the notice boards in the different units as well as being contained in the residents guide to the home. Grampian House DS0000031225.V297208.R01.S.doc Version 5.2 Page 15 There was also a compliments and complaints book available in the home and this had been used by both residents and relatives. Residents were aware of how and who to complain to. One resident commented, “that if wanted to complain about anything they could and that they also knew who to complain to” Whilst other residents in their written responses contained in the Care Homes Survey which were returned to the Commission for Social Care Inspection had confirmed that they were aware of how to make a complaint. Grampian House DS0000031225.V297208.R01.S.doc Version 5.2 Page 16 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): NMS 19 and NMS 26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service. Grampian House is clean, pleasant and hygienic and provides a safe and comfortable environment for its residents in both the intermediate and longterm residential care unit. EVIDENCE: Grampian House had been decorated and furnished to a pleasing and homely standard and took account of the needs of the different residents groups. A resident spoken with commented, ‘ my room is how I like it’ another commented ‘it is well decorated and pleasant to live in’ The communal living areas on both the intermediate and long-term residential care units were well decorated and maintained. Maintenance work undertaken on the homes equipment and facilities by the handyman as well outside contractors had been recorded appropriately. Grampian House DS0000031225.V297208.R01.S.doc Version 5.2 Page 17 Grampian House is clean, tidy and free from unpleasant odours. There were appropriate systems in place for infection control. The homes infection control policies and procedures were written in accordance with relevant legislation and professional guidance. Staff confirmed that they had received appropriate training in infection control and a record of this training had been kept on their personnel file. Grampian House DS0000031225.V297208.R01.S.doc Version 5.2 Page 18 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): NMS 27 NMS 28 NMS 29 and NMS 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Grampian House through its recruitment, employment and training procedures were ensuring that only suitably qualified care staff had being employed. Staffing levels at the home were sufficient to meet the current assessed needs of both groups of residents. EVIDENCE: From a review of the staff rota provided it was noted that staff were being deployed in sufficient numbers as to ensure the current needs of both groups of residents to be met. There was a commitment to training for all staff at the home and currently over 67 of the homes care staff were qualified at NVQ level 2 in care or above. Staff had received appropriate induction training and there was also a rolling training programme operating in the home providing training for staff in moving and handling, first aid training, infection control, fire risk assessment and the Protection of Vulnerable Adults. Grampian House DS0000031225.V297208.R01.S.doc Version 5.2 Page 19 In documentation sent to the Commission for Social Care Inspection by the homes Registered Manager it was also confirmed that staff were undertaking a course in Equality and Diversity. A member of staff commented that,they found the course very interesting and useful in their day-to-day work Records were being maintained of all training being given to staff in the home and individual records of training were been kept on the staffs files. All care staff employed at the home had being recruited in accordance with the homes policies procedures and that of Durham County Councils. All of the appropriate employment checks including a Criminal Records Bureau enhanced level check prior to starting to work at the home had been undertaken and recorded accordingly on the care staff. Where agency staff had being used to cover staff absences it was confirmed by the Registered Manager that all of the appropriate checks had been undertaken and checked prior to them coming to work at the home. However there was a number of other staff who had regular contact with the residents and who were not directly employed by Durham County Council working at the home. It could not be confirmed that all of the appropriate checks had been undertaken on these members of staff. Grampian House DS0000031225.V297208.R01.S.doc Version 5.2 Page 20 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): NMS 31 NMS 33 NMS and 35 and NMS 38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Grampian House has a well-established management structure ensuring that the home promotes the health, safety and welfare of residents and Staff EVIDENCE: There were clear lines of management, accountability and support systems to be found within the home. Formal supervision sessions were being given to all members of the care staff, management team and ancillary staff. Records of staff supervision sessions were being maintained securely and staff confirmed that they had received copies of their supervisions. Grampian House DS0000031225.V297208.R01.S.doc Version 5.2 Page 21 From discussions with staff it was confirmed that they were aware of the changing management structure within the home and outside of the home. Comments received from residents, relatives and visitors during inspection were positive; “Minutes were being kept of the regular residents meetings and the responses to the points raised by residents during these meeting from the manager were also being kept. Grampian House is the subject of regular financial audits undertaken by the Local Authorities audit team that looks at the financial management within the home and the latest report available, confirmed that the home was safeguarding the financial interests of residents. Regular fire alarm tests and fire drills had been undertaken at the home and records were being maintained accordingly. Records were also been were being maintained of when equipment had been serviced and who had undertaken and completed the work. Grampian House DS0000031225.V297208.R01.S.doc Version 5.2 Page 22 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 X 3 X X 4 HEALTH AND PERSONAL CARE Standard No Score 7 3 8 4 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X X X X X 3 STAFFING Standard No Score 27 4 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X X 3 Grampian House DS0000031225.V297208.R01.S.doc Version 5.2 Page 23 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 OP29 Regulation Regulation 19 Schedule 2 Requirement Timescale for action 30/09/06 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Grampian House DS0000031225.V297208.R01.S.doc Version 5.2 Page 24 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 © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. 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