Inspection on 18/02/09 for Granada House

This inspection was carried out on 18th February 2009.

CSCI found this care home to be providing an Good service.

The inspector found no outstanding requirements from the previous inspection report, but made 2 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Similar services:

Fairfields Country Rest Home

Poldhu

Queensmount

Trevaylor Manor

Didsbury Court Rest Home

Belma

Hunters Care Centre

Manor Lodge

Extracts from inspection reports are licensed from CQC, this page was updated on 19/06/2009.

Inspecting for better lives Key inspection report Care homes for older people Name: Address: Granada House 5 St Pauls Road Weston-super-Mare North Somerset BS23 4AB     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Grace Agu     Date: 1 8 0 2 2 0 0 9 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop 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 Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Older People Page 2 of 28 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Care Homes for Older People Page 3 of 28 Information about the care home Name of care home: Address: Granada House 5 St Pauls Road Weston-super-Mare North Somerset BS23 4AB 0193416102 0193416102 jacq@kendrick29.wanadoo.co.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): K & A Care Limited Name of registered manager (if applicable) Ms Jacqueline Lesley Kendrick Type of registration: Number of places registered: Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 old age, not falling within any other category Additional conditions: The maximum number of service users who can be accommodated is 13. The registered person may provide the following category of service only: Care home only - Code PC to service users of either gender whose primary care needs on admission to the home are within the following category: Old age, not falling within any other category (Code OP) Date of last inspection Brief description of the care home Granada House provides personal care for up to 13 elderly people. The house was built at the turn of the century, and has pleasant gardens to the front and rear. It is situated in the south ward of Weston-Super-Mare, about a mile from the town centre. There is level access to both front and rear gardens and to local shops and churches. Care Homes for Older People Page 4 of 28 care home 13 Over 65 13 0 Brief description of the care home A ramp leads from the front door to the garden. Clarence Park is a few minutes walk from Granada House. A chairlift is provided for the main staircase. One bedroom is situated on the second floor; this is accessed by way of a narrow staircase. Bedrooms are for single occupancy and all have en-suite facilities. The fees are North Somerset Social Services rate: £369.34 Care Homes for Older People Page 5 of 28 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: This was an unannounced inspection which took place over eight hours and was undertaken to review the care practices to ensure that it is in line with the legislation and that best practice is being followed at the home. It was also undertaken as a first inspection to the service after change of ownership and registration with the Commission for Social Care Inspection. We conducted a tour of the building and had the opportunity to talk to residents who were in their bedrooms about their care and how they spend their day. Eight residents and two staff members were spoken with during the inspection. To enable us to make a judgment about the conduct of the home we sampled 4 care Care Homes for Older People Page 6 of 28 plans, medication administration records and maintenance records. At the end of the visit we discussed some of the outcome feedback with Ms Jacqueline Kendrick manager of the home. What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line –0870 240 7535. Care Homes for Older People Page 8 of 28 Details of our 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) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 9 of 28 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home provides information to prospective residents and their representatives and ensures that the admission process provides safe guards to meet the assessed needs of the residents. Evidence: The Home has a Statement of Purpose and Service Users Guide, which contains information required by the regulations. The Service Users Guide is given to prospective residents and/or their relatives when they visit the Home or make inquiries to enable them to make informed decision about moving into the Home. The Annual Quality Assurance Assessment (AQAA) stated that the above documents are reviewed at regular intervals and that any additions and/or alterations are bought to the attention of existing residents who receive updated copies of the relevant document. Care Homes for Older People Page 10 of 28 Evidence: Review of the care file of a recently admitted resident showed that the resident had a comprehensive assessment in hospital before moving to the home to ensure that their needs will be met. The assessment is also used as a working tool to enable the home to find out if there were necessary skills and services available before the individual is admitted. The AQAA stated that during the assessment interview prospective residents are invited to visit the home for coffee, lunch or a day, to meet staff and other residents. The home also advises that they can come initially on a months trial. One relative we spoke with confirmed that they were given a contract, which has the Terms and Conditions of their relatives stay at the home including the fees to be paid. Care Homes for Older People Page 11 of 28 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The Home offers care and support to residents throughout their lives and towards the end. It also protects residents by review of their health needs; satisfactory care planning and appropriate medication administration. Evidence: Four care plans were sampled and reviewed during the inspection. There was evidence of pre-assessment of residents before admission to the Home to ensure that their needs are adequately met. There were care plans in place however, these care plans had not described in details how the needs were to be met. We noted that there were detailed entries in the daily report of care provided. It was agreed that care plans need to be comprehensive and individualized to support staff in meeting the needs of the residents. The home has a key worker system in place whereby the key worker communicates any changes in the needs of the resident to the manager, who updates the care plan when ever possible with the resident. There was evidence to suggest that this is Care Homes for Older People Page 12 of 28 Evidence: happening monthly. The staff team works hard to ensure that residents health needs are met. The residents have access to different of health and social care professionals through the normal referral routes such as via their GP. The homes documentation and the service users note that they see their GPs when required and have access to dental, optician and chiropody. For example One of the care files reviewed had a care plan for medical condition with an input from a health professional. A strategy in relation to how to enable the staff to meet the residents specific need was in place. The accident book confirmed that all accidents were well documented and were regularly reviewed. The Manager undertakes monthly accident audit to ensure that measures are in place to prevent re occurrence. All residents have risk assessments including tools for assessing falls and falls prevention. Residents spoken with stated that they are well cared for and that staff treated us with dignity and respect. I decide when I get up and retire and staff help me when I ask them. The AQAA stated that all staff have successfully completed an Administration of Medicine course and liaise and seek advice from the supplying pharmacist on any issues concerning residents medication. We reviewed the homes administration of medicines practices. Three people are currently able to look after their own medicines and are provided with locked drawer. The home has a self-medication policy but this includes a risk assessment to make sure that people are safe to look after their own medicines. Secure storage is available to keep medicine safely. A medicine trolley is used to transport medicines around the home. During the inspection, we saw the lunchtime medicines being given by staff. These were given safely and the medicines administration record sheet signed after the medicines had been taken. Residents we spoke to said that they were happy with the way they are given their medicines.The manager told us that a new cabinet was being expected to replace the exiting one, which had no provision for safe storage of controlled drugs. This cabinet arrived before the inspection was completed.We noted while reviewing medication that handwritten medication by Lloyds Pharmacy on the Medicines Administration Record Sheets had not been signed and dated. The manager stated that she would discuss it with the pharmacy to prevent it from happening again. Evidence of residents wishes in the event of death was noted in the care files viewed. The home also had a death and dying policy. Care Homes for Older People Page 13 of 28 Evidence: Staff interviewed were aware of the importance of ensuring that all information about residents are kept confidential. Staff are also aware of the policies and procedures and where to access them if needed. Care Homes for Older People Page 14 of 28 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The residents are able to control how they spend their time and are actively encouraged to maintain contacts with families and representatives and are provided with varied nutritional meals Evidence: Evidence of discussion with resident staff and entries in the visitors book showed that the Home actively supports the residents to maintain contact with families, friends and advocates. One resident spoken with stated that her granddaughter visits very regularly and that the Home would contact her family anytime she wanted them to. One relative spoken with on the day stated that there are no restrictions to time of visiting and that they visit their relative once week. They are satisfied with the Home and the services provided, staff are very welcoming,They are very good. Residents at Granada House are encouraged to spend their time as they wish. Residents who are able and who wish to go out into the local community for walks and shopping. For example one individual was observed coming back from a walk. The individual told us that they go out everyday for a walk unless the weather is very bad. Care Homes for Older People Page 15 of 28 Evidence: The home has a pleasant communal lounge and a dining room both are well used. Residents were observed going about their daily life in a relaxed and happy way. Staff were available as required and any personal care interventions were carried out in private. The home has an Activity Coordinator who helps to organize regular events at the house based on the residents preferences. Recent activities include Fun in the snow and Valentines afternoon spa with Teddy raffle and chocolates. The manager stated that the Activity Coordinator would be attending training on providing activities for older people in March 2009. The manager also told us that the home is arranging for residents to go to the local church every last Friday of the month for Tombola and other activities such as skittles. There is choice on the main menus and residents may request an alternative, and the cook will provide one. Meals are cooked to cater for individual likes and dislikes. The residents we spoke with told us that they feel the food is good and that they are able to have a choice. On the day of the inspection the menu looked nutritious and the residents told us that they enjoyed it. The 3-week menus that we saw appeared varied and balanced and it appeared that the residents regarding the menus are regularly taken into account.The kitchen was found clean and well organized with all the readings regarding fridges and freezers noted as well as food probe temperatures. There was a kitchen risk assessment in place. The home was inspected by North Somerset Environmental Health Council food Safety Team and was provided with a food safety award. Care Homes for Older People Page 16 of 28 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home has procedures in place enabling individuals to make a complaint and to know that they will be listened to. It ensures as far as possible that residents are protected from harm by policy and procedure about the Protection of Vulnerable Adults from Abuse. Evidence: The home has a complaints procedure, which was displayed in the lobby area of the building and was also noted in the contract, Service Users Guide and individual care files. One complaint had been made since the last inspection, this had been addressed and a report of how the complaint was handled by the provider was shown to the inspector. The Commission for Social Care Inspection has not received any complaints or concerns about the service. Residents asked said they would be able to raise any concerns with the staff or manager. One resident commented that they would trust staff or manager to sort out any concerns or problem that we may have. Recruitment practice was generally good. However the most recently recruited member of staff had a Criminal Record Bureau (CRB) check from a different Care Homes for Older People Page 17 of 28 Evidence: organization,. which was obtained two month previously. The manager confirmed that the home had applied for a current CRB check and would inform the Commission of the outcome. We have issued a requirement to ensure that this is undertaken. The individual had two references on file.The home has a policy on whistle Blowing and Protection of Vulnerable Adult from Abuse. Record confirms that staff have received training on POVA from the home. The managers told us that one senior staff member and herself have been booked to attend training on Deprivation of Liberty on 17/03/09. Care Homes for Older People Page 18 of 28 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home provides a safe and hygienic environment for the residents and staff. People who live and work in the home benefit from a warm, welcoming and well-maintained environment. Evidence: Granada House provides personal care for up to 13 elderly people. The house was built at the turn of the century, and has pleasant gardens to the front and rear. It is situated in the south ward of Weston-Super-Mare, about a mile from the town centre. There is level access to both front and rear gardens and to local shops and churches. A ramp leads from the front door to the garden. Clarence Park is a few minutes walk from Granada House. A chairlift is provided for the main staircase. All bedrooms are single and have en-suite facilities. While touring of the building, we noted that all communal rooms were clean and tidy.The lounge is well used and is nicely presented and has comfortable seating. The dining room is central to the home and is well used. This room is nicely presented at mealtimes when residents eat together. Care Homes for Older People Page 19 of 28 Evidence: The bedrooms on the first floor are accessible by stair lift. Residents were seen to be capably using this during the visit. Bedrooms on the ground and first floor were sampled these were clean and had been personalized by the service user in residence. There is one bedroom on the second floor, which is accessible by a narrow two stage stairway only. This room has been converted in to an office for the manager. The manager stated that this is to provide her with better storage facilities for residents confidential information. The home has assisted bathing facilities and service users are all assisted to some degree with safe bathing. There are sufficient toilet facilities. We noted that some areas of the home were looking tired in some areas of the building. The manager stated that the areas identified would be discussed with the provider. We recommend that refurbishment of the home includes the areas identified as soon as possible. No unpleasant odours were found. Staff have access to hand washing facilities and protective clothing such as gloves and aprons. The home has a fire alarm and safety equipment; this had been serviced annually and was checked weekly. Fire fighting equipment: fire extinguishers had been serviced. Care Homes for Older People Page 20 of 28 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home has a dedicated and trained staff team. Recruitment practice needs to improve to offer adequate protection to the residents. Evidence: We reviewed the homes staff duty rota in place. There were 2 care staff members on duty each shift including night duty. The cleaner and cook each work day duty hours. The manager stated at a discussion that the home is sufficiently staffed to meet the current needs of the residents. The Annual Quality stated that the staffing arrangement is flexible which ensures that the home is able to have more staff on duty when the need arises. The AQAA also states that at weekends the home has increased the staff in the morning so there is plenty of time to help residents wash and dress as needed. One staff record was randomly selected during the visit. The home operates a thorough recruitment programme with references and copies of the terms and conditions of employment kept on file. However current Criminal Records Bureau checks ((RB) have not been undertaken in regards to this individual. This was previously discussed under Standard 16. Care Homes for Older People Page 21 of 28 Evidence: In relation to staff training records show that nine staff have obtained National Vocational Qualification (NVQ) at level 2 and one at Level 3. Twelve staff have also under/taken First Aid Appointed persons training on 26/01/09. Other trainings attended include Moving and Handling continence/catheter care, Administration of Medicines, Fire training, Food Hygiene, Dementia Care and Bereavement. New staff have received thorough induction training.The manager stated that staff are given Training and Assessment Hand book at the start of their employment.The AQAA stated that all staff receive assessment and annual appraisal and ongoing supervision over the past year and training. It also states the home follows Skills for care training in their induction. Care Homes for Older People Page 22 of 28 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The Home benefits from good leadership and management; its practices offer protection to the health and safety of residents. Evidence: On the day of inspection there was a friendly and interactive atmosphere in the home. Residents looked well cared for and were seen talking to staff in an informal way. This is an evidence of the Managers leadership and management style. Staff spoken with were very complimentary of the Managers ability to manage the home. Residents and some relatives made positive comments about the manager and expressed satisfaction with the overall services and management of the home. One resident stated, I am happy here, Jacquie is very good. The Registered Manager, Mrs Jacqueline Kendrick has twenty years of experience as the manager of Granada House and has achieved a National Vocational Qualification in Care Management at level 4. The manager has attended other training to include, Care Homes for Older People Page 23 of 28 Evidence: updates on First Aid, Moving and Handling of medicines, Infection Control, fire awareness and is due to attend. Mrs Kendrick manages the home very well and she has the support and regular support from the new providers. The manager stated that the new providers come down every three weeks for a management meeting and her supervision. The AQAA stated that residents are consulted regularly, on an informal, one to one basis, for views on their care and the way the home is run. In addition there is a 3 monthly residents meetings. The fire logbook was noted to be well maintained and up to date. Staff have attended fire lectures and regular fire drills. Records show that weekly checks are carried out and the call points are rotated, emergency lighting was checked on 12/02/09. The fire alarm was serviced in February 2009. Fire extinguishers were serviced in February. Fire risk assessment was also in date. Portable electrical appliances had been tested. The Stairlift was serviced on 1/09/08. There is also a current and up to date gas inspection certificate at the home. The home has not undertaken the Five Yearly Periodic Inspection of Electrical Installation Safety Certificate at the home. The manager told us that she would discuss it with the new providers and ensure that this is undertaken as soon as possible to ensure that the residents, staff and visitors are protected against any electrical emergency. Generic risk assessments have been undertaken to ensure adequate protection of residents. Specific areas include, the kitchen, dining areas, lounge stairs communal, residents bedrooms Stairlift and rear access to the garden. The residents money reviewed was satisfactory; the amount recorded in the book was a couple of pounds over the amount found in the safe. The manager stated that the difference was due to late recording of the money given to the residents a couple days ago. She would ensure that the it would be recorded appropriately in future. All residents confidential records were securely locked away. Accidents to residents were recorded and reviewed following falls and where appropriate care plans and risk assessments reviewed to ensure that the individual is adequately protected and to prevent further occurrences. The Home has policies and procedures to include complaints, missing persons, risk assessment, whistle blowing, Protection of Vulnerable Adult, Health and Safety, Care Homes for Older People Page 24 of 28 Evidence: recruitment and confidentiality. Care Homes for Older People Page 25 of 28 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 26 of 28 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action 1 18 19 Ensure that current CRB is obtained for all new staff before commencement of employment. To comply with the regulation. 15/04/2009 2 38 13 Undertake the Five Yearly Periodic Inspection of the Electrical Installation Safety Certificate To protect the residents,staff and visitors against electrical emergencies. 15/04/2009 Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations 1 19 We recommend that the refurbishment of the home includes the area identified as looking tired. Care Homes for Older People Page 27 of 28 Helpline: Telephone: 03000 616161 or Textphone: or Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Commission for Social Care Inspection (CSCI). 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