Inspection on 04/10/05 for Granby Court Extended Care Unit

This inspection was carried out on 4th October 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

Granby Court Extended Care Unit 13/06/07

Granby Court Extended Care Unit 26/01/06

Granby Court Extended Care Unit 08/03/05

Granby Court Extended Care Unit 06/05/04

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

CARE HOMES FOR OLDER PEOPLE Granby Court Extended Care Unit Granby Road Harrogate North Yorkshire HG1 4SR Lead Inspector David White Unannounced 04 October 2005 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 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. Granby Court Extended Care Unit J53 J04 S27931 Granby Court ECU V248214 041005 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Granby Court Extended Care Unit Address Granby Road Harrogte North Yorkshire HG1 4SR 01423 536361 01423 531002 Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Granby Care Limited Mrs Suzanne Ott Care Home 41 Category(ies) of Physical Disability PD (41) registration, with number Older People OP (41) of places Granby Court Extended Care Unit J53 J04 S27931 Granby Court ECU V248214 041005 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: 1. (OP)-60 years plus. 2. Service users (OP) up to a maximum of 41. Date of last inspection 08/03/05 Brief Description of the Service: Granby Extended Care provides nursing care for up to 41 clients. The service adjoins Granby Court and provides both permanent and respite/convalescence care. The home is situated on three floors and has comfortable lounge and dining areas. The bedrooms have en suite facilities in addition to assisted bathrooms. A physiotherapy room is also available. Granby Court Extended Care Unit J53 J04 S27931 Granby Court ECU V248214 041005 Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place over 4 hours. Three residents, a member of care staff, the chef and the registered manager were spoken to. The care records of three residents were looked at as well as other documentation and the inspector looked around the environment. What the service does well: What has improved since the last inspection? The high standards of care within the home are being maintained. The home has developed a staff training area. Granby Court Extended Care Unit J53 J04 S27931 Granby Court ECU V248214 041005 Stage 4.doc Version 1.40 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. Granby Court Extended Care Unit J53 J04 S27931 Granby Court ECU V248214 041005 Stage 4.doc Version 1.40 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 Standards Statutory Requirements Identified During the Inspection Granby Court Extended Care Unit J53 J04 S27931 Granby Court ECU V248214 041005 Stage 4.doc Version 1.40 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 standard(s) 3 and 6 Clients and prospective clients and their families are fully aware of the care, services and facilities provided by the home and can feel confident that their needs will be understood by the staff and are met. EVIDENCE: The home provides detailed information about the home for prospective clients and has a thorough pre-admission assessment procedure. People who are interested in moving into the home are offered the opportunity to visit the home beforehand with their families before making any decisions about moving into the home. The admission ensures that new clients are properly assessed and that staff are fully aware of their needs. The registered manager or her deputy carries out pre-admission assessments and information from other sources such as GP is obtained as part of the pre-admission assessment process. The home does not provide any form of intermediate care. Granby Court Extended Care Unit J53 J04 S27931 Granby Court ECU V248214 041005 Stage 4.doc Version 1.40 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 standard(s) 7, 8, 9 and 10 Very good care planning systems were in place to make sure that the health care needs of the clients are understood and met by a respectful staff team. EVIDENCE: The clients looked clean and tidy and well cared for. The care records of three clients were inspected and all had detailed care plans in place. The care plans contained clear and detailed information about the likes and dislikes of each client and their preferred daily living routines. One client had hearing difficulties and the care plan clearly set out how staff should communicate with the client so that the client could understand what was being said. A number of risk assessments were in place to cover a number of aspects of daily living to promote independence and safety. The risk assessments in reducing the risk from falls were very specific in saying how clients should be assisted with their mobility. The activities person keeps a separate record of activities undertaken by each client. Referrals to other health agencies were clearly recorded and GP visits are made to the home on request. The home has a small physiotherapy unit and a physiotherapist visits the home through the week to provide specialist input. All the clients spoken to said that the care was “very good” with one client saying “you can not fault the Granby Court Extended Care Unit J53 J04 S27931 Granby Court ECU V248214 041005 Stage 4.doc Version 1.40 Page 10 care staff”. Staff could be seen treating clients in a respectful manner and addressed the clients by their preferred names. Each client spoken to said that the staff team were very respectful and polite. Proper medication procedures were in place for the administration, recording, storing and return of medication. The Medication Administration Records inspected were accurate and up to date and a random check of the Controlled Drugs supply tallied with the records. Granby Court Extended Care Unit J53 J04 S27931 Granby Court ECU V248214 041005 Stage 4.doc Version 1.40 Page 11 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 standard(s) 12, 13, 14 and 15 Clients enjoy an excellent range of activities both in and outside of the home. Flexible visiting times mean that clients can maintain regular contact with family and friends. The food provided is of good quality and varied to suit different tastes and choices. EVIDENCE: The home has an activities person who carries out a daily programme of activities some on a one to one basis with clients. Entertainers are invited to attend the home and perform concerts and the clients said that they particularly enjoyed these concerts, theme days and tea parties. One client said that they enjoyed the quizzes and another said that the home holds church services. Clients have the chance to go out on outings if they choose to do so but most prefer to occupy themselves within the home. Visiting times are flexible and a client said “I can see family and friends whenever I want”. It was observed that clients have a telephone in their bedroom to be able to receive and make calls. Granby Court Extended Care Unit J53 J04 S27931 Granby Court ECU V248214 041005 Stage 4.doc Version 1.40 Page 12 Clients felt that they were able to carry out their preferred daily routines as they wished. One client said “it is good that there is no pressure to join in activities if you don’t want to”. Clients spoken to said they enjoyed the meals and felt that there was enough choice at mealtimes. The menu was on display and was varied offering lots of choice. Alternative meals are offered if a client does not like the menu options. One client said she particularly liked the “soup and desserts”. Special diets are on offer for those clients with eating difficulties and the chef spoken to had a good awareness of individual client’s needs. The chef has undertaken a number of food and nutrition training courses to help him in his work. Granby Court Extended Care Unit J53 J04 S27931 Granby Court ECU V248214 041005 Stage 4.doc Version 1.40 Page 13 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 standard(s) 16 and 18 All complaints and concerns are dealt with appropriately and abuse policies and procedures safeguard client wellbeing. EVIDENCE: The home has a complaints policies and procedure which clients, relatives and others have access to. The complaints records held by the home contain information about the nature of the complaint, investigations undertaken and actions taken. Clients were aware of who they would need to see if they had any concerns. Adult protection policies and procedures are in place and staff are given adult abuse training within their induction. Staff spoken to showed a good understanding of adult protection procedures. Granby Court Extended Care Unit J53 J04 S27931 Granby Court ECU V248214 041005 Stage 4.doc Version 1.40 Page 14 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 standard(s) 19 and 26 The home is very clean and well maintained so creating a very comfortable and pleasant environment for clients to live in. EVIDENCE: The environment is very clean, bright and spacious. The fabrics, fittings and furniture are all of a very high standard and there is plenty of sitting space in the communal lounges. Clients are able to eat in a nicely set out dining lounge although some clients choose to have their meals in their bedroom. The home has three floors and there is lift access to each floor. One client said that the home was “such a lovely place to live in”. Each bedroom has en-suite facilities and one client said “I love my bedroom and the views from it”. Good laundry systems are in place for the upkeep of bedding, linen and personal clothing and there were plentiful supplies of aprons, hand paper towels and soap dispensers. Laundry assistants are specifically employed to attend to clients’ personal clothing. Cleaning schedules are in place to maintain standards of hygiene and cleanliness throughout the home. Granby Court Extended Care Unit J53 J04 S27931 Granby Court ECU V248214 041005 Stage 4.doc Version 1.40 Page 15 Staff spoken to said that plenty of equipment was available to meet the needs of the clients. Most of the aids, adaptations and equipment seen were modern, up to date and in good condition. The home has a maintenance book to inform the maintenance team of any jobs which need to be done. Granby Court Extended Care Unit J53 J04 S27931 Granby Court ECU V248214 041005 Stage 4.doc Version 1.40 Page 16 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 considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27, 29 and 30 The staff team work positively with clients to improve their whole quality of life. The home’s recruitment procedures protect clients from harm. EVIDENCE: Staffing levels are good so that the needs of the clients can be comfortably met. On the day of inspection there were two qualified nurses and six carers on duty for 34 clients. On this particular day two members of staff were off with sickness at short notice so staffing levels were depleted. Usually there are 3 qualified nurses and 6 or 7 carers in a morning, 2 qualified nurses and 6 carers in an afternoon and 2 qualified nurses and 2 carers on duty during the night. The interaction between the residents and the staff team was good. Clients said that the staff team were “very helpful, polite and always courteous”. Clients felt there seemed to be a sufficient number of staff on duty and said that call bells were usually answered promptly. Staff were observed to be busy and the registered manager said that the dependency levels of clients being admitted to the home had become greater and this had placed more demands on the staff team. For that reason the registered manager has discussed the need for increased staffing levels with the owner of the home and is expecting to recruit extra staff in the near future. Documentation about clients was up to date and daily records reflected the care that was being offered. All staff at the home have undergone a variety of training. The majority of the staff are qualified to NVQ level 2 or above. A recently recruited member of Granby Court Extended Care Unit J53 J04 S27931 Granby Court ECU V248214 041005 Stage 4.doc Version 1.40 Page 17 staff was spoken to and was able to confirm that they had received induction training and had been given a job description and terms and conditions of employment. Records of the induction training undertaken were available within individual staff files. Each member of staff has an individual training record and training plan. There is now a staff training room in the home where in-house training is carried out. Two staff files were inspected including those of the most recently appointed members of staff. Two written references and a satisfactory Criminal Record Bureau check is obtained before new staff start in post. The registered manager when recruiting nurses makes a check with the Nursing Midwifery Council that the nurse is still registered to practice. Granby Court Extended Care Unit J53 J04 S27931 Granby Court ECU V248214 041005 Stage 4.doc Version 1.40 Page 18 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 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31, 33, 35 and 38 The home is well managed and clients are involved in decision-making about how the home is run. Proper attention is given to health and safety so promoting a safe environment for service users and staff. EVIDENCE: The registered manager is very experienced in running the home and has NVQ level 5 in management. A deputy manager supports the registered manager in providing leadership in the home and she has the Registered Manager’s Award. Clients and staff said that the management of the home was “good” and clients said they would have confidence that any matters of concern would be addressed. The organisation has a number of quality performance indicators and the home and individual staff aims and objectives are linked to these. Surveys are sent out to clients and relatives to find out their views about the home. The home Granby Court Extended Care Unit J53 J04 S27931 Granby Court ECU V248214 041005 Stage 4.doc Version 1.40 Page 19 has its own internal quality assurance audit system and is regularly assessed and audited as part of maintaining the ISO 2002 Award and the Investor in People Award. The home holds some personal allowances monies on behalf of the clients and records and receipts from incoming and outgoing monies are kept. All other clients’ finances are looked after by family members or by solicitors acting on their behalf. Formal supervision arrangements are in place for the staff and these are recorded. Arrangements were in place were in place for the promotion and maintenance of a safe and secure environment for clients, visitors and staff. A number of satisfactory safety reports and certificates were seen relating to the premises. Health and safety training is included in the induction programme and this is updated regularly. Accidents are clearly recorded within the daily records and in the home’s accident book. Individual and general risk assessments are in place to promote independence and safeguard clients from harm. Granby Court Extended Care Unit J53 J04 S27931 Granby Court ECU V248214 041005 Stage 4.doc Version 1.40 Page 20 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score x x 3 x x N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 4 13 4 14 3 15 3 COMPLAINTS AND PROTECTION 4 x x x x x x 4 STAFFING Standard No Score 27 3 28 x 29 3 30 4 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x 3 3 x 4 x 3 x x 3 Granby Court Extended Care Unit J53 J04 S27931 Granby Court ECU V248214 041005 Stage 4.doc Version 1.40 Page 21 N/A 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. 1. Standard Regulation None 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. 1. Refer to Standard None Good Practice Recommendations Granby Court Extended Care Unit J53 J04 S27931 Granby Court ECU V248214 041005 Stage 4.doc Version 1.40 Page 22 Commission for Social Care Inspection York Area Office Unit 4, Triune Court Monks Cross York, YO32 9GZ 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. Extracts may not be used or reproduced without the express permission of CSCI Granby Court Extended Care Unit J53 J04 S27931 Granby Court ECU V248214 041005 Stage 4.doc Version 1.40 Page 23 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!