Inspection on 12/12/05 for Granby Lodge

This inspection was carried out on 12th December 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. 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 found no outstanding requirements from the previous inspection report, but made 5 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Granby Lodge 12/12/06

Granby Lodge 21/07/05

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

CARE HOME ADULTS 18-65 Granby Lodge 10 Granby Road Harrogate North Yorkshire HG1 4ST Lead Inspector Mrs Maggie Coxon Unannounced Inspection 12th December 2005 11:15 Granby Lodge DS0000063528.V267955.R01.S.doc Version 5.0 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Granby Lodge DS0000063528.V267955.R01.S.doc Version 5.0 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Granby Lodge DS0000063528.V267955.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Granby Lodge Address 10 Granby Road Harrogate North Yorkshire HG1 4ST 01423 888462 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) Granby Lodge Care Limited Mrs Linda Ann Atcheson Care Home 14 Category(ies) of Learning disability (14) registration, with number of places Granby Lodge DS0000063528.V267955.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. Registered for 14 service users with a learning disability, some of whom may be over 65 years. 21st July 2005. Date of last inspection Brief Description of the Service: Granby Lodge is a semi-detached Grade 2 listed building occupying four floors including cellars. A former dwelling house converted to a care home over 20 years ago, it provides single and shared accommodation on the upper three floors for adults with learning disabilities. Communal space is provided on the ground floor. The manager and staff seek to provide a holistic service including personal care, advice and guidance on matters of daily living, meals, laundry and a domestic service. Clients are encouraged to be involved in all aspects and activities of daily living according to their individual abilities and capabilities. A variety of in-house activities are provided. Clients also attend day care placements and a number of other activities organised outside the home. A large private garden is used for outdoor activities. Clients have easy access to the towns facilities and amenities through the homes central location and use of the registered providers motor vehicles. Full use is made of the local health services including doctors and dentists. Access to more specialised health and social care services is accessed through the doctor. Granby Lodge is owned by Granby Lodge Care Limited and managed on their behalf by Mrs Linda Atcheson who is one of the two directors of the company who are also the registered persons. Granby Lodge DS0000063528.V267955.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was the second inspection to be undertaken between April 2005 and March 2006. It was done on the 12th and 15th December 2005, the latter day at a time when most of the people living in the home would be present. It took 5 hours plus 1 hour’s preparation time. Discussions were held with 13 of the 14 people currently living in the home, with care staff on duty and with the registered manager who was present on the second day. A number of records and most areas of the home, including bedrooms and shared areas, were seen. What the service does well: What has improved since the last inspection? All care staff apart from the most recently appointed carer have completed NVQs in care to level 2. One bedroom and the dining room have been redecorated and new furniture has been purchased for one bedroom. The recording of financial transactions concerning residents’ monies has improved and is now accurate and consistent. Hot water temperatures are better controlled. Care plan reviews are better recorded. Granby Lodge DS0000063528.V267955.R01.S.doc Version 5.0 Page 6 What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Granby Lodge DS0000063528.V267955.R01.S.doc Version 5.0 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Granby Lodge DS0000063528.V267955.R01.S.doc Version 5.0 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 2 Residents are able to make an informed choice about moving in and can be confident that their needs are understood and will be met. EVIDENCE: Whilst no new admissions have been made in recent years the registered persons have produced assessment and pre-admission documentation that if used would glean detailed information about any prospective resident. This documentation would be used for all clients who were to be admitted on a privately funded basis and also where information from a sponsoring authority was not thought to be sufficiently detailed and further information was required. Assessments of need had been undertaken of each of the current residents prior to a care plan being drawn up to describe how these needs were and are to be met. Residents said that the staff team know them very well and provide appropriate support to have their needs and wishes met. Granby Lodge DS0000063528.V267955.R01.S.doc Version 5.0 Page 9 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6,7,8 and 9. People living in the home make as many decisions about their personal lives and about the day-to-day running of the home as possible. They also live as independently as possible, taking into account any risks that have to be considered, with the full encouragement and support of staff. EVIDENCE: A care plan has been developed for each resident that outlines the individual’s skills and needs and identifies how these needs are to be met. These care plans are regularly reviewed. Residents said that they lead interesting and active lives with the support of a committed staff team. They are involved in the running of the home as much as possible and have regular meetings where they can discuss any aspects of living in the home. Residents have independent lifestyles and can take calculated risks subject to the outcome of a risk assessment undertaken by the staff team. A recommendation was made following the last inspection that financial records concerning residents’ personal finances be accurately maintained. It Granby Lodge DS0000063528.V267955.R01.S.doc Version 5.0 Page 10 was not possible to check these on the first day as only the registered manager can access this documentation. It was possible to do so on the second day however when she was present. These were found to be current and accurate. The registered manager is appointee for each resident whose allowances are paid into a residents’ bank account from where personal allowances are withdrawn for each resident as required. Each resident has a bank account for which the registered manager is trustee. The registered manager explained that she planned to set up a system so that each resident’s personal allowance will be withdrawn in full each month and will be paid directly to the individual. Granby Lodge DS0000063528.V267955.R01.S.doc Version 5.0 Page 11 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,14,15,16 and 17. Residents have a varied and interesting lifestyle and are fully involved in their local community. Individuals enjoy a wide range of employment, educational and social opportunities enabling them to have a number of different life experiences. They also develop and maintain good relationships with family and friends. EVIDENCE: Residents lead interesting and active lives with the support of a committed staff team. Each individual has a weekly programme of activities in a variety of local community based settings. A number of them are in paid or voluntary employment and several attend a local college. They have very busy social lives within their local community. Residents are supported to develop and maintain relationships with families and friends. Residents said that they are fully consulted about menus and are involved in their planning. They said that the meals provided are good. Granby Lodge DS0000063528.V267955.R01.S.doc Version 5.0 Page 12 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 18,19 and 20. Residents’ personal and health care needs are fully met. Residents could benefit from a stronger medication system through the appropriate training of staff. EVIDENCE: Each person living in the home is registered with a GP through whom specialist health services are accessed if required. Staff support them in having regular health checks and checks with their dentist, chiropodist and optician. None of the residents is able to take their own medication. There is a monitored dosage system in operation, which is securely stored. Medication administration records are well maintained. Care staff explained that they have not as yet received medication training. The registered manager explained that she had attended some training but had been dissatisfied with the quality of this. Advice was given as to how she can access appropriate training for all staff involved in administering medication. There are locks on bedroom doors to which residents have a key if they so choose. Bathroom doors also have locks. Each of the four residents who require assistance with their personal care needs has their own en suite bathing facilities. Granby Lodge DS0000063528.V267955.R01.S.doc Version 5.0 Page 13 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 22 and 23. Residents’ concerns are appropriately dealt with and their interests are safeguarded. Their safety could be further promoted through the appropriate training of staff in adult protection issues. EVIDENCE: There is a comprehensive complaints procedure in operation that is made available to anyone who wishes to see it. Several of the people living in the home are not able to make a formal complaint but are able to make any dissatisfaction known to staff, who try to address problems promptly and appropriately. Residents spoken with said that they were aware of how to raise any concerns. Staff were seen to have developed very good relationships with residents and to communicate very well with them. No complaints have been made to the home or to the C.S.C.I. within the last twelve months. Staff spoken to were clear about the procedure they would follow if they were to witness the abuse of a resident. They have not however had any adult protection training and would benefit from this. Granby Lodge DS0000063528.V267955.R01.S.doc Version 5.0 Page 14 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 24,25,26,27,28,29 and 30. The standard of the environment is good and provides residents with a safe, comfortable and clean place in which to live. EVIDENCE: The home is well maintained and since the last inspection the dining room and one of the bedrooms have been redecorated and new furniture has been bought for one bedroom. Shared areas include a kitchen, a dining room, a lounge and a conservatory. A number of bedrooms were seen and residents indicated that they are happy with them. Six bedrooms are for single accommodation four are double rooms. All rooms are of a suitable size and are situated on either the ground, first or second floors. Five rooms have en suite facilities. Communal WC facilities and bathrooms are appropriately situated throughout the home. Appropriate aids and adaptations are fitted throughout the home. A good standard of cleanliness is maintained throughout. Granby Lodge DS0000063528.V267955.R01.S.doc Version 5.0 Page 15 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 32,33,34,35 and 36. The residents receive a good standard of care from a skilled and experienced staff team. The safety and wellbeing of residents could however be strengthened through increased staffing levels. EVIDENCE: Staff explained that the home is fully staffed at present, a number of them having worked at Granby Lodge for a number of years. The staffing roster for the week including the inspection shows however that staff are not employed in sufficient numbers to meet the minimum standard required. It also shows that they have not been deployed in such a way as to ensure that the needs of people living in the home can be met at all times in that one evening there was only one staff member on duty between 5.30pm and 9.30 pm. All of the care staff apart from the most recently appointed carer have completed NVQs in care to level 2. They have completed these very quickly with support from the registered persons. Staff have also undertaken training in health and safety, moving and handling, emergency aid and basic food hygiene. As previously mentioned, staff would benefit from having some adult protection training. Granby Lodge DS0000063528.V267955.R01.S.doc Version 5.0 Page 16 Every staff member talked to say that there is high staff morale within the home. They also said that they have regular formal supervision from the registered manager. One carer had been appointed since the last inspection. The recruitment records were not available for inspection however as personnel are not maintained on the premises but within the registered persons’ home. Mrs Atcheson agreed on the second day however that this arrangement is not suitable and said that she and her husband plan to create a new office within Granby Lodge in which they will keep confidential information including recruitment and personnel documentation. She explained that the person concerned had worked previously at Granby Lodge and said that she had undertaken a new CRB check on this individual prior to him commencing work on this occasion. Granby Lodge DS0000063528.V267955.R01.S.doc Version 5.0 Page 17 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 37,38,39 and 42. The residents benefit from a well managed home in which their needs and wishes are put first. EVIDENCE: Mrs Atcheson who as well as one of the registered persons is the registered manager has considerable management experience. She is in the process of completing the Registered Managers Award as part of an appropriate qualification. Staff said that she and her husband are extremely approachable and supportive. They invest a great deal into developing and maintaining a strong and happy staff team. Residents said that they have regular meetings and are able to express their views, wishes and any concerns openly. A recommendation was made following the last inspection that the registered persons should consider approaching families, visiting professionals and other stakeholders to gain their comments on the overall performance of the home. Care staff were not aware if this had been done. Granby Lodge DS0000063528.V267955.R01.S.doc Version 5.0 Page 18 A health and safety issue concerning hot water temperatures was identified at the last inspection. Several hot water outlets were tested on this occasion and all were found to be at a safe temperature. The registered person had been undertaking regular hot water temperature checks up until three months ago but there was no record of tests since then. One of the care staff explained that she understood that a new hot water boiler is to be installed in the forthcoming week. At the outset of this inspection the door to the kitchen and the door to the office were held open by wedges thus preventing them, as fire doors, from closing automatically. One of the care workers removed these when asked to do so. A formal letter requiring a prompt response to address this issue on a permanent basis has been sent to the registered persons. Whilst regular tests and checks of the fire safety system were being done, there was no fire risk assessment for the home in place. The registered persons and staff team are conscious of good practice in relation to health and safety maintenance. They are active in promoting the health, welfare and safety of residents by following appropriate procedures and staff are given training in health and safety matters including fire safety, emergency aid and basic food hygiene. Currently all accidents to residents are recorded on a single document. These composite records do not support the residents’ rights to confidentiality of information concerning them. This was discussed with the registered person who agreed to record incidents correctly from now on. Granby Lodge DS0000063528.V267955.R01.S.doc Version 5.0 Page 19 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score X 3 X X X Standard No 22 23 Score 2 2 ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score 3 3 3 3 X Standard No 24 25 26 27 28 29 30 STAFFING Score 3 3 3 3 3 3 3 LIFESTYLES Standard No Score 11 X 12 3 13 3 14 3 15 3 16 3 17 Standard No 31 32 33 34 35 36 Score X 3 1 2 2 3 CONDUCT AND MANAGEMENT OF THE HOME 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Granby Lodge Score 3 3 2 X Standard No 37 38 39 40 41 42 43 Score 2 3 2 X X 1 X DS0000063528.V267955.R01.S.doc Version 5.0 Page 20 No. Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard YA33 Regulation 18 Requirement Staffing levels must be increased sufficiently and staff must be appropriately deployed to meet residents’ needs fully at all times. Fire doors must not be held open by unauthorized means including the use of wedges and stoppers. The registered persons must undertake a fully recorded fire risk assessment of the home. All accidents must be recorded in a way that ensures the individual’s right to confidentiality of information about them and not on a composite record. Regular checks of hot water temperatures to outlets accessed by residents must be resumed and recorded. Timescale for action 16/01/06 2. 3. 4. YA42 YA42 YA42 23 23 13 12/12/05 16/01/06 16/01/06 5. YA42 13 16/01/06 Granby Lodge DS0000063528.V267955.R01.S.doc Version 5.0 Page 21 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. 2. 3. 4. 5. 6. Refer to Standard YA20 YA22 YA23YA35 YA34 YA37 YA39 Good Practice Recommendations All staff involved in the administration of medication should be provided with appropriate training. Consideration should be given to producing the complaints procedure in more user-friendly formats. All staff should be provided with adult protection training. The registered persons should make suitable arrangements to ensure that recruitment records are available for inspection. The registered manager should complete an appropriate management qualification. The views of families, friends, visiting professionals and other stakeholders, as to the home’s overall performance, should be sought. Granby Lodge DS0000063528.V267955.R01.S.doc Version 5.0 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 Lodge DS0000063528.V267955.R01.S.doc Version 5.0 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. 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