Inspection on 12/12/06 for Granby Lodge

This inspection was carried out on 12th December 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

Granby Lodge 12/12/05

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 Irene Ward Key Unannounced Inspection 12th December 2006 09:00 DS0000063528.V323682.R01.S.doc Version 5.2 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 DS0000063528.V323682.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 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. DS0000063528.V323682.R01.S.doc Version 5.2 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 DS0000063528.V323682.R01.S.doc Version 5.2 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. Date of last inspection 12th December 2005 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. The weekly fees on 12th December 2006 range from £365 to £800 and do not include costs for newspapers, magazines and leisure activities. This information was supplied to the Commission For Social Care Inspection via the pre-inspection questionnaire received on the 6th October 2006. Service users/relatives and other interested parties are able to have access to inspection reports by requesting them from the home. DS0000063528.V323682.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This report follows an unannounced site visit carried out on the 12th December 2006. This visit was carried out by one Regulation Inspector and started at 09.00 hrs and finished at 15.30 hrs with 2 hours preparation time. The inspection process included information provided by the home prior to inspection. Surveys were also sent to relatives and friends and health and social care professionals. Seventeen surveys had been sent and four surveys have been returned to the Commission for Social Care Inspection. All of which were very positive about the overall care provided by the home. The site visit comprised of a full inspection of the premises, which included some service users private accommodation. The care records of four service users were looked, which included service users assessments, care plans and medication records. Staff rotas and health and safety documentation were inspected. Time was spent observing activity in the home and interaction between service users and staff, talking and listening to service users and one relative visiting the home. Time was also spent talking to members of staff. The focus of the inspection was a number of key standards, inspecting the case records of service users in detail to establish if they corresponded with service users experiences in the home. The registered manager who is also one of the registered providers was available throughout the day. There were no requirements outstanding from previous inspections. One requirement was made regarding the reporting of accidents and any other events that affect service users living at the home. One recommendation was made for the home to improve on their quality monitoring systems. The last unannounced inspection was carried out on the 12th December 2005. What the service does well: The staff provide a clean, warm and comfortable home for service user to live in. The home provides good care for service users and supports them to maintain their independence. DS0000063528.V323682.R01.S.doc Version 5.2 Page 6 Members of staff were observed to provide appropriate care when supporting service users in maintaining their independence in daily tasks. One service user said, “The staff look after us really well”. Comments from relatives/visitors were all positive. Relatives made comments such as “the home has nice staff and the manager sets a high standard”. What has improved since 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. The summary of this inspection report can be made available in other formats on request. DS0000063528.V323682.R01.S.doc Version 5.2 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 DS0000063528.V323682.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 2. Quality in this outcome area is good. Service users needs are properly assessed prior to admission. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The manager confirmed that a service user guide is sent to all service users/relatives when making an enquiry about the home. The Statement of Purpose and the Service User Guide has been reviewed and updated. Pre-admission assessments are in place and held on service users individual files. A care needs assessment from local authorities was also in place where necessary. Four service users files were looked at. All files held initial assessments, care plans and risk assessments. Contracts /terms and conditions of residency seen had been signed and agreed with service users or their representatives. DS0000063528.V323682.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7 and 9. Quality in this outcome area is excellent. The care provided to service users’ was good and encouraged service users’ to make their own decisions about how they lived their lives. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Whilst staff were supporting service users during the morning it was clear that they understood individuals needs. They supported people sensitively and supported people to make choices. Service users’ looked well cared for and some made comments about the care they received. One service user who has lived at the home for a long time said, “I still like being here” whilst another said, ”the residents are nice to live with and there is a nice set of staff”. DS0000063528.V323682.R01.S.doc Version 5.2 Page 10 The care plans of four service users’ were looked at. These detailed how needs had been assessed and what actions were needed to meet the identified needs. Individual risk assessments, which were clear and well detailed, had been carried out to promote independence and safety. The care plans contained detailed information about service users, which helped staff to know about the service users’ preferences about how they wished to live their life. Through discussion with staff and the contents of the care plans it was clear that service users are able to make clear choices. Service users plans are written with service users and reviewed regularly. Granby Lodge provides support and care to service users with diverse age and need. The care home has tailored service users care plans to take this into account. Service user plans contain information about every aspect of the service user’s life including areas for developing new skills. DS0000063528.V323682.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 15, 16 and 17. Quality in this outcome area is good. Service users are supported to lead full and active lives This judgement has been made using available evidence including a visit to this service. EVIDENCE: Service users are in paid or voluntary employment and several attend a local college. Service users’ also have opportunities to pursue other interests outside of the home. A number of them enjoy visits to pubs, clubs, theatre, quizzes, visits to a fair and circus and any other activities available to Harrogate residents. One service user said that they go Scuba Diving in Ripon. Service users said they enjoy a variety of activities in the home such as board games in the conservatory and karaoke. One service user said he enjoyed playing the drums as he has a drum kit in his own room. The staff at the home support service users to access a variety of pursuits and interests. DS0000063528.V323682.R01.S.doc Version 5.2 Page 12 There was written information in service user plans about how service users spend their days and these arrangements are discussed with service user representatives and staff. Details about family, friends and significant events are recorded in service user plans. Examples of how service users are supported to maintain relationships with family and friends were given. There was opportunity to speak with a visiting relative who said, “Granby Lodge is an excellent home, the staff are nice and the manager has everyone’s interest at heart”. Menus provided detail of variety and choice. Service users all said that the food at the home was very good. Staff have completed the food hygiene training. DS0000063528.V323682.R01.S.doc Version 5.2 Page 13 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. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19 and 20. Quality in this outcome area is good. Service users’ personal and healthcare is provided appropriately and sensitively according to individual needs. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Staff aimed to promote the independence of the service users’ and to provide support in a sensitive manner. Service users’ preferences as to how they wished to be supported were recorded within individual care plans. Each service user had a GP and access to chiropody, dental and optical services and referrals were made to specialist services as appropriate. The manager also reported good relationships with the local GP practice, district nurse and the neurologist who encourage staff to advise them in their approach with service users to ensure service users health needs are met. Daily record entries reflected the care that was being provided. DS0000063528.V323682.R01.S.doc Version 5.2 Page 14 None of the residents is able to take their own medication. The home has a monitored dosage system in place. There is a policy in place for the storage and administration of medication. The Medication Administration Records were up to date and well maintained. Medication was securely stored in a locked cabinet. All staff are in the process of undertaking accredited training. The home does not hold any controlled drugs. DS0000063528.V323682.R01.S.doc Version 5.2 Page 15 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. JUDGEMENT – we looked at outcomes for the following standard(s): 22 and 23. Quality in this outcome area is good. Service users have access to an effective complaints procedure and are protected from harm. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Service users are provided with a complaints procedure. Service users who are able to read and understand how to make a complaint are able to do so. However some service users would not understand a complaints procedure. Whether it was produced pictorially, symbols in large print or on audiotape they would not understand it. Therefore because of the complexity of service users needs and difficulties with communication it is unlikely that a service user would make a complaint in the usual manner. Staff, therefore, need to have the skills to interpret service users behaviours to identify whether they are unhappy about something. No complaints have been received by the home or the Commission for Social Care Inspection. There is a comprehensive policy and procedure with regard to adult protection and staff have a good awareness of this. Staff receive training in adult protection issues during induction and foundation training and as part of NVQ level 2. DS0000063528.V323682.R01.S.doc Version 5.2 Page 16 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. JUDGEMENT – we looked at outcomes for the following standard(s): 24 and 30. Quality in this outcome area is good. Service users live in a clean, comfortable and safe home. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home continues to be well maintained. 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. DS0000063528.V323682.R01.S.doc Version 5.2 Page 17 A good standard of cleanliness is maintained throughout. A range of maintenance checks is completed on a regular basis to make sure that the house is safe and secure. DS0000063528.V323682.R01.S.doc Version 5.2 Page 18 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. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 34 and 35. Quality in this outcome area is good. Sufficient staffing levels, proper recruitment procedures and good staff training meant that service users’ needs were met and their interests were safeguarded. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Staffing levels were sufficient for meeting the needs of the service users’. The duty roster showed that there is always a minimum of two members of staff on duty throughout the day. However when service users are at home and at peak times such as evenings and weekends staffing would be increased, as staff rotas are based around what service users are doing. This makes sure that service users social activities are not compromised. At night there is one member of staff on waking night and one doing sleep-in duties. The staff files of three members of the staff team were looked at including those of one recently appointed member of staff. These showed that all the DS0000063528.V323682.R01.S.doc Version 5.2 Page 19 necessary pre-employment checks had been carried out prior to the new workers starting in post. The manager completes a training needs analysis annually. Staff training records examined showed a good training programme. Staff have undertaken training in health and safety, moving and handling, emergency aid and basic food hygiene. Eight of the staff have completed NVQ Level 2. The registered manager holds NVQ Level 4 Registered Managers Award. Staff confirmed in discussions held with them that they received regular supervision and regular staff meetings are held. Records of supervision were seen at the site visit to the home. Every staff member talked to say that there is high staff morale within the home and the best things about Granby Lodge is “the really good interaction between service users and staff”. DS0000063528.V323682.R01.S.doc Version 5.2 Page 20 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. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39 and 42. Quality in this outcome area is good. The residents benefit from a well managed home in which their needs and wishes are put first. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Information provided from the pre-inspection questionnaire and the examination of selected health and safety documents show that regular checks to hot water delivery, electricity and gas and fire safety equipment are regularly undertaken. The home has had door-guards fitted to the fire doors that are kept open. The fire doors now close when the fire alarm is activated. All accidents are recorded and are held on individual service users and staff files. However accidents have not been reported to the Commission as DS0000063528.V323682.R01.S.doc Version 5.2 Page 21 required by regulation. This was discussed with the registered manager who agreed that this would be done in future. The home has a good and effective management team in place. The ethos of the home is open and positive. Service users and relatives all commented highly about the home. Staff confirmed that staff supervision and annual appraisals is carried out. Records were held on the three staff files seen. 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. The manager said that she is in the process of developing a questionnaire that will be sent sometime in the New Year to relatives and other interested parties. DS0000063528.V323682.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 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 Standard No Score 1 X 2 3 3 X 4 X 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 3 25 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 X 34 3 35 3 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 4 4 3 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 X 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 3 X 2 X X 3 X DS0000063528.V323682.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 *RQN Regulation 37 (1) Requirement The registered person must notify the Commission any occurrence such as accidents, illness, death and any other event that affects the well-being or safety of any service user. Timescale for action 12/12/06 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard YA39 Good Practice Recommendations The views of families, friends, visiting professionals and other stakeholders, as to the home’s overall performance, should be sought. 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