Inspection on 20/07/06 for Granby Place

This inspection was carried out on 20th July 2006.

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 there to be outstanding requirements from the previous inspection report. These are things the inspector asked to be changed, but found they had not done. The inspector also made 9 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Granby Place 15/01/09

Granby Place 17/01/08

Granby Place 24/07/07

Granby Place 08/11/05

Granby Place 16/07/05

Granby Place 08/11/04

Similar services:

Insight - Eastchurch

Southfields

Thorndene

Magenta

Seabourne House

33 St John`s Church Road

Dovedale Court

Lyncol House

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

CARE HOME ADULTS 18-65 Granby Place 1-3 High Street Northfleet Gravesend Kent DA11 9EY Lead Inspector Helen Martin Unannounced Inspection 20th July 2006 14:30 Granby Place DS0000059719.V295824.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 Granby Place DS0000059719.V295824.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. Granby Place DS0000059719.V295824.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Granby Place Address 1-3 High Street Northfleet Gravesend Kent DA11 9EY 01474 326233 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) DGSM Limited Mrs Rae Sayers Care Home 10 Category(ies) of Learning disability (10) registration, with number of places Granby Place DS0000059719.V295824.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. Two of the 10 service users also have mental health difficulties Ages will be from 45 years of age and above 8th November 2005 Date of last inspection Brief Description of the Service: Granby Place provides accommodation and support for up to 10 people with learning disabilities who are forty-five years of age or above. Currently there is a condition of registration for two residents who also have mental health difficulties. The home is one of four services, within the area, provided by DGSM Limited. The building is owned by a housing association. Granby Place is located in Northfleet High Street and is within easy reach of public transport and all the usual town amenities. Residents have single bedrooms which are located on the ground and first floor. There are two lounge areas, a dining room and a visitors’ room. There is a garden to the rear of the property with car parking facilities. The home employs support workers, operating a roster, which gives 24-hour cover. There is one member of staff who ‘sleeps-in’ at night with on-call cover. The home does not employ specific staff for catering or domestic duties. Current fees for the home are £621.90 per week. Full information about the fees payable and the service the home provides, including inspection reports by the CSCI, are available from the manager. Granby Place DS0000059719.V295824.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This site visit for an unannounced key inspection took place on 20th July 2006. The visit included talking with senior support workers, support workers and residents. The manager was present for some of the occasion. Some judgements about the quality of life within the home were taken from observation and conversations. Some records were looked at. In addition, a tour of the home and garden was undertaken. Residents were happy to talk to the inspector about their life in the home. Postal surveys have been received from six residents and three relatives of residents and this information has been included within the report where appropriate. Granby Place currently has nine residents with one vacancy due to be filled shortly. What the service does well: Granby Place has provided a stable service for the same group of residents for a number of years. Prospective residents are able to ensure that their needs can be met through assessment and the opportunity to visit the home. Residents enjoy living in a clean, comfortable and homely environment. They benefit from a well run home with an open and inclusive atmosphere. Residents are treated with respect. They are supported to make their own choices. Residents enjoy individual lifestyles, which include opportunities for social, educational and recreational experiences. They are able to see their family and friends as often as they wish. A sufficient number of staff are provided, who have a good understanding of individuals’ needs. Residents benefit from support which meets their individual needs and respects their privacy and dignity. Residents’ views and concerns are listened to and they benefit from written complaint information that they can easily understand. Residents are protected from potential abuse. When asked ‘What’s good about living at your home?’ comments from residents who filled in postal surveys included ‘(I) like living here’, ‘(I am) well looked after’, ‘the staff are very kind (and) caring, they will help at any time’, ‘being safe’. Comments received from relatives included ‘I am entirely satisfied with the quality of care my…(relative) receives…’, …(my relative) is looked after in every way at all times, I am so pleased (by) the way the staff look after…(my relative)’, ‘(the) home (is) so clean and tidy, food (is) absolutely first class, care and attentions (is) wonderful, my…(relative) has a new lease of life, super staff’. Granby Place DS0000059719.V295824.R01.S.doc Version 5.2 Page 6 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. Granby Place DS0000059719.V295824.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 Granby Place DS0000059719.V295824.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 2, 3, 4, 5 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Prospective residents are able to ensure that their needs can be met through assessment and the opportunity to visit the home. They would benefit from additional easily understood information before they decide to move in. EVIDENCE: Prospective residents are provided with information prior to their admission regarding the home. The document combines the statement of purpose and the service users’ guide. All of the required information is provided with the exception of terms and conditions of accommodation and a copy of a standard contract. Information is not available in a format that is easily understood by residents. Residents benefit from an assessment prior to their admission to the home, to ensure that their needs can be met. Records seen contained good detail. The manager demonstrated a good understanding of the individual and specialist needs of residents. Prospective residents have the opportunity to stay at the home before they decide to move in. It was mentioned that one individual due to move in shortly Granby Place DS0000059719.V295824.R01.S.doc Version 5.2 Page 9 knows the home well as they have been for visits and stayed; they know the other residents as they attend the same day centres. Previous inspection identified that the manager undertook to review the current personal contract and to have a revised contract available for any new residents. This inspection identified that not all aspects of standard 5 were included. Granby Place DS0000059719.V295824.R01.S.doc Version 5.2 Page 10 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, 9, Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Residents are supported to make their own choices. Their changing needs would be better reflected by continued improvements to the systems for care planning and risk assessment. EVIDENCE: The home continues to be in the process of reviewing the format and information contained within all residents’ care plans. Newer documentation seen was detailed and holistic in nature and reflected residents’ changing needs and goals. Care plans not yet reviewed contain little information, some of which is not updated. Care plan reviews seen were recorded and in date. Daily notes are recorded in individual books, although not all entries are signed by staff. Residents are supported to take risks as part of maximising their independence, although it continues to be the case that some activities are not recorded. Many risk assessments seen were undated. Granby Place DS0000059719.V295824.R01.S.doc Version 5.2 Page 11 Residents are encouraged to make choices. Residents receive continuity of care by having individual key workers. Residents are encouraged to participate as much as possible in all aspects of life within the home. Residents’ meetings are held regularly where there is the opportunity to talk about any issues including holidays and choice of food. Granby Place DS0000059719.V295824.R01.S.doc Version 5.2 Page 12 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): 11, 12, 13, 14, 15, 16, 17 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents enjoy individual lifestyles, which include opportunities for social, educational and recreational experiences. They would benefit from the cost of their holidays being included within their contract price. EVIDENCE: Residents are supported towards independent living skills, dependant on their capacity, and also have the opportunity for personal, emotional and social development. Residents are treated as individuals who have different interests and aspirations. Activities and development opportunities are provided accordingly and recorded within care plans. Residents are part of the local community. During weekdays some residents enjoy attending day centres, participating in social events, activities that personally interest them or to further develop their life skills. The day centres provide transport. One resident has been in paid full time employment for Granby Place DS0000059719.V295824.R01.S.doc Version 5.2 Page 13 some years and is able to travel to and from the home independently using public transport. Another resident is currently undertaking a college course. Residents spend time at the home in the evening, weekends and on the days when they do not attend day centres or work. Their individual interests are encouraged and these are in evidence. Residents are encouraged with shopping, cooking, cleaning and laundry tasks wherever possible. Residents have access to the home’s garden. Residents are able to see their family and friends as often as they wish. Individuals can visit the home at any reasonable time and can be received in private, either in residents’ rooms or the designated visitor’s room. Some residents visit their families on occasions. Residents have been able to maintain friendships outside of the home. It was said that all residents enjoy holidays with the exception of two, one of which prefers day trips out. Holidays have included the Edinburgh Tattoo and a 40s weekend. The organisation pays for staff costs but does not pay for the resident. Residents enjoy privacy in their rooms and staff respect this. Staff talk to residents in a friendly and polite way. Residents choose what they would like to eat during residents’ meetings and a written menu is developed from this. Support workers demonstrated a good understanding of individuals’ likes and dislikes. It was mentioned that residents could have snacks and drinks at any time. A record of food consumed by residents is kept. Granby Place DS0000059719.V295824.R01.S.doc Version 5.2 Page 14 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, 20, Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents benefit from support which meets their individual needs and respects their privacy and dignity. They would be better protected by improvements to the system for the administration of medication. EVIDENCE: Residents are given the personal support they need to maximise their independence, while respecting their dignity and privacy. Residents are able to exercise choice. They have individual clothing and hairstyles. Staff have an understanding of the preferred routines of each resident. Residents have access to health care professionals. They are supported with appointments. Health care records are contained within care plans. No residents currently keep their own medication. Arrangements are in place for the storage and administration of medication. All records are maintained appropriately with the exception of some hand written administration records. These were not countersigned by a second member of staff or confirmed in writing by a prescribing GP. Records for the return of unwanted medication to Granby Place DS0000059719.V295824.R01.S.doc Version 5.2 Page 15 the pharmacy were not present within the home. The manager stated that all staff were trained and assessed as competent to administer medication and a record was kept of signatures. The home provides recent reference material but has not obtained a copy of the Royal Pharmaceutical Society Guidelines for the Administration of Medication within a Care Home. Granby Place DS0000059719.V295824.R01.S.doc Version 5.2 Page 16 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, 23 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents’ views and concerns are listened to and they benefit from written complaint information that they can easily understand. Residents are protected from potential abuse. EVIDENCE: Residents are at ease talking with staff who listen to their views and concerns. The manager said that no complaints had been received by the home, although should this be the case, these would be taken seriously, acted upon and recorded. The home provides a written complaints procedure. This is also provided in a format that residents can easily understand. It was said that this was in the process of updating. Residents are protected from potential abuse by the procedures in place within the home. Written policies and procedures were available for staff. The manager demonstrated a good understanding of adult protection procedures. The home has a system in place, which aims to protect the financial interests of residents and holds small amounts of cash on their behalf. This is kept securely. All money is stored individually and appropriate transaction records are maintained. Cash checked tallied with accounts seen. Receipts were seen for purchases made on residents’ behalf. The manager said that no one within the organisation was an appointee for any resident. Granby Place DS0000059719.V295824.R01.S.doc Version 5.2 Page 17 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, 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents benefit from living in a clean, comfortable and homely environment. This would be enhanced by some additional repairs and replacement. EVIDENCE: The building fits in with the local community and has a style and atmosphere that meets individuals’ needs. Residents are able to go anywhere in the house and garden. The back garden is tidy and attractive and a broken fence has now been repaired. There are plans to provide a sensory garden. Since the last inspection the security of the car park and back garden has been improved by the provision of a locked gate to the service road leading to the main road. Residents benefit from living in a clean, comfortable and homely environment. The house is maintained and decorated by Hyde Housing Association. Since the last inspection, new carpet has been provided for the upstairs corridor. The flooring in the dining room is old and worn and is in need of replacement. Granby Place DS0000059719.V295824.R01.S.doc Version 5.2 Page 18 Adequate recreational, dining, toilet, bathing and individual accommodation are available to residents. The home provides two lounge areas, a conservatory and a visitors’ room. All residents have their own rooms, which are on the ground and first floor. Residents clearly like their rooms, which are all individual and highly personalised. They are able to choose the colour schemes and how their furniture should be arranged. The manager said that all residents’ bedrooms are now provided with washbasins with the exception of one. It was stated that although the home was able to supply this, the resident concerned refused. The manager mentioned that a recorded risk assessment would be undertaken to include the resident, their relatives, representatives and care manager. Since the last inspection, the suitability of armchairs for individual residents has been reviewed and new chairs have been provided where necessary. The manager described plans for the re-decoration of one resident’s room, which included the provision of a bed head. A hoist is available for residents who need assistance with bathing. The inspector was assured that the layout of the home did not cause any problems for two residents with some mobility problems. The first floor is not served by a shaft or stair lift. The home has a staff call system; although staff call points are not contained within the bathroom with the hoist or in the television room. Granby Place DS0000059719.V295824.R01.S.doc Version 5.2 Page 19 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): 31, 32, 33, 34, 35, 36 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Residents benefit from a sufficient number of staff who have a good understanding of their needs. Residents would be better protected by improvements to the systems for staff training and qualification. EVIDENCE: Staff showed a good understanding of residents’ needs and the home’s philosophy and values. Residents benefit from good support and interaction. Induction training for staff is provided, although records seen are in brief detail. The manager said that Learning Disabilities Award Framework induction and foundation training is in the process of introduction. The manager will undertake an assessor’s course. Although some staff have undertaken specific training in learning disabilities, most have not. Training certificates are kept in staff files. It was evident that although some courses had been updated, some had not. It was not possible to fully assess whether all staff had undertaken appropriate updated courses as the training matrix was not kept within the home but maintained centrally by the organisation. Staff training continues to need review to ensure that the needs of residents are fully met. Granby Place DS0000059719.V295824.R01.S.doc Version 5.2 Page 20 The manager stated that currently one support worker was qualified to NVQ level 3 with a further two to NVQ level 2. There is a total staff team of nine. It was mentioned that a further individual is part way through an NVQ level 3. Previous inspection identified problems for members of staff undertaking an inhouse assessed NVQ scheme and no progress has been made. It continues to be the case that in-house support and assessment has been withdrawn with no replacement provided. This had led to an interruption of study and uncertainty about verification of previous work for the staff concerned. The manager stated that staff undertook regular recorded one-to-one supervision. Records were seen. At the time of the site visit, the number of staff on duty met residents’ needs. There are usually two staff provided during the day with one ‘sleeping-in’ at night. Staffing hours are recorded on a roster and arrangements are in place for on-call back up. The manager works with the direct care of residents and has some ‘supernumerary’ days for management and administration. Staff support residents with cooking, cleaning and laundry tasks wherever possible, although one ancillary member of staff is provided for laundry tasks. A procedure is in place to ensure that the home appoints suitable staff who can support the needs of residents. Staff files seen evidenced that pre-employment checks had been undertaken, including a criminal records bureau check, proof of identity and written references. Granby Place DS0000059719.V295824.R01.S.doc Version 5.2 Page 21 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, 40, 41, 42 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Residents benefit from a well run home with an open and inclusive atmosphere. Their interests would be better promoted by a qualified manager and a review of quality assurance, policies and procedures and record keeping. EVIDENCE: The manager has completed an NVQ level 4 in care and is currently undertaking the Registered Manager’s Award, which is due to be completed by September 2006. The manager works with the direct care of residents in addition to ‘supernumerary’ days for management and administration. There is an open and inclusive atmosphere in the home. Residents are comfortable chatting and spending time with staff. Residents’ meetings are held regularly. Granby Place DS0000059719.V295824.R01.S.doc Version 5.2 Page 22 The manager described the system for quality assurance within the organisation. The home receives feedback from the organisation following meetings centrally. It was evident that this system is in the process of development as it does not yet include formally seeking views of the service from residents, their representatives or health and social care professionals. The Commission continues not to have received any reports from the home regarding reviews of quality of care. The home has a range of recorded policies and procedures that are available for staff. Since the last inspection the majority of these have been updated by the organisation with a remaining few currently in the process of review. Records have been mentioned where appropriate previously within this report. Since the last inspection hot food temperatures have been recorded. The home’s accident and incident book continues to need updating to a newer format that preserves confidentiality. Accidents and incidents are recorded within care plans and daily notes, although one entry seen was not contained within the accident and incident book. Records and certificates indicated the regular testing and maintenance of systems and equipment within the home. Individual environmental risk assessments are undertaken for each resident. A fire drill was undertaken on the day of the site visit. It was mentioned that these were undertaken on a regular basis. Two of the home’s four external doors are alarmed and locked at night. The manager assured the inspector that there was a system in place regarding locked fire exits at night, which would not impede escape in the event of fire. The manager also assured the inspector that a previous fire exit route through a first floor resident’s room was no longer used. It was said that arrangements were agreeable to the fire authority. Granby Place DS0000059719.V295824.R01.S.doc Version 5.2 Page 23 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 2 2 3 3 3 4 3 5 2 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 2 25 2 26 2 27 3 28 3 29 2 30 3 STAFFING Standard No Score 31 3 32 2 33 3 34 2 35 2 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 2 3 3 2 X LIFESTYLES Standard No Score 11 3 12 3 13 3 14 2 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 2 X 2 3 2 2 2 3 X Granby Place DS0000059719.V295824.R01.S.doc Version 5.2 Page 24 Are there any outstanding requirements from the last inspection? Yes 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 YA1 Regulation 4&5 Requirement The registered person shall compile a statement of purpose and produce a service users’ guide in relation to the care home. In that, the document combing the statement of purpose and service users’ guide must include terms and conditions of accommodation and a standard form of contract. This requirement has been repeated from inspection dated 16th July 2005 and 7th November 2005. 2 YA6 YA41 12 & 15 The registered person shall ensure that the home promotes the health and welfare of service users and provides a written care plan as to how these needs are to be met. In that, updated care plans must be provided for each resident. All documents must be kept up to date and completed with sufficient detail. Granby Place DS0000059719.V295824.R01.S.doc Version 5.2 Page 25 Timescale for action 06/10/06 06/10/06 This requirement has been repeated from inspection dated 20th July 2005 and 7th November 2005. 3 YA20 13(2) The registered person shall make arrangements for the recording, handling, safekeeping, safe administration and disposal of medicenes received into the care home. In that, a record of medication returned to the supplying pharmacy must be kept within the home. 4 YA35 18(1)(c)(i) The registered person shall ensure that staff working at the home receive training appropriate to the work they are to perform. In that, a review must be undertaken to ensure that appropriate training is provided to meet the needs of all residents. This requirement has been repeated from inspection dated 7th November 2005. 5 YA35 YA41 17(2)(3) Sch 4 The registered person shall maintain in the care home the records specified in Schedule 4: ‘A record of all training undertaken, including induction training’ The registered person shall ensure that these records are kept up to date and are at all times available for inspection by any person authorised by the Commission to enter and inspect Granby Place DS0000059719.V295824.R01.S.doc Version 5.2 Page 26 06/10/06 06/10/06 06/10/06 the care home. In that, the staff training matrix was not kept within the home but maintained centrally by the organisation. Staff training records must be held within the home and be available for inspection by the Commission. 6 YA32 18 (2) The registered person shall ensure that persons working in the care home are appropriately supervised. In that, whilst it is acknowledged that a process is in operation, supervision must ensure that all the training needs of staff are identified, such as the necessary provision of assessment for NVQ qualifications. This requirement has been repeated from inspection dated 16th July 2005 and 7th November 2005. 7 YA39 24 06/10/06 The registered person shall establish and maintain a system for reviewing and improving the quality of care at the home. The registered person shall supply to the Commission a report in respect of any review conducted. In that, the system for quality assurance within the home must be developed as it does not yet include formally seeking views of the service from residents, their representatives or health and social care professionals. The Commission continues not to have received any reports from the home regarding reviews of quality of care. These must be Granby Place DS0000059719.V295824.R01.S.doc Version 5.2 Page 27 06/10/06 supplied. This requirement has been repeated from inspection dated 16th July 2005 and 7th November 2005. 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 YA1 Good Practice Recommendations It is recommended that the combined statement of purpose and service users’ guide should be available in a format that is easily understood by residents. It is recommended that the personal contracts for new residents are reviewed and, if necessary, updated so that the contracts reflect the reasons why the service user is receiving residential care. In that, residents’ contracts should be reviewed to ensure that all aspects of standard 5 are included. This recommendation has been repeated from inspection dated 16th July 2005 and 7th November 2005. 3 4 YA6 YA9 It is strongly recommended that staff sign all entries in residents’ daily notes. It is strongly recommended that, with regard to risk assessments: 1. All risk assessments should be recorded where necessary. 2. All recorded risk assessments should be dated. 5 YA14 It is recommended that residents have the option of a minimum seven-day annual holiday outside of the home, included within the basic contract price. DS0000059719.V295824.R01.S.doc Version 5.2 Page 28 2 YA5 Granby Place In that, the organisation continues to pay for staffing costs but not for residents. This recommendation has been repeated from inspection dated 7th November 2005. 6 YA20 It is strongly recommended that, with regard to medication: 1. All hand written entries in Medication Administration Record sheets should be countersigned as correct by a second member of staff and confirmed in writing by the prescribing GP. 2. The home should obtain a copy of the latest Royal Pharmaceutical Society Guidelines for the Administration of Medication within a Care Home. 7 8 9 YA24 YA25 YA26 It is recommended that the old, worn flooring in the dining room should be replaced. It is recommended that all residents should be provided with bed heads. It is strongly recommended that all residents’ bedrooms should be provided with a washbasin. In that, the manager said that all residents’ bedrooms are now provided with washbasins with the exception of one. It was stated that although the home was able to supply this, the resident concerned refused. The manager mentioned that a recorded risk assessment would be undertaken to include the resident, their relatives, representatives and care manager. This issue has been repeated from inspection dated 7th November 2005. 10 YA29 It is strongly recommended that a review should be undertaken to ensure that adequate staff call points are provided where necessary within the home. It is recommended that a minimum of 50 of the staff team should complete an NVQ level 2 qualification as soon as possible. In that, currently three out of nine staff are qualified to Granby Place DS0000059719.V295824.R01.S.doc Version 5.2 Page 29 11 YA32 NVQ level 2 or equivalent. This issue has been repeated from inspection dated 7th November 2005. 12 YA34 It is strongly recommended that, with regard to staff recruitment files: The application form should contain the facility for the selfdisclosure of any police cautions. In that, this was not assessed on this occasion. This issue has been repeated from inspection dated 7th November 2005. 13 YA35 It is recommended that the home’s recorded induction training should comply with LDAF specifications. In that, the home’s induction record continues to be recorded in brief detail. This issue has been repeated from inspection dated 7th November 2005. 14 YA37 It is strongly recommended that the manager complete their stated intention to finish their Registered Manager’s Award course by September 2006. It is recommended that the organisation complete the review of policies and procedures to ensure that they are up to date and specific to the home. It is recommended that, with regard to record keeping: 1. The home should obtain an updated format for the recording of accidents and incidents that preserves confidentiality. In that, the home’s accident and incident book continues to need updating to a newer format that preserves confidentiality. This issue has been repeated from inspection dated 7th November 2005. 2. All recorded accidents and incidents should be contained within the designated accident and Granby Place DS0000059719.V295824.R01.S.doc Version 5.2 Page 30 15 YA40 16 YA41 incident book in addition to care plans. Granby Place DS0000059719.V295824.R01.S.doc Version 5.2 Page 31 Commission for Social Care Inspection Maidstone Local Office The Oast Hermitage Court Hermitage Lane Maidstone ME16 9NT 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 Place DS0000059719.V295824.R01.S.doc Version 5.2 Page 32 - 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!