Inspection on 04/10/05 for Granby Rose SDU

This inspection was carried out on 4th October 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Granby Rose SDU 16/05/07

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

CARE HOMES FOR OLDER PEOPLE Granby Rose SDU Highgate Park Harrogate North Yorkshire HG1 4SR Lead Inspector David White Unannounced Inspection 4th October 2005 09:30 X10015.doc Version 1.40 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 Rose SDU DS0000065470.V257709.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 Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Granby Rose SDU DS0000065470.V257709.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Granby Rose SDU Address Highgate Park Harrogate North Yorkshire HG1 4SR 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) 01423 505533 01423 562831 Granby Holdings Limited Mrs Bernadette Mossman Care Home 25 Category(ies) of Dementia - over 65 years of age (25) registration, with number of places Granby Rose SDU DS0000065470.V257709.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection Brief Description of the Service: Granby Rose is a care home for up to 25 people with dementia. The home is situated close to Granby Court and Granby Extended Care, and close to the town centre of Harrogate. The home is purpose built to the highest standards of practice in caring and supporting people with dementia. The home supports clients and their families in coping with dementia, to live an independent and dignified life. Granby Rose SDU DS0000065470.V257709.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place over 4 hours. Three clients, a relative, two members of care staff and the registered manager were spoken to. The care records of three clients were looked at as well as other documentation and the inspector looked around the environment. What the service does well: All the clients said that the “care was very good and the staff are always helpful and polite”. Staff encourage clients to make their own choices and maintain their independence. Clients said that they enjoy the quality of the home’s living environment that is spacious, exceptionally clean and well maintained. Clients enjoy a range of activities. Thorough pre-admission procedures mean that clients are only admitted if the home is able to meet their needs. Care planning documentation is good taking into account the client and their families wishes and preferences about how the client is to be cared for. Clients receive a high standard of care from well-trained staff. Clients, relatives and staff feel that the management of the home is very good. A relative said that the registered manager was “brilliant”. The home continually looks at ways of improving services through a number of systems that seek the views of clients, relatives and others. Granby Rose SDU DS0000065470.V257709.R01.S.doc Version 5.0 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 Rose SDU DS0000065470.V257709.R01.S.doc Version 5.0 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Granby Rose SDU DS0000065470.V257709.R01.S.doc Version 5.0 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 3 and 6 Clients and their families are aware of the care, services and facilities provided by the home and can feel confident that their needs will be understood and met by the home’s staff. EVIDENCE: Prospective clients and their relatives are given information about the home prior to admission. Clients and relatives are invited to the home for a meal and a visit prior to making a decision about moving into the home. The admission procedure is very thorough and this makes sure that clients are properly assessed and that staff are fully aware of their needs. The registered manager or her deputy carries out pre-admission assessments and information is gathered from other sources such as GPs as part of the assessment process. Any risks are identified as part of the pre-admission process. The home does not provide intermediate care. Staff spoken to have a good understanding of the needs of the clients and receive a wide range of training specific to the needs of the clients in their care. Granby Rose SDU DS0000065470.V257709.R01.S.doc Version 5.0 Page 9 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 and 10 The care planning documentation is informative and detailed so providing staff with the information to be able to care for the clients. Risk assessment strategies are in place to promote the independence and safety of clients. EVIDENCE: The care plans of three clients were looked at. Care planning documentation was good and contained detailed information that specified the needs of each client and how these were to be met. Risk assessments are in place regarding the prevention of pressure sores, to reduce risks from falling, nutrition and mental health. The mental health assessment is initially carried out as part of the pre-admission process and is regularly reviewed. One care plan inspected was that of a client who was at risk of falling. This care plan was particularly impressive in stating how the home had adopted a positive risk taking approach to the possibility of the client falling. This approach was used as a result of discussions between the client, his wife and the staff team taking into account the client’s personal wishes about how he wanted to be supported with his mobility despite the potential risks. Daily records were up to date and reflected the care being provided and any involvement from other health professionals was clearly recorded. A chiropodist makes regular visits to the Granby Rose SDU DS0000065470.V257709.R01.S.doc Version 5.0 Page 10 home and clients have access when needed to GPs and dental services. Care plans are reviewed regularly and encourage the involvement of the family and other health professionals. Staff said that handover periods take place between shifts so that information can be passed on. All the staff spoken to had a good knowledge and understanding of the needs of the clients. Proper medication procedures were in place for the administration, recording, storing and disposal of medication. The Medication Administration Records inspected were accurate and up to date. Granby Rose SDU DS0000065470.V257709.R01.S.doc Version 5.0 Page 11 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 and 15 Clients enjoy an excellent range of activities both in and out of the home. Continuing contact with family and friends is encouraged by flexible visiting times. The meals provided are of good quality and to suit different tastes. EVIDENCE: The emphasis of care is in maintaining the independence and individuality of the clients. Clients are encouraged to make their own choices about their daily routines. The home has an activities person who provides a range of activities that includes one to one activities. As well as in-house activities such as baking and flower arranging, the home has visits from entertainers and takes clients on trips out. Clients said that the activities help to keep their minds active and one said “it is good because you do not have to join in if you don’t want to”. One client said “it is nice that staff have time to sit down and talk to you”. Visiting times are flexible so that clients can see relatives and friends at any reasonable time. A relative spoken to said that he was always made to feel welcome by “friendly and courteous staff”. He also said that he was kept fully up to date with the client’s progress, is informed of any changes to their care and is invited to care plan reviews. Granby Rose SDU DS0000065470.V257709.R01.S.doc Version 5.0 Page 12 Clients spoken to said that they fully enjoyed the meals and felt that there was enough choice at mealtimes. One said the food was “marvellous” and a relative had also observed that the quality of the food was good. The menus are varied to suit all tastes with attention to individually assessed nutritional requirements. Staff provide support for clients who need assistance with eating. Granby Rose SDU DS0000065470.V257709.R01.S.doc Version 5.0 Page 13 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18 All complaints and concerns are dealt with appropriately and abuse policies and procedures safeguard client wellbeing. EVIDENCE: The home has a complaints policies and procedure which clients, relatives and other visitors have access to. The complaints records held by the home contain information about the nature of the complaint, investigations undertaken and actions taken. Clients and a relative spoken to were aware of who they would talk to if they had any concerns. Adult protection policies and procedures are in place and staff are given adult abuse training within induction. The training manager for the home and another member of staff will be attending a two-day course on issues specifically relating to adult protection and this training will be then given to the other members of care staff at the home. Since the previous inspection there had been one alleged incident of abuse and correct procedures had been followed by the management of the home. Granby Rose SDU DS0000065470.V257709.R01.S.doc Version 5.0 Page 14 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19 and 26 The home is exceptionally clean and well maintained so creating a very comfortable and pleasant environment for clients to live in. EVIDENCE: The design and layout at the home is very attractive, homely, welcoming and comfortable for clients. The home is very well maintained and the fabrics, fittings and furniture are all of a very high standard. All the bedrooms seen were very clean and tidy and have en-suite facilities. There are plans for the development of a sensory room specific to the needs of the client group to promote environmental stimulation and relaxation. All the clients are able to sit in an enclosed garden area if they choose. All the clients said that they liked their living environment and one client said “it is a wonderful place in which to live”. Good laundry systems are in place for the upkeep of bedding, linen and personal clothing and there were plentiful supplies of aprons, hand paper towels and soap dispensers. Hot water temperatures were properly regulated Granby Rose SDU DS0000065470.V257709.R01.S.doc Version 5.0 Page 15 and proper sluicing facilities and systems were in place to deal with soiled items and to reduce any risks from cross-contamination. Recommendations made from a recent visit by the fire authority are being acted upon. Environmental health authority recommendations made at their last visit have been acted upon. Granby Rose SDU DS0000065470.V257709.R01.S.doc Version 5.0 Page 16 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 29 and 30 Staffing morale was high resulting in an enthusiastic and well-trained staff team that works positively with clients to improve their whole quality of life. The home’s recruitment procedures protect residents from harm. EVIDENCE: Inspection of the duty rotas and observation showed that the numbers and skill mix of the staff team ensure that client needs are easily met. There was a good atmosphere in the home and one client said that this was always the case and that “staff were always cheerful”. All the clients spoken to were complimentary about the staff team saying that the care was very good. Clients felt that there were always enough staff on duty and that call bells requests were responded to promptly. The home employs kitchen staff, housekeepers and laundry assistants to help maintain excellent standards of hygiene and cleanliness throughout the home and an activities person is employed through the week. All staff receive a range of training. An induction programme is in place for all new staff and a new member of staff spoken to was able to confirm that she had induction training. The induction programme is detailed and covers a number of aspects of working at the home including how to meet the needs of the clients and the values of the organisation. The home has a training manager who organises the training programme. Staff spoken to said “there is so much training on offer”. Each member of staff has a set of training Granby Rose SDU DS0000065470.V257709.R01.S.doc Version 5.0 Page 17 objectives which are held within their individual training records. Recently the home has started taking students placements. Both the registered manager and her deputy are NVQ assessors. Two staff files inspected were those of recently appointed members of staff and these contained evidence that two written references and a satisfactory Criminal Record Bureau and POVA check had been obtained before the new members of staff started working at the home. Granby Rose SDU DS0000065470.V257709.R01.S.doc Version 5.0 Page 18 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 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, 33, 35 and 38 The home is well managed and run in the best interests of the clients. Proper attention is given to health and safety in promoting a safe environment for service users, staff and visitors. EVIDENCE: The registered manager is experienced in running the home and is a registered mental health nurse. She has an extremely good knowledge of the client group and the care provided by the home is based on current best practice. Clients, relatives and staff spoke well of the registered manager’s abilities. A visitor said she was “absolutely brilliant” and both clients and staff said that the management of the home was “very good”. The registered manager has undertaken a number of management courses to develop her skills and abilities in her role as manager of the home. Granby Rose SDU DS0000065470.V257709.R01.S.doc Version 5.0 Page 19 The organisation has a number of quality performance indicators and the home and individual staff aims and objectives are linked to these. Surveys have been sent out to clients and relatives to find out their views about the home and the findings from these surveys is published. The home produces a newsletter keeping all interested parties aware of information about the home and there is a relative support group. The home has its own internal quality assurance audit system and is regularly assessed and audited as part of maintaining the ISO 2002 Award and the Investor in People Award. The home holds some personal allowances monies on behalf of the clients and records and receipts from incoming and outgoing monies are kept. All other clients’ finances are looked after by family members or by solicitors acting on their behalf. Arrangements are in place for the protection and health and safety of clients. Individual and general risk assessments are carried out to promote a safe environment. Aids, adaptations and equipment are all regularly serviced. Hot water temperatures are monitored monthly and there is a planned programme of maintenance work at the home. A number of records were inspected about different aspects of health and safety and these were all up to date and in good order. All staff receive health and safety training from the point of induction. Granby Rose SDU DS0000065470.V257709.R01.S.doc Version 5.0 Page 20 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 4 13 4 14 4 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 4 X X X X X X 4 STAFFING Standard No Score 27 3 28 X 29 3 30 4 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 4 X 3 X X 3 Granby Rose SDU DS0000065470.V257709.R01.S.doc Version 5.0 Page 21 Are there any outstanding requirements from the last inspection? N/A 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. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Granby Rose SDU DS0000065470.V257709.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 Rose SDU DS0000065470.V257709.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. 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!