Inspection on 25/09/06 for Grange Care Centre, The

This inspection was carried out on 25th September 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 but made no statutory requirements on the home.

Other inspections for this house

Grange Care Centre, The 28/11/05

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

CARE HOMES FOR OLDER PEOPLE Grange Care Centre, The The Grange Care Centre 2 Adrienne Avenue Southall Middlesex UB1 2QW Lead Inspector Mrs Clare Henderson Roe Key Unannounced Inspection 10:15 25 & 26 September 2006 th th 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 Grange Care Centre, The DS0000063541.V312790.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 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. Grange Care Centre, The DS0000063541.V312790.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Grange Care Centre, The Address The Grange Care Centre 2 Adrienne Avenue Southall Middlesex UB1 2QW 020 8832 8600 020 8832 8601 manager.grange@lifestylecare.co.uk 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) Life Style Care Plc Ms Deborah Noela Northrop Care Home 160 Category(ies) of Dementia (94), Old age, not falling within any registration, with number other category (46), Physical disability (20) of places Grange Care Centre, The DS0000063541.V312790.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 28th November 2005 Brief Description of the Service: The Grange Care Centre is a purpose built care home and is situated in Greenford off the Ruislip Road. It is easily accessed via public transport and the A40. The home is registered to provide care for 94 service users with a diagnosis of dementia, (26 beds for personal care and 68 for nursing care), 46 nursing beds for service users requiring general nursing care and 20 nursing beds for younger adults with physical disability. The home is divided into 8 units. On each unit there are three communal areas. Each unit has two serveries where staff can provide drinks and snacks for service users and visitors. All bedrooms are single with en suite facilities, consisting of toilet and wash hand basin, with 50 also containing shower facilities. There are assisted bath and shower facilities, plus additional toilet facilities in each unit. Each floor has an activities room. On the first floor there is a hairdressing salon and a shop. There is dedicated storage space for the hoists and wheelchairs on each unit. There is a dedicated servicing area on the second floor where the laundry and kitchens are situated. There are several staff changing facilities and two staff rooms, one of which is the only smoking area in the home. A ‘relatives’ room, training rooms and additional staff areas are available on the third floor. There is a well maintained enclosed garden which backs onto the canal. Fees range from £566.50 to £1000 per week dependent on assessed need. Grange Care Centre, The DS0000063541.V312790.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced inspection carried out as part of the regulatory process. A total of 29 hours was spent on the inspection process. The Inspector carried out a tour of the home, and service user plans, medication records, staff records, financial records, management records, administration records, maintenance and servicing records were viewed. 19 service users, 10 visitors, 15 staff and 1 healthcare professional were spoken with as part of the inspection process. The pre-inspection questionnaire, sent to the home at the time of inspection, has also been used to inform this report. It must be noted that it is sometimes difficult to ascertain the views of service users with dementia care needs. What the service does well: What has improved since the last inspection? There have been improvements in the completion of service user plan documentation since the last inspection. Shortfalls identified in the report should be easily addressed. The activity provision has improved since the last inspection, with action needed to ensure the documentation for each service users interests is individualised. The Registered Manager has plans to address this finding. Grange Care Centre, The DS0000063541.V312790.R01.S.doc Version 5.2 Page 6 What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Grange Care Centre, The DS0000063541.V312790.R01.S.doc Version 5.2 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 Grange Care Centre, The DS0000063541.V312790.R01.S.doc Version 5.2 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): 1, 2, 3 & 4.The home does not provide intermediate care. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users and their representatives are provided with the information they need to make an informed choice about the home. Written contracts are in place, thus ensuring information regarding the homes terms and conditions are understood. Service users are fully assessed prior to admission to the home, to ascertain that the home is able to meet their needs. Staff had received training in dementia care, thus providing them with the knowledge to care for service users with such a diagnosis. EVIDENCE: The home has a Statement of Purpose and a Service User Guide. Copies of the Service User Guide are given to each service user on admission and copies of both documents are available in the home. These were up to date and provide comprehensive information about the care provision and facilities available at the home. A copy of the last inspection report was available on each unit and in the main entrance. Grange Care Centre, The DS0000063541.V312790.R01.S.doc Version 5.2 Page 9 One Inspector sampled service user records in respect of contracts. These were available in the records viewed. This included contracts for privately funded service users, Primary Care Trust (PCT) and Social Services contracts. These detailed the services available and the fees payable. Pre-admission assessments were viewed on each unit. These were comprehensive and gave a good picture of the needs of the service user. Social Services needs led assessments had also been obtained. Staff working on the dementia care units had received training appropriate to the needs of the service users and further dementia care training is planned. Staff spoken with confirmed they had received this, plus training in other areas relevant to the needs of the service users. The Deputy Manager has undertaken training in Tissue Viability and was due to complete her postgraduate diabetic specialist training in the near future. Grange Care Centre, The DS0000063541.V312790.R01.S.doc Version 5.2 Page 10 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 & 10. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Overall the service user plans were up to date, however shortfalls in completion could place service users at risk of their needs not being fully met. Shortfalls in risk assessment documentation could potentially place service users at risk. Medications are being well managed at the home, however some shortfalls need addressing to fully safeguard service users. Staff care for the service users in a gentle and courteous manner, thus respecting their privacy and dignity. EVIDENCE: Two service user plans were viewed on each unit. Overall these were up to date and gave a good picture of the service users needs. The ‘resident assessment’ document was not being completed fully, thus information regarding service users social history and mental health needs had not always been ascertained. In one instance the service user plan had not been reviewed promptly for a service user who had been to hospital and then readmitted to the home. There was evidence of new care plans being formulated for newly identified risks. Risk assessments for falls were in place and there was evidence that falls documentation had been reviewed following falls and Grange Care Centre, The DS0000063541.V312790.R01.S.doc Version 5.2 Page 11 accidents. There was evidence of input from the service users and/or their representatives, signing agreement to the service user plan and also in most cases signing the individual care plans. Wound care documentation was viewed. For one service user each on Primrose and Buttercup units the documentation had not been reviewed to fully reflect the current condition of the wound. Wound care documentation viewed on other units was up to date. The scoring on the wound assessments had not always been correctly added up. Pressure relieving equipment was seen in use in the home and is identified in the service user plan. There is evidence that wound care is effective within the home. There was evidence of input from the Tissue Viability Nurse specialist, plus the Deputy Manager is trained in this specialist area of care. Nutritional assessments were in place, and care plans had been formulated for service users with any identified problems. Monthly weights were being carried out and where problems with eating and drinking or weight loss had been identified referrals made to the Dietician. The Speech & Language Therapist has input to assess service users with any swallowing difficulties. Moving & handling assessments were in place and the equipment to be used for each service user identified. Care plans had been formulated for safe environment and mobility needs. Continence assessments had not always been completed. Care plans for continence care needs were in place. Where bedrails are in use, risk assessments had not always been carried out, and in one instance written consent for their use had also not been obtained, which was addressed at the time of inspection. Some of the shortfalls identified are repeat findings from the last inspection. The Registered Manager was very clear that additional training on the formulation and reviewing of service user plans is required and said that this would be incorporated into the training programme. Input from healthcare professionals is recorded in the service user plan, and there was evidence of regular GP input. The Inspectors spoke with the GP who visits 3 times per week. He said that the home is well organised for his visits and staff are helpful and professional. The CSCI Pharmacist Inspector carried out an inspection on 25/09/06 and a separate report is available. The requirements and recommendations resulting from that inspection have been incorporated into this report. Staff were heard conversing with service users in a gentle and courteous manner, respecting their privacy and dignity. Where service users were seen to be agitated, staff were managing them in a patient and calm manner. Service users clothing viewed is individually labelled. Service users receive post unopened. Several service users had their own telephones in their rooms. Grange Care Centre, The DS0000063541.V312790.R01.S.doc Version 5.2 Page 12 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 & 15 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The activity input for the home is good, providing a variety of activities, outings and entertainments to meet the service users needs. The home has an open visiting policy, thus encouraging service users to maintain contact with family and friends. Information regarding advocacy services is freely available, thus ensuring the service users right to independent representation is respected. The food provision in the home is good, offering variety and choice, however choices are not always respected, thus compromising the service available to service users. EVIDENCE: The home has one full time and one part time activities co-ordinator in post. Service users were seen participating in activities and it was clear that several service users enjoy joining in as much as they could. Outings are arranged and there were photographs in areas of the home for outings recently undertaken. Service users can choose if they wish to join in with activities. The activities co-ordinator visits each unit and sets up activities that the staff can undertake with service users, as well as having an activities programme for all those who wish to join in with. Outside entertainers also visit the home. Care plans for social and leisure activities remain very general, and the Registered Manager said that she is bringing in ‘life maps’ for each service user, in order to identify Grange Care Centre, The DS0000063541.V312790.R01.S.doc Version 5.2 Page 13 their individual history and social and leisure interests. The activities coordinator does keep a record of the activities each service user attends. Examples of service users artwork are displayed in areas of the home. It was clear from speaking with service users that they enjoy the activity provision in the home, plus the fact that if they do not wish to partake, then their wishes are respected. The Registered Manager is working with the activities coordinators to bring in more ideas for activities on an ongoing basis. The home has an open visiting policy and visiting is encouraged. Visitors spoken with said that they are made welcome at the home and representatives said that they are kept up to date with any concerns. Service users can choose to receive visitors in the privacy of their own rooms or in one of the communal rooms, as they so wish. Information about advocacy services is displayed in the reception area of the home. Service users are encouraged to bring possessions into the home in line with fire safety. It was clear that work has taken place to review the menus for the home in consultation with the service users and their representatives. The menus have also been reviewed by the dietician services. Service users spoken with generally were satisfied with the food provision. Service users have a choice of meals and are asked about this, with a menu list for each unit being completed. Additional alternatives are available to the 2 choices for each meal. Copies of the menu for the week are displayed in the dining rooms. The Registered Manager has also formulated picture menus to be used for service users with communication difficulties. One Inspector viewed three lunchtime meals, and in each case the choice list, which had been completed the previous day, was not being adhered to when serving service users with their meals, to include those with specialist needs. This was discussed with the Registered Manager and with the staff on the units, and is to be addressed. Jugs of water and refreshments were seen in each service users room. Drinks and snacks are available throughout the 24 hour period. One Inspector viewed the kitchen and a good amount of fresh vegetables plus tinned and frozen foodstuffs were available. Grange Care Centre, The DS0000063541.V312790.R01.S.doc Version 5.2 Page 14 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 & 18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home has clear complaints procedures in place to address any concerns raised by service users and their visitors. There is a robust system in place for the safeguarding of service users from abuse. EVIDENCE: Details of the complaints procedure are available in the Statement of Purpose and Service User Guide, and are also displayed in the home. There had been 11 complaints since the last inspection. These had all been fully investigated and where any shortfalls had been identified an action plan had been formulated. A register of complaints is maintained and the documentation viewed was comprehensive. The Registered Manager has an ‘open door’ policy for visitors, and does deal promptly with any concerns raised. Representatives spoken with said that the Registered Manager is approachable and deals promptly with any issues. The home has adult protection policies and procedures in place that dovetail with the Ealing Safeguarding Adults documentation. Staff spoken with said that they had received POVA training and were clear to report any concerns. Whistle Blowing was discussed and generally staff understood this. The Registered Manager reports to CSCI and the Ealing Safeguarding Adults Team any incidents that she feels might require investigation under safeguarding adults procedures, and appropriate procedures are followed. Grange Care Centre, The DS0000063541.V312790.R01.S.doc Version 5.2 Page 15 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, 20, 21, 22, 24, 25 & 26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home has been built to a high standard, and is well maintained, thus providing a smart, clean and homely environment for service users to live in. Communal rooms are available on each unit, providing the service users with a choice of venue. Equipment in the home is available to meet the service users needs, thus providing for the service users needs. Clear infection control procedures are in place and being adhered to, thus safeguarding service users. EVIDENCE: A tour of each unit was carried out. The home was purpose built in 2005 and is being maintained in good condition. The décor and furnishings throughout are of good quality. The carpet on one floor has been identified as having a manufacturers flaw, and was being replaced at the time of inspection. The home has a redecoration and refurbishment plan in place. The home has CCTV fitted externally for security purposes. Grange Care Centre, The DS0000063541.V312790.R01.S.doc Version 5.2 Page 16 There is a good provision of communal space on each unit. There is a dining room, a sitting room, and a multi-purpose room on each unit, plus an additional small dining/sitting room available on the larger units. The gardens are well tended and enclosed. Staff were available to supervise and assist service users in the communal areas. All bedrooms have en suite toilet and wash hand basin facilities, and 50 bedrooms have a shower facility also. Assisted bath and shower facilities are available on each unit, and good quality equipment has been installed. Toilets are available near the communal areas. Separate sluice rooms are available on each unit. All the beds in the home are electronic profiling beds. A range of moving and handling hoists are available on each unit to meet the assessed needs of the service users. The home has two passenger lifts and there are rails in each corridor. Rails are also available in the en suite and toilet, bath & shower facilities. There is a call bell system throughout the home, and these were being answered promptly. Designated storage areas for aids and equipment are available on each unit. Bedrooms viewed were individualised and personalised and contained suitable furniture and fittings, with varying complementary colour schemes throughout the home. The units were pleasantly warm and there was adequate ventilation throughout. Low temperature surface radiators are in place throughout the home. Emergency lighting is provided throughout the home and regularly checked by the maintenance man. Monthly random hot water temperature checks are carried out and records are maintained. The laundry room was clean and tidy. The two staff working in the laundry were clear about the laundering procedures, and clothing was being carefully ironed and cared for. Items viewed were labelled correctly. Staff spoken with said that any unlabelled items are returned to the units for staff and visitors to check through for identification purposes. The machines are industrial, with four washing and four drying machines available. There is also a rotary iron and general irons available. Copies of the infection control procedure were available on each unit and in the laundry and kitchen. Protective clothing to include gloves and aprons was available on throughout the home. Individual sluice rooms with electronic sluicing disinfectors are available on each unit. The home was clean and smelled fresh throughout. Any odours that occur are swiftly addressed. Grange Care Centre, The DS0000063541.V312790.R01.S.doc Version 5.2 Page 17 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, 28, 29 & 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is appropriately staffed to ensure that the needs of the service users can be met at all times. Systems for vetting and recruitment practices are in place and protect service users. There is a comprehensive ongoing training programme, providing staff with the skills to meet the needs of service users, to include specialist care needs. EVIDENCE: At the time of inspection the home was being staffed to meet the needs of the service users. The Registered Manager has a clear understanding that staffing is determined according to the assessed needs and dependency needs of the service users. Where additional care needs are identified, staffing is reviewed to address this. Domestic, maintenance and administrative staff are employed in appropriate numbers to meet the needs of the home. A separate duty roster is available for each unit and for the ancillary staff. The Registered Manager reported that 90 of care staff are qualified to NVQ level 2 or above, or have an equivalent qualification. Staff spoken with said that they do receive regular training in topics relevant to the service users needs. Staff employment records were sampled and those viewed contained the information required by the Care Homes Regulations 2001. In some cases Grange Care Centre, The DS0000063541.V312790.R01.S.doc Version 5.2 Page 18 POVA First checks had been carried out and Criminal Records Bureau checks were being awaited. These staff were being chaperoned at all times when working in the home. The Registered Manager has in place a staff training and development programme. All new care staff receive induction training to meet the core induction standards for Skills for Care. Grange Care Centre, The DS0000063541.V312790.R01.S.doc Version 5.2 Page 19 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, 36 & 38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The Registered Manager is competent and skilled and has developed an atmosphere of openness and respect, thus making service users, visitors and staff feel valued. Systems for quality assurance are in place, thus providing an ongoing process of review and feedback. Service users monies are well managed and securely stored. Staff receive supervision, thus promoting communication and review of practice. Systems for the management of health and safety throughout the home are good, thus safeguarding service users, staff and visitors. EVIDENCE: The Registered Manager is a first level registered nurse with a mental health qualification, plus she has completed the Registered Managers Award, NVQ level 4. She has several years experience in managing care homes for older people and has the skills and experience to manage service users, visitors and Grange Care Centre, The DS0000063541.V312790.R01.S.doc Version 5.2 Page 20 staff effectively and with respect. Staff and visitors spoken with said that the Registered Manager is approachable and listens to their opinions, and any issues are promptly addressed. There are clear lines of accountability within the home and the Registered Manager communicates a clear sense of direction and leadership. The processes of running the home are open and transparent. The home has in place effective quality assurance and monitoring systems. Audits for accidents, wound care, medication, service user plans and health & safety are carried out periodically by the Registered Manager and the Regional Manager. Regulation 26 unannounced visits on behalf of the Responsible Individual are carried out and copies of the report sent to CSCI. The Registered Manager has an annual development plan for the home. Satisfaction surveys are sent out from head office and the results are received and collated there also. An action plan is generated by head office to address any shortfalls identified by the surveys, and this is actioned by the Registered Manager of the individual home. A summary of the service user survey results is displayed in the main entrance. The home has in place the ISOQAR9001 Quality Assurance System. This requires three monthly quality assessments to be undertaken by the Registered Manager or Regional Manager. Service user and relatives meetings take place and minutes are published. Staff meetings are carried out with each unit and department. Small amounts of personal monies are held for some service users. The records viewed were up to date and gave a clear picture of income and expenditure, with receipts being retained. Secure facilities are provided for the safekeeping of monies and valuables on behalf of service users. The home has a system in place for formal supervision for all staff. This is linked to the appraisal system within the home. Supervision records are maintained and are signed by the supervisor and supervisee. The Registered Manager has a supervision matrix that evidences regular supervision sessions taking place and future planning also. The training matrix evidenced that staff had received health & safety training to include moving & handling, fire awareness, food safety, first aid, COSHH and infection control. Fire drills were taking place for both day and night staff. Staff spoken with said that they receive training in all health & safety topics. A list of staff trained in first aid is displayed by the lift. A sample of servicing and maintenance records were viewed and those viewed were up to date. The home employs one full time and one part time maintenance person. There is a maintenance book where staff report any concerns of this nature and once action has been taken the book is signed off. The fire risk assessment had been reviewed in 2006. Risk assessments for equipment and safe working practices were in place, with relevant copies in the kitchen and laundry areas plus on each unit. Grange Care Centre, The DS0000063541.V312790.R01.S.doc Version 5.2 Page 21 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 3 3 3 3 X N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 2 9 2 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 3 15 2 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 3 3 3 X 3 3 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 3 X 3 3 X 3 Grange Care Centre, The DS0000063541.V312790.R01.S.doc Version 5.2 Page 22 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 OP7 Regulation 17 Requirement Service user plan documentation must be complete and updated following any changes in the service users condition. Pressure sore risk assessments must be accurately completed. (previous timescale of 16/12/05 not met) Wound care documentation must accurately reflect the condition of each wound. All assessments to include continence assessments must be fully completed. Prior to use a full assessment for the use of bedrails must be completed and there must be evidence that the use of bedrails is appropriate for the service user. (previous timescale of 16/12/05 not met) Medicines must be checked and recorded accurately when received into the home in all units Continuous supplies of medication must be maintained in the home That staff update their DS0000063541.V312790.R01.S.doc Timescale for action 20/10/06 2. OP8 17 13/10/06 3. 4. OP8 OP8 17 13(7) 13/10/06 13/10/06 5. OP9 13(2) 01/10/06 6. 7. OP9 OP9 13(2) 13(2) 01/10/06 01/11/06 Page 23 Grange Care Centre, The Version 5.2 8. 9. OP9 OP12 13(2) 15(1) 10. OP15 16, 17 knowledge of currently prescribed medication That staff monitor pain relief as per the homes policy. The care plans for each service users social and leisure interests must reflect their individual needs and identify how these are to be met. (previous timescale of 16/12/05 not met) A choice of meals must be available to service users and these choices must be discussed, recorded and respected. (previous timescale of 16/12/05 not met) 01/10/06 01/11/06 13/10/06 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 OP9 Good Practice Recommendations That the use of bulk prescriptions is considered for laxatives and sip feeds. Grange Care Centre, The DS0000063541.V312790.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection West London Area Office 11th Floor, West Wing 26-28 Hammersmith Grove London W6 7SE 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. 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