Inspection on 28/11/05 for Grange Cottage Home For Elderly Persons

This inspection was carried out on 28th November 2005.

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

The inspector 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

Grange Cottage Home For Elderly... 18/07/07

Grange Cottage Home For Elderly... 05/06/06

Grange Cottage Home For Elderly... 16/08/05

Grange Cottage Home For Elderly... 03/11/04

Grange Cottage Home For Elderly... 17/05/04

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

CARE HOMES FOR OLDER PEOPLE Grange Cottage Home For Elderly Persons Albert Road Grange-over-Sands Cumbria LA11 7EZ Lead Inspector Ray Mowat Unannounced Inspection 28th November 2005 2.00pm 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 Cottage Home For Elderly Persons DS0000022643.V265970.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. Grange Cottage Home For Elderly Persons DS0000022643.V265970.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Grange Cottage Home For Elderly Persons Address Albert Road Grange-over-Sands Cumbria LA11 7EZ 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) 015395 33122 Mr Michael Frois Mr Michael Frois Care Home 9 Category(ies) of Dementia - over 65 years of age (2), Old age, registration, with number not falling within any other category (9) of places Grange Cottage Home For Elderly Persons DS0000022643.V265970.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. The home is registered for a maximum of 9 service users to include: up to 9 service users in the category of OP (Older People) up to 2 service users in the category of DE(E) (Dementia over 65 years of age) 16th August 2005 Date of last inspection Brief Description of the Service: Grange Cottage is registered to provide residential services for nine older people two of whom may have dementia. The registered owner manager is Mr Michael Frois. The home is situated in a residential area of the town of Grange-over-Sands, Cumbria. The home is a large Victorian semi-detached property with a purpose built bungalow within the grounds adjacent to the home. The home has also been extended and a conservatory added. The main house has six single bedrooms, two on the ground floor and four on the first floor, these are accessed by a staircase, which also has a chairlift. On the third floor is a private flat that is used by live-in staff. In addition there is a lounge area, dining room, kitchen, a shower room with toilet and a laundry with a sluice facility. The bungalow has three en-suite rooms, a lounge /dining room and a bathroom with toilet. All the rooms are connected to the call bell system. The home is well situated for the local amenities in the centre of Grange. There is wheelchair access to the front of the home, where there is a well-kept garden with seated areas. There is also pedestrian access to the rear of the home, which leads to the town. Grange Cottage Home For Elderly Persons DS0000022643.V265970.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection took place from 2pm on the 28th November 05. This enabled me to experience life in the home on a late shift. I met with all the residents during the inspection and spoke to the staff on duty. I also spent time looking at information about the residents and also information that is needed for the smooth running of the home. What the service does well: 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 Grange Cottage Home For Elderly Persons DS0000022643.V265970.R01.S.doc Version 5.0 Page 6 contacting your local CSCI office. Grange Cottage Home For Elderly Persons DS0000022643.V265970.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 Grange Cottage Home For Elderly Persons DS0000022643.V265970.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): 1, 3, 4. The home’s assessment procedure ensures individual needs are fully assessed and an appropriate service is provided. EVIDENCE: The Home currently has one vacant room and another room was being used by someone on a short-term basis. This was to enable them to “try out” the home and to provide them with some additional support. An assessment had been completed by the home and a basic care plan compiled, which was kept under review. The home was working closely with the social worker and intermediate support team, to ensure all needs were fully assessed and the care was appropriate. The home completes a dependency profile on a monthly basis, which identifies changes that may require action. The information the home had gathered at the time of admission was sufficient for the home to accurately assess the person’s needs and to guide and support staff in providing an appropriate service. The manager and staff are aware of the resources available to them and the constraints of the environment. By Grange Cottage Home For Elderly Persons DS0000022643.V265970.R01.S.doc Version 5.0 Page 9 following this admissions procedure both parties can make informed decisions about a placement. Clear contracts of terms and conditions were issued and held on file, however the most recent resident or their representative had not signed it as required. Grange Cottage Home For Elderly Persons DS0000022643.V265970.R01.S.doc Version 5.0 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. The content of care plans was inconsistent and it was not clear what information was current, due to the volume of information held. EVIDENCE: Based on the information gathered prior to admission and from the initial assessment, the home compiles individual care plans. The content and quality of these was inconsistent. The volume of information held in the files should be reduced, ensuring information held is up to date and accurate and thus avoiding confusion and making it easier to find. Although there was evidence of reviews, using the monthly dependency profile assessment, it was not clear if other information, such as general and manual handling risk assessments were being reviewed. It is recommended such documents are signed and dated when they are agreed and also when they are periodically reviewed. There was evidence the home was making appropriate referrals to specialist services and health agencies when needs are identified. Staff provide support to people to arrange and attend appointments, dependent on the individual’s needs or preference. Grange Cottage Home For Elderly Persons DS0000022643.V265970.R01.S.doc Version 5.0 Page 11 The content of daily care notes had improved, containing appropriate details to maintain a continuity of care, including both significant events and routine care. A medication error was noted on one file, however this had not been notified to the commission as required under regulation 37. This is subject to a requirement. Medication records were checked against the contents of the medication cabinet. It was apparent medication had been administered on the previous evening and not signed for. This is subject to a requirement. In addition medication was being stored on top of the medication cabinet. An immediate requirement was issued to ensure medication is securely stored at all times. Residents I spoke to during the inspection felt “happy in the home”, with one person describing the staff as “like family”. Grange Cottage Home For Elderly Persons DS0000022643.V265970.R01.S.doc Version 5.0 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. On the whole residents were pursuing a lifestyle of their choice both in the home and in the community. EVIDENCE: Based on discussions with residents they were able to lead a “lifestyle of their choosing”. Some of the residents enjoy an independent lifestyle pursuing their hobbies and interests in the home and in the community. Others prefer a more sedentary lifestyle. A recent social work review was very positive, with the residents quoted as saying “the food is very good and my room is first class”, they also said they “enjoy the privacy”. The home has worked closely with one of the residents and the social work team, to enable them to travel independently to a nearby town to visit their relative. Initially the home provided full support but over a period of time they have reduced the staff support, with the resident undertaking the activity independently. This was very important to the resident and something they look forward to each week. Church services are held in the home and special occasions are celebrated, which residents appreciate. Grange Cottage Home For Elderly Persons DS0000022643.V265970.R01.S.doc Version 5.0 Page 13 The menus reflected a good choice of freshly prepared food, with individual tastes catered for. Some residents choose to eat in their rooms whilst others preferred the company in the dining room. Grange Cottage Home For Elderly Persons DS0000022643.V265970.R01.S.doc Version 5.0 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, 17. The home’s policies and practice safeguard residents from abuse or harm and ensure their rights are protected. EVIDENCE: The home maintains a record of complaints and their investigation, as required. There have been no new complaints since the last inspection. At the last inspection a complaint investigation was in process. A meeting was arranged with the complainant and it has been resolved. The home respects people’s legal rights and a record is held on file relating to their needs and preferences regarding their affairs. This involves the home liaising with families, advocates and solicitors. Grange Cottage Home For Elderly Persons DS0000022643.V265970.R01.S.doc Version 5.0 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, 23, 24, 25, 26. Grange Cottage is homely and comfortable and provides a suitable living environment for the current residents. EVIDENCE: Since the last inspection a programme of redecoration was underway. The vacant room has had a new carpet fitted and was in the process of having a toilet added to create an en-suite facility. Future plans will be examined at the next inspection. The home liaises with relevant professionals regarding specialist equipment to support and promote independence. A good example of this was a recent referral, to the specialist social worker for the people with sensory impairments, for an assessment. Residents spoken to were “happy in the home” and felt their rooms were “comfortable”. Some residents had brought their own furniture and other belongings, which gave rooms a personal and homely feel. Although some of the decoration is dated, the home is clean and hygienic throughout. Grange Cottage Home For Elderly Persons DS0000022643.V265970.R01.S.doc Version 5.0 Page 16 The security of the home was discussed with staff, due to the changing needs of residents. It is recommended this be reviewed with residents, to ensure their safety at all times. Grange Cottage Home For Elderly Persons DS0000022643.V265970.R01.S.doc Version 5.0 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, 30. The home is ensuring an adequate number of suitably trained staff are on duty, to meet the needs of the residents. EVIDENCE: These standards were assessed and met at the last inspection. In the absence of the registered manager and deputy, the staff files were not available for this inspection. Based on my discussions with staff, they were receiving relevant training, with two of them recently enrolled on NVQ training. They also had received suitable refresher training. There is a core group of staff who have worked at the home for a number of years, who have developed positive relationships with the residents. The home has also recently recruited two overseas staff who are integrating into life in the home. When I was talking to one resident about various aspects of life in the home, she described the staff as “wonderful and so kind”. Grange Cottage Home For Elderly Persons DS0000022643.V265970.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, 36, 37,38. The management and recording of health and safety issues was inconsistent leaving residents at risk and must be improved. EVIDENCE: Grange Cottage is a small family run home, which prides itself in promoting people’s independence. Residents felt it was “their home” and said they are regularly consulted. Staff support was unobtrusive, with staff taking an “enabling role”, supporting people to achieve their goals. Supervision records were not available, however staff said management support was “always available and appropriate”. Although monitoring systems were in place for routine safety checks, the records sampled were not up to date or accurate. An example of this was two dates in the fire log referring to 2006. The home must review their records and ensure all necessary checks are being completed in the required timescale and accurately recorded. Grange Cottage Home For Elderly Persons DS0000022643.V265970.R01.S.doc Version 5.0 Page 19 As mentioned previously risk assessments must be signed and dated when agreed and subsequently when reviewed. Cleaning materials, which are COSHH substances, were being stored in the upstairs bathroom and were accessible to residents. These must be securely stored at all times. An immediate requirement was issued relating to this to ensure the safety of residents. Grange Cottage Home For Elderly Persons DS0000022643.V265970.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 3 X 2 3 X N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 1 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 3 18 X 3 3 3 3 3 3 2 3 STAFFING Standard No Score 27 3 28 3 29 X 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 X 3 X X 3 3 1 Grange Cottage Home For Elderly Persons DS0000022643.V265970.R01.S.doc Version 5.0 Page 21 Are there any outstanding requirements from the last inspection? No STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1 Standard OP31 Regulation 37 Requirement The home must notify the commission of all significant events in line with regulation 37 of the Care Home regulations 2001. Medication must be securely stored at all times. (This was an immediate requirement) Medication records must be completed at the time of administration. COSHH substances must be securely stored at all times. (This was an immediate requirement) The home must maintain records in the home, to ensure the safety and welfare of residents. Timescale for action 01/12/05 2 3 4 OP9 OP9 OP38 13 (2) 13 13(4) a 28/11/05 05/12/05 28/11/05 5 OP38 17 01/01/06 Grange Cottage Home For Elderly Persons DS0000022643.V265970.R01.S.doc Version 5.0 Page 22 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 2 3 4 Refer to Standard OP2 OP7 OP7 OP25 Good Practice Recommendations It is recommended contracts of terms and conditions are agreed and signed on admission to the home. It is recommended the content of care plan files be reviewed, ensuring information is relevant, up to date and accurate. It is recommended risk assessments are agreed and signed by residents or their representative, when they are compiled and then on review. The security of the home should be reviewed with residents, to ensure their safety at all times. Grange Cottage Home For Elderly Persons DS0000022643.V265970.R01.S.doc Version 5.0 Page 23 Commission for Social Care Inspection Eamont House Penrith 40 Business Park Gillan Way Penrith Cumbria CA11 9BP 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 Grange Cottage Home For Elderly Persons DS0000022643.V265970.R01.S.doc Version 5.0 Page 24 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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