Inspection on 14/12/06 for Grange Court

This inspection was carried out on 14th December 2006.

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

The inspector 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 Court 15/11/05

Grange Court 03/05/05

Grange Court 23/09/04

Grange Court 07/05/04

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

CARE HOMES FOR OLDER PEOPLE Grange Court Church Gardens Garforth Leeds LS25 1HG Lead Inspector Catherine Paling Key Unannounced Inspection 14th December 2006 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 Grange Court DS0000033226.V320635.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 Court DS0000033226.V320635.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Grange Court Address Church Gardens Garforth Leeds LS25 1HG 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) 0113 2864845 0113 2864845 Leeds City Council Department of Social Services Jane Hawkhead Care Home 33 Category(ies) of Old age, not falling within any other category registration, with number (33) of places Grange Court DS0000033226.V320635.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 15th November 2005 Brief Description of the Service: Grange Court is a residential home providing personal care for men and women over pensionable age. There are 30 permanent places with three places available for respite care. The home is on two floors, with a passenger lift providing access to both floors. All bedrooms are single with their own washbasin; there are no en-suite facilities. There is a range of communal toilet and bathing facilities throughout the home. The large communal dining room is on the ground floor, together with a choice of lounge areas, one of which is a designated smoking area. The home is situated off the main shopping street in Garforth town centre, close to local amenities including the library, medical centre, shops and post office. Garforth is a close-knit community, about 10 miles from the centre of Leeds. Information about the service is available in a combined Statement of Purpose and Service User Guide. This document was reviewed in May 2006. The fees range from £94.45 to £ 458.86 per week. There are additional charges for chiropody, dental and optical services, social activities, newspapers, personal items and travel. This information was provided by the service on the pre-inspection questionnaire completed in November 2006. Grange Court DS0000033226.V320635.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The Commission for Social Care Inspection (CSCI) inspects homes at a frequency determined by how the home has been risk assessed. The inspection process has now become a cycle of activity rather than a series of one-off events. Information is gathered from a variety of sources, one being a site visit. All regulated services will have at least one key inspection between 1st April 2006 and 30th June 2007. This is a major evaluation of the quality of a service and any risk it might present. It focuses on the outcomes for people using it. All of the core National Minimum Standards are assessed and this forms the evidence of the outcomes experienced by residents. More information about the inspection process can be found on our website www.csci.org.uk On some occasions it may be necessary to carry out additional site visits, some visits may focus on a specific area and are known as random inspections. This visit was unannounced and one inspector was at the home from 09:30 until 15:00 on 14th December 2006. The manager was available to assist during the inspection. The purpose of the inspection was to make sure the home was operating and being managed for the benefit and well being of the residents and in accordance with requirements. Before the inspection accumulated evidence about the home was reviewed. This included looking at any reported incidents, accidents and complaints. This information was used to plan the inspection visit. A number of documents were looked at during the visit and all areas of the home used by residents were visited. A good proportion of time was spent talking with residents as well as with the manager and her staff. A pre-inspection questionnaire (PIQ) had been completed before the visit to provide additional information about the home. Some survey forms were left at the home providing the opportunity for residents and/or visitors to comment on the home, if they wish. Information provided in this way may be shared with the provider but the source will not be identified. A number of survey forms were returned and indicated satisfaction with the service. What the service does well: Grange Court DS0000033226.V320635.R01.S.doc Version 5.2 Page 6 There is a lively and welcoming atmosphere at the home. Staff and residents have a good rapport and visitors are made welcome at the home. Pre-admission practices are thorough particularly when there are complex needs to address. The manager makes good use of the support of other healthcare professionals to make sure that needs can be met at the home. Staff put a lot of effort into helping residents make decisions about their daily routines and what they want to do. Residents have been asked about the menus choices on more than one occasion and changes made to meet their wishes. The meals are well presented and nutritious. What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Grange Court DS0000033226.V320635.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 Court DS0000033226.V320635.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. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 3, 4 and 5. (Standard 6 does not apply to this service) Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. There is sufficient information available to residents and their families to make an informed decision about the home. All residents have their needs assessed before being admitted to the home. EVIDENCE: There is a statement of purpose and service user guide available to provide information about the service provided at the home. This is reviewed regularly to make sure that the information is up to date. The most recent review was May 2006. Pre- admission information was looked at for a recently admitted resident who had particularly complex needs. There was a whole range of information that had been collected providing clear evidence of the decision making process and who had been involved in making the decision as to how the needs of the resident would be met. Systems were put in place before admission so that Grange Court DS0000033226.V320635.R01.S.doc Version 5.2 Page 9 the resident could be assured that their needs would be met. In other cases the Easy Care document and the local authority care plans were available providing information about care needs. It is part of the admission process to encourage prospective residents to visit and spend time at the home before they make the decision to move in. Grange Court DS0000033226.V320635.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. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 and 10. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The home is good at meeting the care needs of the residents but records do not consistently provide evidence of this. Medication practices are safe and healthcare needs are met. Staff respect the privacy and dignity of residents. EVIDENCE: The manager and the care staff were knowledgeable about the individual care needs of the residents who said that they felt well looked after by the staff. Daily records provide some evidence of the care provided but detailed care plans are not in place. Individual plans of care are in the form of a Lifestyle plan for every resident. There is a variable standard of recording with some good personal details about individual care needs documented. However, review and update of care was not always clear in that entries were not always dated or signed Grange Court DS0000033226.V320635.R01.S.doc Version 5.2 Page 11 Risk assessments had not always been completed. For example, nutritional risk assessments and falls risk assessments had not been completed for all residents. Daily records were kept and were very informative about the complex care needs of one resident and the input required from other healthcare professionals. However, the care plan did not contain detail of the care that this resident needed. The district nursing service were visiting the home very regularly and it was evident that they work closely with the home to make sure that the care staff have the support they need when residents need nursing care. Some Lifestyle plans had been signed by residents, but this was not always the case. However, it was clear from discussion with staff and residents that staff did discuss care needs with the residents. Staff responsible for the administration of medicines have received training. Observed medications practices were safe. Grange Court DS0000033226.V320635.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. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 and 15. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents are able to exercise choice in their daily routines and they are encouraged to participate in social and leisure activities. Residents’ food choices are taken into consideration and they are provided with nutritious and attractive meals. EVIDENCE: Observation and discussion with some of the residents made it clear that residents were able to exercise choice and control over their daily lives as far as possible. Residents spoken with were satisfied with their care and happy living at the home. There was a range of activities planned to take place over the Christmas period that included local school choirs and the Christmas party that was due to take place on the evening of the visit. Formal invitations had also been sent out the relatives and a large number of visitors were expected. Residents were looking forward to the party and many had a rest in their rooms in preparation for the activities. Staff had also helped residents choose party outfits to change into before the party. Grange Court DS0000033226.V320635.R01.S.doc Version 5.2 Page 13 There is no residents’ committee at the moment although the manager is keen to re-convene these as soon as the staffing levels allow. This would be a means of further enabling residents to be more involved in the arrangements of the entertainment and activities programme. There has previously been an active resident’ group at the home. Residents had again been involved in a survey to review the menu choices at mealtimes. The main meal of the day is usually served in the evening. On the day of the visit the Christmas party was to take place in the evening and party food was being prepared. The main meal was served at lunchtime. The menus provided a balanced and interesting choice of food and residents said that they enjoyed the food. Grange Court DS0000033226.V320635.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. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. There is a robust complaints procedure and residents are confident that complaints will be taken seriously. Residents are protected by the existence of a vulnerable adults procedure and by staff. EVIDENCE: There is a comprehensive and clear complaints procedure in place that is readily available to residents and relatives. The residents spoken with knew who to talk to if they were unhappy and were confident any concerns would be looked into. Staff are aware of adult protection and have received training. There are robust procedures in place to protect residents and whistle blowing procedures to protect staff. Grange Court DS0000033226.V320635.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. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 20, 21, 22, 23, 24, 25 and 26. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home provides a safe and well-maintained environment. Although there are no en suite facilities there are excellent communal facilities. EVIDENCE: The refurbishment of the sanitary facilities has been completed. This work has been carried out to a high standard providing excellent sanitary facilities for residents. All areas are large enough to allow for full assistance by staff. Ceiling tracking has also been fitted to allow for mechanical assistance where that is needed. Residents’ rooms are attractively furnished and they are able to bring in personal items to make their rooms more homely. Only personal laundry is carried out on site. The laundry was well organised and all residents have a personalised basket for their laundry. Good hand Grange Court DS0000033226.V320635.R01.S.doc Version 5.2 Page 16 washing facilities were provided in the laundry and in all the communal areas. All areas of the home were clean, tidy and fresh smelling. All staff receive training in the prevention of cross infection by means of a distance learning package. Grange Court DS0000033226.V320635.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. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 and 30. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Overall, the numbers of staff were sufficient to meet the needs of the residents. Staff are trained and competent to do their jobs. The recruitment procedures protect the residents. EVIDENCE: Staffing difficulties have been experienced in the past and there were a number of vacancies at the time of the visit. The manager said that a number of interviews had been conducted and once recruitment processes had been completed the current difficulties would be largely resolved. There is a stable core staff team providing stability for residents. The recruitment function is carried out centrally with managers involved in the interview process on a rotational basis. Staff do not take up post until all the required checks have been completed. There is 75 of the care staff that have a National Vocational Qualification (NVQ) in care at level 2 or above. Mandatory training is well established and staff have access to a range of training to make sure that they have the necessary knowledge to care for the residents effectively. Grange Court DS0000033226.V320635.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 32, 33, 35 and 38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is well managed. The interests of the residents are seen as very important to the manager and staff and are safeguarded at all times. EVIDENCE: The registered manager is experienced and provides clear leadership to staff. She has achieved an NVQ in care at level 4 and is waiting to commence a management and leadership development programme early in 2007. There is a clear commitment by the manager and her staff to safeguarding the best interests of the residents. This is evident from discussion with staff and residents. Grange Court DS0000033226.V320635.R01.S.doc Version 5.2 Page 19 Contact with residents and their family’s is informal and done on an individual basis with no regular formal meetings held. The manager and the senior staff are accessible to residents with the more mobile residents feeling able to call in at the office to talk with the manager. The manager tries to hold quarterly staff meetings with the most recent held in August. Separate meetings are held for the domestic and kitchen staff. Some residents manage their own finances and look after their pocket money. There are lockable facilities in the bedrooms for the safe keeping of valuables. Other residents hand small amounts of money to staff to keep in the safe. There are clear records of all residents’ money and the home is subject to external audit with a system of frequent in-house ‘spot checks’ carried out. All new staff are given fire instruction and regular fire drills are held for all staff, including the night staff. It was again identified at this visit that two of the linen store cupboards did not have smoke detectors fitted. Records are kept of accidents occurring to residents and the manager keeps a running log of accidents to try to identify any trends. Monthly reports are made to the provider on the number of accidents occurring at the home. All staff have health and safety training and information is displayed about the responsibilities of the individual. There are arrangements in place for the monthly provider visits, as required, and reports of these visits are forwarded to the CSCI. Grange Court DS0000033226.V320635.R01.S.doc Version 5.2 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 3 3 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 3 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 X 18 3 3 3 4 3 3 3 3 3 STAFFING Standard No Score 27 3 28 4 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 3 X 3 X X 2 Grange Court DS0000033226.V320635.R01.S.doc Version 5.2 Page 21 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 15 Requirement The individual records must consistently provide detail and evidence of care. Care plans must be in place and contain detailed instructions on how to meet the needs of the residents. The care plan must be reviewed and updated if needed on a monthly basis. 2. OP38 23(4) (Timescale of 07/03/05 not met) The provider must seek the advice of the fire safety officer regarding the fitting of smoke detectors in linen cupboards. 05/03/07 Timescale for action 07/05/07 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 Grange Court DS0000033226.V320635.R01.S.doc Version 5.2 Page 22 Commission for Social Care Inspection Aire House Town Street Rodley Leeds LS13 1HP National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 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 Court DS0000033226.V320635.R01.S.doc Version 5.2 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. 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