Inspection on 03/05/05 for Grange Court

This inspection was carried out on 3rd May 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 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 14/12/06

Grange Court 15/11/05

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 Unannounced 3 May 2005 09.00hrs rd 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 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 J52 J03 S33226 Grange Court V221483 030505 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Grange Court Address Church Gardens Garforth Leeds LS25 1HG Telephone number Fax number Email 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 Dept of Social Services Jane Hawkhead Care Home Only 33 Category(ies) of Old Age (33) registration, with number of places Grange Court J52 J03 S33226 Grange Court V221483 030505 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: None Date of last inspection 23rd September 2004 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. Grange Court J52 J03 S33226 Grange Court V221483 030505 Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The Commission for Social Care Inspection has to carry out at least two inspections of care homes every year. The inspection year runs from April to March and this was the first inspection for 2005/2006. Copies of previous inspection reports are available at the home or on the Internet at www.csci.org.uk. The last inspection of the home was in November 2004. This was an unannounced inspection by one inspector who spent five and a quarter hours at the home. The main purpose of this inspection was to make sure that the home continues to provide a good standard of care for the residents and to assess progress on meeting the requirements and recommendations made at the last visit. The methods used at this inspection included looking at records; observing working practices; talking to staff and residents; and discussion with the manager. Comment cards were left at the home for residents and relatives inviting them to share their views of the home with the CSCI. Any comments received would be shared with the manager anonymously. The term residents and not service users will be used throughout the report, at their request What the service does well: The residents spoken with spoke highly of the staff one resident saying that the ‘staff are all wonderful’. Residents wanting to move into the home are able to make visits to the home to help them make their mind up. One resident who had taken advantage of this opportunity said that she ‘fell in love with the place’ at her visit and moved in shortly afterwards. Another resident visiting the home was being well looked after by the staff and enjoyed her visit. Staff put a lot of effort into enabling residents to make decisions about their daily routines and what they want to do. The atmosphere at the home is relaxed and welcoming. Residents have been consulted about the meals on more than one occasion and changes made to meet their wishes. The meals are well presented and nutritious. Grange Court J52 J03 S33226 Grange Court V221483 030505 Stage 4.doc Version 1.30 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. Grange Court J52 J03 S33226 Grange Court V221483 030505 Stage 4.doc Version 1.30 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 Standards Statutory Requirements Identified During the Inspection Grange Court J52 J03 S33226 Grange Court V221483 030505 Stage 4.doc Version 1.30 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 standard(s) 3 and 5 Pre-admission visits to the home are carried out effectively. Assessment processes do not guarantee that all the needs of residents are met. EVIDENCE: The individual records of three recently admitted residents were looked at and the pre-admission information either lacked detail or was out of date. One resident had been coming to the home regularly for respite care and had recently become a permanent resident, however there was no information in the file saying how this decision had been made and there was no assessment of care needs before the placement had became permanent. The local authority assessment was over twelve months old. The records of a resident admitted two days previously for regular respite at the home were largely blank with no suggestion that care needs were being re-assessed at each admission. At the time of the visit a prospective resident was spending the day at the home as part of the pre-admission process, she was made to feel welcome and enjoyed the visit. Another recently admitted resident spoke of her preadmission visit, which she had enjoyed and which had helped her make the decision to move into care. An Introductory Assessment had been completed Grange Court J52 J03 S33226 Grange Court V221483 030505 Stage 4.doc Version 1.30 Page 9 at this visit and recorded in her records although this information lacked detail despite this resident being able and willing to talk about her care needs. The local authority Easycare Assessment information was on the file and supplemented the home’s assessment. A recommendation has been made for Standard 3. Grange Court J52 J03 S33226 Grange Court V221483 030505 Stage 4.doc Version 1.30 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 standard(s) 7, 8 9 and 10 Overall the home is good at meeting the care needs of the residents but records do not consistently provide evidence of this. EVIDENCE: Individual plans of care are in the form of a Lifestyle plan for every resident. There has been an improvement in the standard of recording since the last inspection with some good personal details about individual care needs documented. However, review and update of care was not clear in that entries were not dated or signed. In the case of a resident admitted for respite there was no current information about care needs. Risk assessments had not been completed for all residents. Daily records were kept but issues identified within the daily records, such as a resident being confused with an instruction to ‘observe’ did not inform the care plan or generate further comment. Although residents had not always signed the plan it was clear from discussion with staff and residents that staff did discuss care needs with the residents. Care staff were knowledgeable about the individual care needs of the residents who said that they felt well looked after by the staff. Staff treated the residents with respect. Grange Court J52 J03 S33226 Grange Court V221483 030505 Stage 4.doc Version 1.30 Page 11 The manager makes sure that health care needs are met and there was records of doctor’s visits. The district nurse visits the home regularly and said that she could rely on staff to carry out her instructions and to call her if there were any problems. It was recorded in the individual records looked at that the residents preferred not to handle their own medicines. Staff involved in the administration of medicines were confident to do so and had had training. Grange Court J52 J03 S33226 Grange Court V221483 030505 Stage 4.doc Version 1.30 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 standard(s) 12, 13 14 and 15 Residents are able to exercise choice in their daily routines although there was a lack of stimulation and interest offered to residents. Residents are provided with nutritious and attractive meals. EVIDENCE: Residents and relatives confirmed that visitors were made welcome at the home throughout the day and that visitors could be seen in private. Although residents were content at the home there was a lack of stimulation observed during the inspection a view that was supported by comment cards returned following the inspection. There is a Residents Committee at the home and one resident who was an active member said that it was sometimes hard to get other residents involved. Residents said that they could make choices in their day-to-day lives and staff were observed to facilitate this. Residents had been involved in a recent survey to review the menu and choices at mealtimes. The outcome of this had been to serve the main meal of the day in the evening at the request of the residents and to review the choice available. The menus provided a balanced and interesting choice of food and residents said that they enjoyed the food. Grange Court J52 J03 S33226 Grange Court V221483 030505 Stage 4.doc Version 1.30 Page 13 A requirement has been made for Standard 12. Grange Court J52 J03 S33226 Grange Court V221483 030505 Stage 4.doc Version 1.30 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 standard(s) 18 Residents are protected by the existence of a vulnerable adults procedure and by staff awareness. EVIDENCE: One resident who had recently moved into the home said that she felt safe living at Grange Court. All the staff spoken with had an awareness and knowledge of the vulnerable adults procedure and had received some training with regard to adult protection as part of National Vocational Training. Care staff were clear about actions to be taken if they suspected abuse had taken place and were also aware of the Whistle blowing policy. Grange Court J52 J03 S33226 Grange Court V221483 030505 Stage 4.doc Version 1.30 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 standard(s) 19 and 21 Residents are provided with a safe and well-maintained environment. EVIDENCE: All the bedrooms have been redecorated and residents were happy with the standard of decoration in their rooms. The manager said that later this year the communal sanitary facilities will be upgraded to make sure that the increasing needs of the residents can be met. The manager was asked to forward a schedule of works when one is available. Grange Court J52 J03 S33226 Grange Court V221483 030505 Stage 4.doc Version 1.30 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 considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27 and 30 The use of agency staff ensures that there are sufficient staff to meet the needs of the residents and staff shortages have not had an impact on residents. Staff are trained and knowledgeable in meeting residents needs. EVIDENCE: The home continues to experience staffing difficulties, as there are several vacancies for care staff on both day and night duty. In addition, there is one care officer vacancy with another on long term sick. Adequate staffing levels were being maintained by use of regular agency staff; care officer cover provided from other local authority establishments; and with the goodwill of permanent staff who have been willing to do overtime. All the vacant posts have been advertised and some interviews for the vacant posts had already been arranged. All the staff spoken with had received mandatory training with the majority either having completed NVQ level 2 training or were registered to start. Staff were knowledgeable about the needs of residents and had received appropriate training. A requirement has been made for Standard 27. Grange Court J52 J03 S33226 Grange Court V221483 030505 Stage 4.doc Version 1.30 Page 17 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 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 32 and 38 The home is well managed and the staff team are given clear guidance and direction by the experienced manager. The health and safety of the residents is protected in that staff have undergone fire training. Records of accidents were not sufficiently detailed to be satisfied that accidents had been dealt with appropriately. EVIDENCE: The registered manager provides clear leadership to the staff operating an ‘open door’ policy, which is made use of by residents, staff and visitors. Residents and visitors made positive comments about the staff team with one resident saying that he thought the home was ‘well run’ and ‘well organised’. All staff have now taken part in a fire drill. There has been no response to the fire report of November 2004 as requested in a letter from the CSCI in November 2004. Grange Court J52 J03 S33226 Grange Court V221483 030505 Stage 4.doc Version 1.30 Page 18 Accidents to residents are being recorded but the information was minimal both on the form and in the individual records. A requirement and a recommendation have been made for Standard 38. Grange Court J52 J03 S33226 Grange Court V221483 030505 Stage 4.doc Version 1.30 Page 19 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score x x 2 x 3 x 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 2 13 3 14 3 15 3 COMPLAINTS AND PROTECTION 3 x 2 x x x x x STAFFING Standard No Score 27 2 28 x 29 x 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score x x 3 x 3 x x x x x 2 Grange Court J52 J03 S33226 Grange Court V221483 030505 Stage 4.doc Version 1.30 Page 20 yes Are there any outstanding requirements from the last inspection? 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 7 Regulation 15 Requirement Timescale for action 1/09/05 2. 12 16(2)(n) 3. 27 18 4. 38 23(4) The individual records must consistently provide evidence of care. The residents and/or their representatives must be involved in the development of the care plan which must be reviewed on a monthly basis. (Previous timescale of 7/03/05 not met) The residents must be consulted 3/10/05 about a programme of activities to provide stimulation and leisure, taking into account their differing abilities. All efforts must continue to ongoing recruit to the current staff vacancies. Appropriate staffing levels must be maintained at all times ensuring continuity of care for the residents. The fire report of November 25/07/05 2004 must be responded to. 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 J52 J03 S33226 Grange Court V221483 030505 Stage 4.doc Version 1.30 Page 21 Grange Court 1. 3 2. 38 All residents must have their needs fully assessd prior to admission to the home. This information should be relevant and up to date so that an informed decision can be made regarding whether care needs can be met. Resident accidents should be recorded in sufficient detail to provide evidence that accidents have been dealt with appropriately. Grange Court J52 J03 S33226 Grange Court V221483 030505 Stage 4.doc Version 1.30 Page 22 Commission for Social Care Inspection Aire House Town Street Rodley Leeds LS13 1HP 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 Court J52 J03 S33226 Grange Court V221483 030505 Stage 4.doc Version 1.30 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. 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