Inspection on 09/08/06 for Grange Court

This inspection was carried out on 9th August 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 05/03/09

Grange Court 25/03/08

Grange Court 04/09/07

Grange Court 28/02/06

Grange Court 08/09/05

Grange Court 02/03/05

Grange Court 11/02/05

Grange Court 20/12/03

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

CARE HOMES FOR OLDER PEOPLE Grange Court Station Road Baildon Shipley West Yorkshire BD17 6HS Lead Inspector Stevie Allerton Key Unannounced Inspection 9th August 2006 10:45 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 DS0000001244.V304286.R02.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 DS0000001244.V304286.R02.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Grange Court Address Station Road Baildon Shipley West Yorkshire BD17 6HS 01274 531222 01274 531222 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) Mr Ronald Berry Mrs Doreen Berry, Michael Stephen Berry, Anita Anne Berry Belinda Cook Care Home 30 Category(ies) of Dementia - over 65 years of age (10), Mental registration, with number disorder, excluding learning disability or of places dementia (1), Old age, not falling within any other category (30) Grange Court DS0000001244.V304286.R02.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 28th February 2006 Brief Description of the Service: Grange Court is a family run concern, providing a thirty bedded home for elderly people. It is situated on the outskirts of the village of Baildon, Shipley West Yorkshire. Grange Court is a former coaching inn, with parts of the building dating to the fifteenth century and it still retains many of the original features. Over the years various alterations have been undertaken to make the home more accessible. All bedrooms are located on the first and second floors, the floors being accessed via a passenger shaft lift or staircase with stair lift. There is a mix of double and single rooms available with disabled access via a ramp to the front of the building. Residents may bring in furniture and electrical items, though appliances are inspected for safety before use. In each residents room, a plug point is available for a television and individual telephone lines can be arranged on request. All meals can be served in residents own room or in the dining area. Refreshments, tea/coffee and light snacks are available at any time of the day or night and relatives of residents are encouraged to share food at the home to promote a homely atmosphere. Support services are in place with a choice of General Practitioners, chiropodist, dentist and optician. Fees cover the costs of full accommodation, care and laundry facilities, but do not include chiropody, hairdressing and personal copies of newspapers and other personal requirements. Current fees range from £402 to £457 per week. Grange Court DS0000001244.V304286.R02.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was carried out without prior notification and was conducted by one inspector over the course of a full day, starting at 10.45am and finishing at 6.15pm. The Manager, Belinda Cook, was on duty throughout the day and made herself available to answer questions and supply care records, etc. The Operations manager, Steve Wiggins, was also in the home. Michael Berry, one of the registered providers, joined the other managers and was given feedback by the inspector on the findings of this inspection at the end of the day. The inspector would like to thank everyone who took the time to talk to her and express their views. Before the visit, accumulated information about the home was reviewed. This included looking at the number of reported accidents and incidents, reports from other agencies, i.e., the Environmental Health Officer, and information supplied by way of an annual questionnaire. This information was used to plan the inspection visit. The inspector case tracked four service users. Case tracking is the method used to assess whether people who use services receive good quality care that meets their individual needs. Where appropriate, issues relating to the cultural and diverse needs of residents and staff were considered. Using this method, the inspectors assessed all twenty-two key standards from the Care Homes for Older People National Minimum Standards, plus other standards relevant to the visit. The inspector spoke with identified service users and relevant members of the staff team who provide support to them. Documentation relating to these service users was looked at. Where possible, contact was also made with relatives and external professionals to obtain their opinions about the quality of services provided at the home. What the service does well: There is a good rapport between staff, service users and their families, which was evident throughout the day. Service users said that they liked the staff looking after them and felt well cared for. Grange Court DS0000001244.V304286.R02.S.doc Version 5.2 Page 6 The house feels homely, well decorated and comfortable. Service users said that they liked their surroundings, that the house had character but also provided all of the facilities they wanted. 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 DS0000001244.V304286.R02.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 DS0000001244.V304286.R02.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): 3 Quality in this area is good. This judgement has been made using available evidence, including a visit to the home. Service users are properly assessed before admission. They and their families have access to a good standard of information about the service, that enables them to reach a decision about whether it is likely to be able to meet their needs. EVIDENCE: The Manager described the admissions process, from initial referral and assessment through to actual admission. Families are encouraged to look round and to make comparisons with other care homes before coming to a decision on behalf of their relative. The files of those case tracked reflected the process as described. An initial car plan is drawn up from the assessment information and made available to all staff; an assessment is then carried out over the first 72 hrs in the home. Grange Court DS0000001244.V304286.R02.S.doc Version 5.2 Page 9 The service user guide was seen – this contained a very good standard of information for those being admitted to the home, and their relatives. A copy of the terms and conditions was supplied. This was written in very plain language, was easy to understand and clearly outlined the obligations and expectations of both parties. All of the service user surveys that were returned confirmed that they had received a copy of the contract. Grange Court DS0000001244.V304286.R02.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 area is excellent. This judgement has been made using available evidence, including a visit to the home. The care plans had previously provided staff with a good level of knowledge to ensure that personal and health care needs were met, but the introduction of the new social care plan will provide staff with an excellent tool to ensure a more holistic, person-centred approach. This could be particularly beneficial for those with dementia. EVIDENCE: Four service users were selected for case tracking, with a range of care needs and length of time resident at the home. The care plans in place were thorough and supported by appropriate risk assessments. They also include information regarding specific religious or cultural needs. The Manager has introduced an additional element that concentrates on social care – just one had been completed so far, but this was seen to provide staff with an important tool in progressing towards more person-centred care planning. Grange Court DS0000001244.V304286.R02.S.doc Version 5.2 Page 11 Health care needs are addressed appropriately and there was evidence within the care plan records that, where health problems have been identified, there is good follow-up action and advice sought from GPs, District Nurses, etc. An optician service was visiting the home on the day of inspection, which most service users were taking advantage of. Staff observed in practice were supporting people in line with the written care plans. Pressure relieving aids were in use where a need for these had been identified. Service users spoken to about their care said they felt well looked after by the staff. One gentleman experiences a lot of pain due to his condition, but said that the staff had worked well with the doctors to find the best way of controlling it and tried very hard to make him as comfortable as possible. The medication system was inspected. The home uses a pre-dispensed system supplied by Boots’, who have also provided accredited training to the staff designated to administer medication. Service user have lockable cabinets in their own rooms, where some have their medication stored for easy access, particularly where they spend a lot of time in their own rooms. Other drugs are locked securely in a trolley. Grange Court DS0000001244.V304286.R02.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 area is good. This judgement has been made using available evidence, including a visit to the home. There is a suitable range of activities for service users, if they want to join in, which provides them with good opportunities for social contact and mental stimulation. The way that the new social activity care plan is being implemented will ensure that social opportunities are tailored to each individual. Food provision is good. Service users are able to have some influence over how the home runs. EVIDENCE: Care plans are evaluated monthly on a summary sheet and there was evidence to show where individuals had been gradually encouraged by the staff to take part in some communal activities and celebrations. Visiting families are an important part of daily life for some service users and clearly have a good rapport with the staff. Those spoken to during the inspection said they felt welcomed into the home at all times. An activities programme was displayed, showing something of interest happening every day; one of the senior care staff takes the lead with activities. Some individuals are able to continue with their own hobbies and interests in Grange Court DS0000001244.V304286.R02.S.doc Version 5.2 Page 13 their own rooms; one gentleman had brought from his home many small items of woodcarving that he had created over his lifetime. Service users said that staff were good at doing shopping for personal items for them. A new tool for assessing individuals’ social care needs was being tried out; this started with a questionnaire, from which was developed an Individual Action Plan, with suggestions for suitable activities, no matter what the extent of someone’s disability or memory impairment. There is a very good section in this, called “How do you like to do things”, which asks questions about preferred times for getting up & going to bed, what the person would like help with and what they are still good at doing. In one of the care plan files looked at, the person’s preferred time for breakfast and supper and where she preferred to eat these meals was noted. Menus were supplied prior to the inspection; these showed a good range and choice of meals and service users confirmed that the food was to their liking. One visitor said that the standard of food appeared to be high, apart from the occasional meal that was cold on arrival. There are apple & plum trees in the garden of the home, the fruit of which is used to make home-made puddings, which the service users spoken to said they appreciated. Grange Court DS0000001244.V304286.R02.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 area is good. This judgement has been made using available evidence, including a visit to the home. The home provides clear information about raising concerns or making formal complaints. Staff training ensures a greater level of protection for potentially vulnerable service users. EVIDENCE: The Manager confirmed that all staff had now had Adult Protection training, which had broadened their awareness. The company’s “Compliments, Concerns & Complaints” procedure was on display, easily accessible for visitors. Those visitors spoken to on the day expressed confidence in being able to raise concerns directly with the staff, feeling that they are listened to and their concerns addressed. Grange Court DS0000001244.V304286.R02.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, 22, 23, 24 & 26 Quality in this area is good. This judgement has been made using available evidence, including a visit to the home. The accommodation meets the needs of the service users and provides a pleasant environment in which to live. Environmental Health and Fire Safety standards continue to be improved, ensuring that service users are safe. EVIDENCE: A tour of the premises provided evidence that the home is comfortable, wellappointed and kept to a good standard of repair. Service users who were identified as requiring pressure-relieving mattresses, etc, were found to have all equipment in place. Bedrooms are individualised, service users being encouraged to bring pictures and personal possessions in to the home with them. One lady spoken to in her Grange Court DS0000001244.V304286.R02.S.doc Version 5.2 Page 16 room said that she had chosen the colour of the décor before she moved in. All bedrooms seen had soap & clean towels; most have vinyl floor-covering, although carpets can be fitted if the service user prefers. Some have their own telephones. There is a passenger lift to one part of the home and a stair lift to the other. There are plans to extend the office for the Manager and to improve facilities for service users, by creating a hair salon/treatment room. Discussions are also taking place about creating French doors from the stable wing out onto the patio. The laundry is compact and well-organised. The washing machine has a sluice cycle and alginate bags are in use for foul linen. Whilst there were appropriate facilities for staff to wash their hands, there were no paper towels in place, which the Manager undertook to rectify at the time.. The Environmental Health Officer inspected the kitchen in June 2006 and reported that everything was satisfactory, so a kitchen inspection was not carried out on this occasion. The home complies with current fire safety standards and has a plan in place to upgrade in line with the Fire Officer’s recommendations. Grange Court DS0000001244.V304286.R02.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 area is adequate. This judgement has been made using available evidence, including a visit to the home. Greater emphasis on supporting staff development, through National Vocational Qualifications (NVQ) and other specialist training, would ensure service users continue to receive an increasing standard of professional care. Recruitment practice is sound. The staff rota provides sufficient staffing levels to meet the needs of the current service users. EVIDENCE: The Manager supplied information prior to the inspection, about training that had taken place over the previous 12 months and what was planned. Apart from the Adult Protection training and Pressure Area Care, all other training had concentrated on mandatory updates on Fire, Moving & Handling, Health & Safety, etc. Records did not show that all staff had been part of a fire practice/drill at the appropriate intervals. The Manager and the Operations Manager are both Moving & Handling Facilitators, updating their own skills annually. NVQ is not currently active in this home, despite it being part of the National Minimum Standards, and only 2 staff have an NVQ qualification. Despite the home having a registration for people with Dementia, there was no evidence of Grange Court DS0000001244.V304286.R02.S.doc Version 5.2 Page 18 any specialist training for this area of care being given regularly, other than the in-house information sheets. The staff records were looked at for a new employee. These showed that all proper checks are taken up before employment commences, such as 2 written references and CRB/POVA checks. There was also a record of the person’s induction training. Care practice was discussed with staff on duty, who were able to describe how the needs of particular service users were met; this included the care of someone’s catheter and, how to operate a nebuliser. The staff were able to discuss their work professionally and knowledgably. The senior on duty described how one service user was able to exercise his preference for only one certain member of staff to assist him to have a bath, and only at particular times; this was achieved through negotiation between the resident and the carer, and an agreed plan reached. Each of the seniors and the Deputy supervise 3 or 4 staff each. The staff team covers a wide range of age, background and experience. Staff rotas were supplied; these showed appropriate levels of staff on each shift. There is one vacancy for an additional housekeeper. During feedback, the provider said that he felt there was a good staff team at the home, that they know the expected standards and work to them. Service user and families were also very happy with the staff, saying that they were very caring, respectful and professional. Grange Court DS0000001244.V304286.R02.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, 32, 33, 35, 37 & 38 Quality in this area is good. This judgement has been made using available evidence, including a visit to the home. Record keeping was generally of a good standard and it could be seen that staff were supported to ensure the correct level of care for service users. There are sound administrative systems in place, which support the Manager. Service users have opportunities to contribute their views and influence how the home runs. The home continues to look at improving standards for service users. EVIDENCE: A selection of policies, procedures and records were sampled. These included: Health & Safety procedures, risk assessments, fire safety records, maintenance records and accident records. Records that supported the home’s quality Grange Court DS0000001244.V304286.R02.S.doc Version 5.2 Page 20 standards were also seen, including quarterly quality audits and minutes of residents’ meetings. The home had updated its accident reporting documents following the last inspection, these currently comply with Data Protection legislation and also have facility for a monthly audit of untoward events. The records showed that the last fire practice for staff took place 6 months ago; the Manager should record all fire practices, along with the names of the staff that took part, so that all staff have the benefit of fire training at the right intervals. Residents’ meetings minutes showed that they are consulted about meals, their bedrooms and about activities. Quality surveys were sent out last year to a range of people who have contact with the home; these were due to be repeated later this year. Moving & Handling risk assessments and subsequent plans are supported pictorially, so that there is no doubt about which technique or piece of equipment should be used; this supports staff whose literacy skills may be poor. Grange Court DS0000001244.V304286.R02.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 X X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 4 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 X 3 3 3 X 3 STAFFING Standard No Score 27 3 28 2 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 3 X 3 X 3 2 Grange Court DS0000001244.V304286.R02.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. 2. 3. Standard OP28 OP38 OP38 Regulation 18(1) 23(4)(e) 23(4) Requirement Efforts must be made to develop NVQ training within the home. All staff must receive fire practice at least twice a year; records must be kept. Work must be carried out to comply with the requirements of the Fire Officer. (Outstanding from previous inspections, but still within the timescale) Timescale for action 31/03/07 31/10/06 10/04/07 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 DS0000001244.V304286.R02.S.doc Version 5.2 Page 23 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 DS0000001244.V304286.R02.S.doc Version 5.2 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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