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Inspection on 24/05/05 for Grange Crescent

Also see our care home review for Grange Crescent for more information

This inspection was carried out on 24th May 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 found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

Service users at the home said they were looked after well by the staff. They were all pleased with the environment, acknowledging in particular the standard of cleanliness within the home. Comments like `it is a nice place to live` and `we`re well looked after` were said. They also said that the staff were `friendly`, `helpful` and `kind` and if they had any issues or complaints they were able to speak to the staff or manager and they would do their best to sort things out. All areas within the home were pleasant and were cleaned to a high standard. Service users said that they received good meals and have a stimulating and varied life at the home. Relatives said they could visit the home at any reasonable time and that the staff worked hard and provided a good service for the old people. Staff had demonstrated they were able to use efficiently and effectively policies and procedures that were in place should an allegation of abuse be made. The staff team are well trained and work hard to build good relationships with service users and their families. There was a quality assurance system, which sought the views of service users, via a questionnaire. Service user meetings took place regularly both at the home and at other Sheffcare venues. Service users said they felt involved in the running of the home and that they could influence the quality of the care offered. They also said that their representatives were informed when CSCI inspections took place and had access to copies of the inspection report.

What has improved since the last inspection?

Since the last inspection redecoration of some communal areas and some bedrooms had taken place. The care plans and individual risk assessments contained most of the information as required by the regulations. Service users said that the quality and choice of the food served in the home had " really improved" over the past few months.

What the care home could do better:

Care plans for some service users must be improved to ensure that staff can monitor more carefully the service users health care. Medication administration charts must always be signed to show whether medication has been given or not. The staff must ensure that cupboards that contain hazardous substances are kept secure at all times. Fire doors must fully close on their rebates. Some equipment needs replacing/repairing.

CARE HOMES FOR OLDER PEOPLE Grange Crescent 47 Grange Crescent Sheffield South Yorkshire S11 8AY Lead Inspector Janice Griffin Unannounced 24 May 2005 9:00 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 Crescent J55 S2963 Grange Crescent V218777 24.05.05 UI Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Grange Crescent Address 47 Grange Crescent Sheffield S11 8AY 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) 0114 255 5539 0114 250 6863 None South Yorkshire Housing Association Mrs Dawn Martin PC Care Home only 42 Category(ies) of OP Old Age (42) registration, with number of places Grange Crescent J55 S2963 Grange Crescent V218777 24.05.05 UI Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: None Date of last inspection 30 November 2004 Brief Description of the Service: Grange Crescent is a purpose built 42-bed home for older people accommodated on four wings. Three of the wings have ten bedrooms, and the fourth has twelve. The four wings are on two floors and each has a lounge, dining area, kitchen and each bedroom has an en-suite toilet and shower. The home is in a residential area of Sheffield with good access to public services and amenities, (e.g. bus service, shops, libraries etc). It is in the main welldecorated and furnished to a good standard. The gardens are landscaped and accessible to the service users. South Yorkshire Housing Association is the Registered Provider, they work in partnership with Sheffcare Limited, who provide the staff at the home. Grange Crescent J55 S2963 Grange Crescent V218777 24.05.05 UI Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection was unannounced and took place over six hours from 7:00am to 13:15pm. Opportunity was taken to make an inspection of the home and examine a sample of records. The inspector spoke to ten service users, two relatives and five members of staff. What the service does well: What has improved since the last inspection? Since the last inspection redecoration of some communal areas and some bedrooms had taken place. The care plans and individual risk assessments contained most of the information as required by the regulations. Service users said that the quality and choice of the food served in the home had “ really improved” over the past few months. Grange Crescent J55 S2963 Grange Crescent V218777 24.05.05 UI Stage 4.doc Version 1.30 Page 6 What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Grange Crescent J55 S2963 Grange Crescent V218777 24.05.05 UI 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 Crescent J55 S2963 Grange Crescent V218777 24.05.05 UI 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) These standards were not checked at this inspection they will be checked at the next one. EVIDENCE: Grange Crescent J55 S2963 Grange Crescent V218777 24.05.05 UI Stage 4.doc Version 1.30 Page 9 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 and10. The service users said that the staff promoted their privacy and dignity and that their health care needs were met, they also said they received visits from health care professionals, including dental and optical treatment. The home used the services of a continence advisor and service users were provided with appropriate supplies. One service user was reported to be losing weight but her weight had not been checked for several months. Service user, where appropriate, can take responsibility for their own medication but were not always protected by the homes policies and procedures for recording of medication. EVIDENCE: Three service users plans of care were checked. Each set out individual service users needs and the action required and taken by staff to ensure those needs were met. Discussion with service users identified that a range of health professionals visited the home to assist in maintaining health care needs. One-service users daily recordings stated that she was loosing weight but her weight had not been checked for several months. This does not protect the well being of service users. Grange Crescent J55 S2963 Grange Crescent V218777 24.05.05 UI Stage 4.doc Version 1.30 Page 10 Service users who were able could retain control of their own medication, a lockable facility was provided to store such items. This allows service users to have control over their own medication. Records were kept of medication received, and disposed of. Some medication recording charts had not been signed on some occasions to show whether medication had been given or not. This does not ensure the safe administration of medicines. A pharmacist had checked the home’s medication systems at regular intervals. Grange Crescent J55 S2963 Grange Crescent V218777 24.05.05 UI Stage 4.doc Version 1.30 Page 11 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 and15. Service users spoken to said that they were happy with their lifestyle within the home. Activities that matched preferences and capabilities were on offer; activities and trips outside the home did benefit those service users who enjoyed being ‘active’ and ‘busy’. There were no restrictions on visiting times and service users were able to receive visitors in private. Meals were of a high standard and served in pleasant surroundings. EVIDENCE: Service users said that staff assist them to take up opportunities for personal development, including fulfilling spiritual needs. Examples of this were encouraging self help, decision making, inclusion into the community, having the same opportunity to experience everyday activities as afforded to other people and making choices about how they spend their time, where, and who with. This helps the service users to exercise control over their lives. Relatives were seen visiting freely and being offered hospitality, which creates a home that people want to visit. Bedrooms seen were personalised and observation of the interaction between service users and staff confirmed that personal autonomy and choice were well respected. This supported service users to exercise control and choice over their daily routines. The service users said the quality of the meals provided was much improved and that individual food likes and dislikes were accommodated. This allowed the service users to exercise control over their diet. Grange Crescent J55 S2963 Grange Crescent V218777 24.05.05 UI Stage 4.doc Version 1.30 Page 12 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) 16 and18. Staff had an understanding of the procedures to be followed should they suspect any abuse at the home. Discussions with service users confirmed they had nothing to complain about, they were ‘happy’ and ‘well looked after’. EVIDENCE: Service users said that if they had any concerns they would feel comfortable in talking to the staff or the manager. Complaints procedures and an ethos were in place to enable service users and relatives to feel confident that any concerns they voiced would be listened to. Staff had received formal adult protection training. This helps to ensure that service users are protected from abuse. Grange Crescent J55 S2963 Grange Crescent V218777 24.05.05 UI Stage 4.doc Version 1.30 Page 13 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) 19,21, 23, 24 and 26. The location and layout of the home is suitable for its stated purpose. Service users bedrooms met individual’s needs in a comfortable and homely way. The home was comfortable and had a homely atmosphere. Some of the appliances need repairing/replacing. EVIDENCE: The home was very clean, with no unpleasant odours noticeable. All the service users said their rooms were well maintained and kept clean. Since the last inspection some bedrooms and communal areas have been redecorated. This has markedly improved the environment at the home. Three bedrooms were checked in detail and many others seen, all were comfortable and homely. Service users spoken to said they were satisfied with their bedrooms, which they were able to personalise this they said made their rooms comfortable and homely. The home had an appropriate amount of sitting, recreational and dining space and there were sufficient rooms for a variety of activities to take place. Grange Crescent J55 S2963 Grange Crescent V218777 24.05.05 UI Stage 4.doc Version 1.30 Page 14 Outdoor space and all areas of the home were accessible to people in wheelchairs. Furnishings and fittings were domestic in design and in good condition. This made the home look cosy and comfortable. Two washing machines and the dishwasher were out of order. The staff said this made their work much harder. The string light cords, in some bathrooms and toilets were sticky and dirty, this is not hygienic. Grange Crescent J55 S2963 Grange Crescent V218777 24.05.05 UI Stage 4.doc Version 1.30 Page 15 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) 27,28 and 30. The home had 3 care staff and 1 domestic assistant vacancy; agency staff covered the posts. The service users said they felt safe and that the staff were competent and knowledgeable. EVIDENCE: The manager stated that although there were care staff and domestic vacancies agreed care staffing levels were being maintained, as agency staff would be used to cover some shifts. Service users spoken to said that staff were kind, and helpful. Training needs of care staff were identified via supervision and appraisal sessions. Staff spoken to confirmed they receive much more than three days paid training, this demonstrates the provider’s commitment to investing in the staff. Grange Crescent J55 S2963 Grange Crescent V218777 24.05.05 UI Stage 4.doc Version 1.30 Page 16 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) 31, 32 and 38. There was a positive style of management in the home, which benefits the wellbeing of the service users. The service users and relatives spoken to said the manager was committed and very professional. A safe environment is not provided in all parts of the home. EVIDENCE: Arrangements for all staff to undertake fire training and the regular servicing of the homes equipment and appliances were satisfactory which assisted the protection of service users and staff from a risk of harm. Records confirmed that weekly fire checks, alarm systems, extinguishers and emergency lighting had been completed as necessary. All staff had received fire practices and/or drills as required by the homes policy and procedures. Risk assessments were seen in individual service user files, these had been reviewed and updated as necessary, thereby promoting the safety of service users. Grange Crescent J55 S2963 Grange Crescent V218777 24.05.05 UI Stage 4.doc Version 1.30 Page 17 Nurse call systems, the lift, gas and boilers had all been services as required. One fire door was not fully closing on its rebate and hazardous substances were insecurely stored. This could affect the wellbeing and safety of service users. Grange Crescent J55 S2963 Grange Crescent V218777 24.05.05 UI Stage 4.doc Version 1.30 Page 18 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 x x x N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 2 9 2 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION 2 3 3 x 3 3 x 2 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 Standard No 16 17 18 Score 3 x 3 3 3 x x x x x 1 Grange Crescent J55 S2963 Grange Crescent V218777 24.05.05 UI Stage 4.doc Version 1.30 Page 19 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 38 Regulation 13 Requirement Hazardous substances must be stored in a secure place at all times. This requirement has been outstanding since 2004. Fire doors must fully close on their rebates.This requirement has been outstanding since 2004. Medication record charts must be signed to show whether medication has been given or not. Service users must be weighed at regular intervals. The broken euipment must be repaired/replaced. The string lighting pull cords need replacing. Timescale for action Immediate 2. 38 23 31/5/05 3. 9 13 Immediate 4. 5. 6. 8 19 26 12 16 16 Immediate 1/7/05 1/7/05 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard 28 Good Practice Recommendations By 2005 a minimum of 50 of the care staff must be trained to NVQ level 2. J55 S2963 Grange Crescent V218777 24.05.05 UI Stage 4.doc Version 1.30 Page 20 Grange Crescent Commission for Social Care Inspection Ground Floor, Unit 3 Waterside Court Bold Street Sheffield, S9 2LR 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 Crescent J55 S2963 Grange Crescent V218777 24.05.05 UI Stage 4.doc Version 1.30 Page 21 - 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. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!