Inspection on 27/07/06 for Grange Crescent

This inspection was carried out on 27th July 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is (sorry - unknown). 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 Crescent 17/07/07

Grange Crescent 23/11/05

Grange Crescent 24/05/05

Grange Crescent 30/11/04

Grange Crescent 21/07/04

Grange Crescent 18/02/04

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

CARE HOMES FOR OLDER PEOPLE Grange Crescent 47 Grange Crescent Sheffield South Yorkshire S11 8AY Lead Inspector Janice Griffin Key Unannounced Inspection 27th July 2006 06:30 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 Crescent DS0000002963.V300378.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 Crescent DS0000002963.V300378.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Grange Crescent Address 47 Grange Crescent Sheffield South Yorkshire S11 8AY 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) 0114 255 5539 0114 250 6863 none None South Yorkshire Housing Association Mrs Dawn Tina Martin Care Home 42 Category(ies) of Old age, not falling within any other category registration, with number (42) of places Grange Crescent DS0000002963.V300378.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 23rd November 2005 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). South Yorkshire Housing Association is the Registered Provider; they work in partnership with Sheffcare Limited, who provides the staff at the home. A range of information including a copy of the last inspection report was available on the notice board in the entrance to the home. The weekly fees are: £305 to £339. This information was provided on the 27th July 2006. The home charges extra for chiropody, toiletries, clothing, telephone, holidays and hairdressing. Grange Crescent DS0000002963.V300378.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced inspection that took place from 06:30 am to 14:45 pm. As part of the inspection process the inspector spoke to, ten service users, two relatives, three staff and the manager. The inspector would like to thank the service users, the relatives, the staff and the manager for their openness and for their commitment to the inspection process. The inspector was pleased to note that all the service users and relatives spoke positively of the ongoing support provided by the staff. Observations confirmed that service users were extremely comfortable and at ease in the company of the manager and staff who were approachable, supportive and appeared sensitive to their needs and feelings of the service users. The relatives described the service as in the main excellent. A number of records were examined which included, the managers preinspection questionnaire, service users surveys, medication records, three service users care plans, three weeks menus and three weeks staff rotas. Records relating to staff recruitment, service users finances, staff training and the homes quality assurance systems were also checked. Several areas of the building were also inspected. Since the last inspection no complaints have been made about this home. The home has a system for displaying information and bringing attention to community events and activities. Feedback on the inspection was given to the manager. What the service does well: The relatives said the service users were well cared for by the staff. They described the staff as being “very good” and very hard working. Service users were able to visit the home for trial periods. The manager considers carefully the needs assessment for each prospective service user before agreeing to their admission to the home. Service users were only admitted once it had been determined that the home could meet their needs. Clear information about contracts/terms and conditions, fees and extra charges is available in a format appropriate to each individual service user and their families. All service users attended a wide variety of social and leisure activities and these were based very much on the personal preferences of each individual. Feedback was being sought on a regular basis from service users and their families. Grange Crescent DS0000002963.V300378.R01.S.doc Version 5.2 Page 6 Staff interacted well with each service user and it was obvious from discussions with service users and relatives that staff had developed positive relationships with them. The cook was familiar with the dietary needs of service users. The staff team are qualified and experienced to work with the needs of service users. The home has a policy for medication and the staff understood the policy. Records were in the main well ordered and up to date and the manager was keen to ensure that any issues found were addressed. 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 Crescent DS0000002963.V300378.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 Crescent DS0000002963.V300378.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 2,3 and 6. Quality in this outcome area is: good. This judgement has been made using available written evidence, discussion with ten service users, two relatives and a visit to the home. No service user moves into the home without having his or her needs assessed which ensures that their care needs will be met. Service users were able to have informal introductory visits to the home at the time of their admission. The relatives confirmed that this helped the service users to get to know everyone at the home, which made them feel less anxious. This home does not provide intermediate care services. EVIDENCE: Detailed full needs assessments have been completed by the referring social worker for all service users admitted to the home. Families had been involved in the assessment process as appropriate. Grange Crescent DS0000002963.V300378.R01.S.doc Version 5.2 Page 9 The manager confirmed that service users were only admitted to the home once they were sure that they could meet their needs. Relatives spoken to said at the time of the service users admission they were able to have informal introductory visits to the home and they had been provided with a contract containing the relevant information. Records checked confirmed that service users families had been involved in decisions regarding the arrangements. An up to date contract/statement of terms and conditions had been provided to service users. These clearly detailed the fees, including any extra charges, and the services and facilities provided by the home Grange Crescent DS0000002963.V300378.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 at least once during a 12 month period. 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 after discussion with ten service users, two relatives, three staff and using available written evidence and observations made by the inspector at the visit to the home. Observations made by the inspector confirmed that the staff promoted the service users privacy and dignity. The information in one care plan was inadequate to ensure that the service users social care needs could be met. This does not protect the well being of service users. Two other care plans checked were of a good standard and the service users health; social and personal care needs were well documented. There was evidence to show that relatives were involved in the care planning and reviewing process. This allows the relatives to have a say in how the service users needs are being met. Some medication practices could cause a risk to the service users health and welfare. Grange Crescent DS0000002963.V300378.R01.S.doc Version 5.2 Page 11 EVIDENCE: Three service users plans of care were checked. Each set out most of the service users individual needs and the action required and taken by staff to ensure those needs were met. Discussion with staff identified that a range of health care professionals visited the home to assist in maintaining health care needs. One-service users care plan did not give any information about the service users religious and cultural needs, parts of the plan were not completed and some sections were not dated or signed by the writer. Relatives were involved in the care planning and reviewing process. Staff were observed to be assisting service users in a positive and friendly manner, doors were closed where staff were assisting with personal care. A range of aids to assist service users with mobility problems were provided; these included lifting hoists, assisted baths, walking frames and wheelchairs. Records were kept of medication received, and disposed of and the medication administration system was managed reasonably well. One medication recording charts had not been signed on one occasion to show whether medication had been given or not. Medication was securely stored. A pharmacist had checked the home’s medication systems in February 2006 and no issues of concern were reported. Grange Crescent DS0000002963.V300378.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,14 and 15. Quality in this outcome area is: adequate. This judgement has been made using available written evidence, discussions with ten service users, two relatives and three staff members and a visit to the home Service users had access to a range of leisure activities based on their individual choices and preferences. Service users were supported with maintaining and developing contact with their family and friends, and relatives said that they were always welcome at the home. Which creates a home that people want to visit. A good choice of food was offered to all service users at meal times. This promotes the rights and choices of service users. Some service users were very critical of the food, they said hot food was sometimes served warm and dried up. They also said that the home often ran out of some soft drinks. This could affect the health and well being of service users. Grange Crescent DS0000002963.V300378.R01.S.doc Version 5.2 Page 13 EVIDENCE: Service users and staff confirmed that the activities co-ordinator ensured that service users were regularly supported with their leisure and social needs. A programme of the daily leisure activities was displayed on the notice board. They also confirmed that service users had regular contact with representatives from the local churches and that they were able to visit them at the home if they wished. Throughout the day friends and family were seen visiting freely and being offered hospitality. The inspector observed breakfast and lunch, the meal served at breakfast looked appetising and plenty of choice of food was available. The meal served at lunchtime was not as good, some food looked dry and unappetising. It was a very hot day and the service users complained that the home did not have any cold drinks to offer them other than water, the staff said this happened on a regular basis and they sometimes brought cold drinks in for service users. Five service users were receiving special diets. Special cutlery and crockery was provided for those service users who had difficulty using knives and forks. Grange Crescent DS0000002963.V300378.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 inspected at least once during a 12 month period. 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 after discussion with ten service users, two relatives, three staff members and using available written evidence including a visit to the home. The homes complaints procedure was clear, accessible and contained the necessary information. This is good management practice. Service users were protected from abuse by the awareness of staff through training and the homes procedures. EVIDENCE: The complaints procedure was available for service users, their relatives and staff. The manager confirmed that this would be available in alternative formats and languages should this be requested. All the service users and relatives spoken to said that they knew that they could complain if they were not happy about anything and that they felt able to discuss any issues or concerns that they may have with the manager. The complaints records confirmed that no complaint has been made at the home since the last inspection. Staff had received formal adult protection training this included physical, emotional and sexual abuse. The manager was aware of the Sheffield City Councils adult abuse procedures. Grange Crescent DS0000002963.V300378.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19 and 26. Quality in this outcome area is good. This judgement has been made after discussion with ten service users, two relatives, three staff members and using available written evidence including a visit to the home. The environment within the home was clean providing a comfortable environment for service users. The home was well decorated and looked very homely. The service users said this made them feel at home. One refuse bin was not fitted with a lid. This is not hygienic. Grange Crescent DS0000002963.V300378.R01.S.doc Version 5.2 Page 16 EVIDENCE: Some parts of the home had been redecorated and some carpets and fixtures replaced. The bedroom doors were fitted with suitable door locks and lockable facilities were provided in all bedrooms. Each bedroom had an en-suite facility. Service users could smoke in a designated smoking area. Appropriate seating had been provided in the garden for those service users wishing to sit outdoors whenever the weather permitted. Each floor had a number of toilets and bathrooms. Assisted baths and showers were provided for those service users with mobility problems. Toilets were easily accessible as they were close to lounge and dining areas. All the toilets had been adapted for service users with physical disabilities. Staff confirmed that they were provided with protective clothing if they needed it and that all the equipment was in good working order and that it had been serviced as required. One refuse bin, which contained waste food, was not fitted with a lid. Grange Crescent DS0000002963.V300378.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27,28,29 and 30. Quality in this outcome area is good. This judgement has been made after discussion with ten service users, two relatives, three staff members and using available written evidence including a visit to the home. Care staff had a range of skills and experience, which effectively supported the service users. This will ultimately benefit the health and welfare of the service users. The homes recruitment procedures were not adequate, as they do not protect the service users from harm. The home had a training and development plan and all staff had completed a range of training relevant to their role. This allows the staff to ensure they meet the individual assessed needs of service users. Grange Crescent DS0000002963.V300378.R01.S.doc Version 5.2 Page 18 EVIDENCE: The service users, staff and relatives said that there was always enough staff on duty. They said that the staff worked very hard and described them as “very caring, kind and understanding”. Staff were approachable and sensitive to the needs of service users and were able to communicate effectively with each person. Three staff files were checked; the files demonstrated that a thorough recruitment processes had not been followed as required by the Care Homes Regulations. Gaps were noted in two staff’s employment history. Staff spoken to had an understanding of the home’s fire procedures; they had received training on moving and handling, fire, food safety and infection control. Staff files checked and discussions with three staff and the manager confirmed that all staff had completed detailed induction training. 76 of the staff team were qualified to NVQ level 2. Staff were being formally supervised at the frequency required to fully ensure individual staff development and the monitoring of care practices Grange Crescent DS0000002963.V300378.R01.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): 31,33,35 and 38. Quality in these outcome areas is: good. This judgement has been made after discussion with ten service users, two relatives, three staff, the manager, and using available written evidence including a visit to the home. The service users, relatives and staff spoken to said the manager was approachable and very professional. The manager has completed NVQ level 4 training. This has enhanced her management abilities. Service users and relatives surveys are completed six monthly, which ensures that the home is run in the best interest of service users. Records were in the main up to date and well ordered to ensure the best interests of service users. The homes policies and procedures met the required standards. A safe environment was provided in all parts of the home. This protects the health and welfare of the service users. Grange Crescent DS0000002963.V300378.R01.S.doc Version 5.2 Page 20 EVIDENCE: The manager had a job description that clearly defined her roles and responsibilities and staff were aware of her role. Service users and staff said she was committed to ensuring that the home provides a high standards of care, she completes regular internal audits on all aspects of the service provided by the home. She has completed her NVQ level 4 training. Staff spoken to had an understanding of the home’s fire procedures; they had received training on moving and handling, fire, food safety and infection control. There was a quality assurance system, which sought the views of service users and relatives. The responsible individual visit the home on a regular basis a report is written following the visits. A copy of the responsible individuals monthly report is sent to the local office of the Commission For Social Care Inspection. No fire exits were blocked and hazardous substances were securely stored. The manager handles money on behalf of some service users, account sheets were kept, receipts were available for all transactions and all transactions were witnessed by a second individual. The accounts are audited annually. Grange Crescent DS0000002963.V300378.R01.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 3 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 2 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 2 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X X X X X 2 STAFFING Standard No Score 27 3 28 4 29 2 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X X 3 Grange Crescent DS0000002963.V300378.R01.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 Standard OP7 Regulation 15 Requirement Timescale for action 01/10/06 2 OP9 13 The care pans must detail the service users religious and cultural needs. Care plans must be signed by the writer and dated. Medication record charts must be 27/07/06 signed to show whether medication has been given or not. This requirement as been outstanding since November 2005. Hot food must be served hot and not overcooked. A choice of hot and cold drinks must be available at all times. Waste bins must be fitted with secure lids. Gaps in staff’s employment history must be explored. 01/08/06 3 OP15 16 4 5 OP26 OP29 23 19 01/08/06 01/08/06 Grange Crescent DS0000002963.V300378.R01.S.doc Version 5.2 Page 23 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 Crescent DS0000002963.V300378.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Sheffield Area Office 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 DS0000002963.V300378.R01.S.doc Version 5.2 Page 25 - 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!