Inspection on 11/04/07 for Grange-Lea Residential Care Home

This inspection was carried out on 11th April 2007.

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 made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Grange-Lea Residential Care Home 07/11/06

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

CARE HOMES FOR OLDER PEOPLE Grange-Lea Residential Care Home 38 Preston Down Road Preston Paignton Devon TQ3 2RL Lead Inspector James Rose Unannounced Inspection 11th April 2007 09:00 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-Lea Residential Care Home DS0000068170.V333319.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-Lea Residential Care Home DS0000068170.V333319.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Grange-Lea Residential Care Home Address 38 Preston Down Road Preston Paignton Devon TQ3 2RL 01803 522342 01803 408901 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 Alan Ralph Albert Baker Mrs Michelle Andrea Baker Mrs Eleanor Morgan Care Home 32 Category(ies) of Old age, not falling within any other category registration, with number (32) of places Grange-Lea Residential Care Home DS0000068170.V333319.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 08/11/06 Brief Description of the Service: Grange-Lea is a detached extended building which stands in its own grounds and offers 24-hour residential care for up to 32 persons in the category of old age. The home has three lounge areas and meals are taken in a separate dining room. All the bedrooms at the home are single occupancy and have on suite facilities available. The home is surrounded by well-tended gardens and a hard standing car park is provided. There is good level access into the home; a vertical lift is available and appropriate aids for persons that have mobility issues. Because the home is built on the side of a hill it has extensive views of the surrounding Torbay area. The fees payable at Grange-Lea are: Lowest £298.16 and the highest £440.00 payable weekly. Grange-Lea Residential Care Home DS0000068170.V333319.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place over 12 hours during April 2007. Samples of the care records were examined and six residents were asked for their views of the service provided at the home, this was undertaken individually in private. Evidence was also gathered from questionnaires. Healthcare professionals and visitors were consulted. A complete tour of the building was undertaken where all rooms were seen. Four of the care team were interviewed individually in private as part of the inspection process. The acting manager and the proprietor assisted throughout the inspection process. What the service does well: The home has an experienced care team available that is committed to providing a high standard of service to the residents. The residents consulted individually and as a group advised that they were very happy at the home and had positive comments to make about their carers one person said “… couldn’t do better” another remarked, “I can’t fault them, I’ve never been so well looked after”. Appropriate friendly banter was overheard during the inspection and good relationships were demonstrated between carers and residents during the inspection. It was clear from observations made during the inspection that care was delivered in a sensitive way to meet the needs of the individual. The home provides a wholesome appealing balanced diet that is served in the home’s dedicated dining room or in a resident’s own room if they wish. In addition to all the meals the kitchen staff also produce confectionary for the residents. Daily consultation takes place with each resident about what foods they would like to consume, sherry is also provided by the home with wine provided on birthdays and holidays. Visitors are able to share a meal with their relative in the home and extra support is given to the relatives and friends of a resident who is in the terminal phase of their life, no extra charges are made. Grange-Lea Residential Care Home DS0000068170.V333319.R01.S.doc Version 5.2 Page 6 Residents are consulted individually to ascertain their views on the quality of the service provided and for any development of the service undertaken. A questionnaire process is also used. A comfortable, safe, well-maintained environment is provided for residents. The atmosphere is homely and friendly and residents were very relaxed. When the inspector introduced himself to a group of residents he was told “Well you won’t find anything wrong here!” What has improved since the last inspection? What they could do better: No requirements or recommendations are raised in this report. Grange-Lea Residential Care Home DS0000068170.V333319.R01.S.doc Version 5.2 Page 7 Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Grange-Lea Residential Care Home DS0000068170.V333319.R01.S.doc Version 5.2 Page 8 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-Lea Residential Care Home DS0000068170.V333319.R01.S.doc Version 5.2 Page 9 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 3 and 6. Quality in this outcome area is good. Comprehensive, detailed assessments were available for each resident in the home. This judgement has been made using available evidence including a visit to this service. EVIDENCE: A sample of six assessments were examined in detail, these covered all the needs of the person in the areas of health, personal and social. The home completes an assessment of a prospective resident before they are offered a place to ensure all their needs can be met by the service provided at Grange Lea. All the residents consulted as part of the inspection process confirmed that all their needs were met at the home and they had no unmet needs. Grange-Lea Residential Care Home DS0000068170.V333319.R01.S.doc Version 5.2 Page 10 From observations made during the inspection process it was clear that the care team provided a very individual service to residents with all their needs being well known. Standard 6 refers to a service not provided at Grange Lea. Grange-Lea Residential Care Home DS0000068170.V333319.R01.S.doc Version 5.2 Page 11 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 and 10. Quality in this outcome area is good. Detailed individual care plans were available in the home that covered all the needs of a resident. Health needs were well covered. Residents are able to self medicate and are protected by the administration procedures of the home. All residents consulted felt they were treated with respect and their privacy was maintained. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Individual care plans are produced for residents from the assessments undertaken prior to them being offered a place at the home. Since the time of the last inspection a new set of care plans has been produced. Health needs were comprehensive, social elements were also covered and the way they were recorded was discussed and it was agreed that this element would be developed further. Grange-Lea Residential Care Home DS0000068170.V333319.R01.S.doc Version 5.2 Page 12 Four healthcare professionals were consulted and they advised that the home ensured that they were accessed for residents when needed and that they had no concerns about the service provided. Two visitors were also consulted in private and they stated that their relatives at the home had no unmet needs and that they received a “very good service”. Residents that wish are able to self medicate at the home subject to a risk assessment process to ensure they have the capacity. The recordings undertaken by the home of the administration of medication was examined and found to be clear and complete, medication was booked in when received and recorded when issued and unused medication was returned to the pharmacist, this demonstrated that residents were appropriately protected. All medication was stored under secure conditions. Six residents were consulted during the inspection process; they were interviewed individually in their own rooms and were well able to express their views. Service users advised that they felt they were always treated with respect and that their privacy was maintained and was seen as important by their carers. Appropriate interaction was overheard and observed many times during the inspection process. It was clear that service was delivered in an unhurried way to residents and great care taken when residents were mobile. Personal care was always delivered in private. One residents said “If I had known it was going to be like this I would have come in earlier” another stated “I get well looked after and the food is wonderful, what more could I want”. Grange-Lea Residential Care Home DS0000068170.V333319.R01.S.doc Version 5.2 Page 13 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13 14 and 15. Quality in this outcome area is excellent. The lifestyle experienced by them at the home satisfied their preferences and met all their needs. Residents are able to receive visitors at anytime. Assistance and support is provided to enable residents to exercise real choice and control over their lives. A wholesome balanced diet is provided that is to the liking of the residents that is served in a dedicated dining room. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Six residents were consulted individually in their own rooms about life at Grange Lea. They were all very clear that they enjoyed life at the home. One resident said “There’s plenty on for us and carers will always give you a hand if you want it” another remarked, “This is much better than I thought it was going to be!” residents went on to be complimentary about the care team and stated that they had all their needs met by the service provided at the home. The home has developed the way is provides activities for the residents, rather than have a fixed programme they have a range of activities and crafts available and residents choose which ones they would like. This has proved to be successful and some residents advised that they preferred this approach. Grange-Lea Residential Care Home DS0000068170.V333319.R01.S.doc Version 5.2 Page 14 When asked residents could not make any suggestions of additions they would like made to the activities provided. The home also provides trips out for the residents; these are more usually undertaken in the summer during good weather although trips have been undertaken to the theatre locally. The home has an unrestricted visiting policy and procedure and residents and two visitors confirmed that they could come at anytime. Residents are encouraged to maintain contact with the local community and one resident is assisted to continue to attend a local lunch club. The home seeks residents’ views at every opportunity to ensure they get the service they want; this was undertaken through residents’ meetings however it has been found that if they consult on an individual basis they are able to get more information. There is also a rolling programme in place that sends a questionnaire to three residents every month. Residents clearly felt they were in control of matters that affected them and they could choose when they went to bed and when they got up and made other domestic choices such as when their room was cleaned etc. All the residents consulted advised that they liked the food provided at the home and did not wish the menu to be changed or any additions made. One resident said, “I enjoy the food here, it’s wonderful, as good as I could do” another remarked, “I like the food and I can have it in my room if I want”. Residents are consulted daily about what foods they would like to eat. Sherry is also served at the main meal of the day and wine is provided for birthdays and holidays. Three of the residents stated, “fresh fruit is always available you only have to ask”. Snacks and hot drinks are always available form the home’s kitchen on a 24-hour basis. The meal served on the day of the inspection was of good quality and was clearly much appreciated by the residents. The home has a dedicated dining room with small individual tables available; currently the dinning room is being redecorated. Grange-Lea Residential Care Home DS0000068170.V333319.R01.S.doc Version 5.2 Page 15 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18. Quality in this outcome area is excellent. Residents were confident that if they raised an issue with the home it would be dealt with appropriately. Service users are protected from abuse and the care team receives training in the adult protection procedures in place. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Six residents were consulted in private in their own rooms as part of the inspection process, they were all confident that if they had an issue they wanted resolved this would be undertaken quickly by the management of the home, to their satisfaction. They said that small matters had been attended to during their stay but they had never had to raise a formal complaint. No complaints were made during the time of the inspection. Four members of the care team at the home were interviewed individually in private, when asked about the home’s adult protection policy and procedure they were clear on the types of abuse possible and what action they should take if they discovered abuse taking place. Grange-Lea Residential Care Home DS0000068170.V333319.R01.S.doc Version 5.2 Page 16 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 19 and 26. Quality in this outcome area is good. Residents live in a comfortable, safe, well-maintained establishment. The home is clean and pleasant with high standards of hygiene evident throughout. This judgement has been made using available evidence including a visit to this service. EVIDENCE: A complete tour was undertaken of the building as part of the inspection process and all rooms were seen. The home was very well maintained and substantial work had been completed since the last inspection. Seven bedrooms had been redecorated and where necessary the carpet had been replaced. New furniture had been provided in bedrooms and easy chairs had been provided for some of the lounge areas. Some new dining furniture had also been purchased. The home has an active redecoration programme running and currently the dining room is being undertaken. Grange-Lea Residential Care Home DS0000068170.V333319.R01.S.doc Version 5.2 Page 17 A substantial investment has been made by the home in modernising the vertical lift as recommended by the company that regularly services it. The fire alarm system has also been upgraded to ensure the home is well covered and residents are safe. A large set of sit on scales has also been purchased to assist with monitoring the weight of residents. The bathrooms’ of the home has been completely refurbished and now provide a much-improved environment for residents. The home has had a programme running to ensure that all the radiators in the building are covered to ensure residents are protected from hot surfaces, this has now been completed. All areas of the home were seen and high standards of hygiene were evident throughout. Grange-Lea Residential Care Home DS0000068170.V333319.R01.S.doc Version 5.2 Page 18 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 and 30. Quality in this outcome area is good. There are always adequate care staff to meet residents’ needs that are trained and competent to fulfil their role. The home has an appropriate recruitment policy and practice. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The staffing levels at the home remain at the same level as at the last inspection, this is adequate and ensures that there are always sufficient experienced carers on duty to meet all the needs of the residents in the home. All the residents consulted during the inspection process also confirmed this. The home has an appropriate policy and procedure and maintains personnel files that complies with the legislation, this ensure residents are adequately protected. Two references are taken up on an applicant and appropriate checks are always undertaken on any new personnel. The home has an active training programme that is well recorded and includes a comprehensive induction for each new staff member followed by basic training; the home then encourages and supports carers to undertake more advanced courses. Grange-Lea Residential Care Home DS0000068170.V333319.R01.S.doc Version 5.2 Page 19 Grange-Lea Residential Care Home DS0000068170.V333319.R01.S.doc Version 5.2 Page 20 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35 and 38. Quality in this outcome area is excellent. The registered manager of Grange-Lea is well qualified and experienced and is fit to be in charge. The home is run in the best interest of the residents and their financial interests are safeguarded. Health and Safety issues are given a high priority and are addressed promptly. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The registered manager for the home is currently on maternity leave and this role is being covered by her deputy, this has not affected the running of the home and the quality of the service to the residents has been maintained. It was clear from observations made at the time of the inspection that residents’ needs took precedence over the routines of the home. Residents also Grange-Lea Residential Care Home DS0000068170.V333319.R01.S.doc Version 5.2 Page 21 confirmed in conversation that their needs were given priority and when they used their emergency call bells they were answered promptly. Good quality consultation takes place with the residents to ensure their needs are met by the service provided. Six residents records were examined of the assistance the home provides concerning the administration of residents’ pocket monies. These were all clearly recorded and all cash available was correct. A receipt is retained by the home of any purchases made on behalf of a resident and all transactions are recorded and witnessed. The issues covered by the health, safety and welfare of residents and staff were taken very seriously by the management of the home and were given appropriate priority. Risk assessments were in place of hazards and all equipment was regularly serviced. The homes passenger lift was maintained under contract. The legislation for the use and storage of chemical was observed and reporting of incidents was undertaken when required. The fire precautions undertaken by the home were appropriate and up to date. This comprehensive approach ensures that residents live in a safe environment that is well managed. Grange-Lea Residential Care Home DS0000068170.V333319.R01.S.doc Version 5.2 Page 22 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 3 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 4 13 3 14 3 15 4 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X X X X X 3 STAFFING Standard No Score 27 3 28 3 29 3 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-Lea Residential Care Home DS0000068170.V333319.R01.S.doc Version 5.2 Page 23 Are there any outstanding requirements from the last inspection? No 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. Standard Regulation Requirement Timescale for action 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-Lea Residential Care Home DS0000068170.V333319.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Ashburton Office Unit D1 Linhay Business Park Ashburton TQ13 7UP National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Grange-Lea Residential Care Home DS0000068170.V333319.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. 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