Inspection on 07/11/06 for Grange-Lea Residential Care Home

This inspection was carried out on 7th November 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 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 11/04/07

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 7th November 2006 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.V316183.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.V316183.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.V316183.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 15/11/05 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 £289.00 and the highest £420.00 payable weekly. Grange-Lea Residential Care Home DS0000068170.V316183.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 11.5 hours during November 2006. 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 also consulted. A complete tour of the building was undertaken where all rooms were seen including the communal areas. Four of the care team were interviewed individually in private as part of the inspection process. The registered manager and the proprietor assisted throughout the inspection. What the service does well: The home has a very low turnover of carers and the experienced care team available is committed to providing a high standard of service to the residents. Residents consulted advised that they were very happy at the home and had positive comments to make about their carers who one person said “… couldn’t do better”. Appropriate friendly banter was often overheard during the inspection and good relationships were clearly demonstrated between carers and residents during the inspection. Service was seen to be delivered in a sensitive, unhurried way to residents. 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. 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. Residents meetings are held to ascertain their views and they are also consulted individually. A questionnaire process is also used. A comfortable, well maintained environment is provided for residents. One resident said, “I couldn’t do better than this, I am very well cared for” another person said “It’s very good here the ‘girls’ (carers) are very patient and will always help you when you need it” Grange-Lea Residential Care Home DS0000068170.V316183.R01.S.doc Version 5.2 Page 6 What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Grange-Lea Residential Care Home DS0000068170.V316183.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-Lea Residential Care Home DS0000068170.V316183.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. JUDGEMENT – we looked at outcomes for the following standard(s): 3 and 6. Quality in this outcome area is good. Detailed quality assessments are available for each resident in the home that covers all their needs. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Five assessments were examined at this inspection; all needs were recorded in the areas of health, personal and social. The home undertakes to complete this detailed assessment of prospective residents before they offer a place; this approach is followed even if the person to be assessed is living out of county. All the residents consulted at the time of the inspection confirmed that all their needs were met by the service provided. No unmet need was apparent. Standard 6 refers to a service not provided at Grange-Lea. Grange-Lea Residential Care Home DS0000068170.V316183.R01.S.doc Version 5.2 Page 9 Grange-Lea Residential Care Home DS0000068170.V316183.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. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 and 10. Quality in this outcome area is Good. Individual care plans are available that are comprehensive and show how all needs are met. All health needs are met and residents that wish are able to self medicate. Residents are protected by the policies and procedures that are in place for the administration of medication. Residents felt that they were always treated with respect and their privacy was maintained. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Five care plans were examined in detail at this inspection. Health, personal and social needs were well addressed. All the care plans seen provided a detailed foundation for the service to be provided by the home to the individual resident. However, the registered manager felt that this system could be improved further and is going to present the information is a clearer format. The home has a good relationship with the local healthcare professionals; five were consulted as part of the inspection process and they all advised that the home had their confidence and made appropriate access available to them Grange-Lea Residential Care Home DS0000068170.V316183.R01.S.doc Version 5.2 Page 11 when they were required. All the residents consulted stated that their needs were well met by the home and that they agreed their care plan, which was, reviewed on a monthly basis. Residents that wish are able to self medicate at the home subject to a risk assessment process to ensure they have the capacity. The recording undertaken by the home of the administration of medication was examined and found to be clear and complete, this demonstrates that residents are appropriately protected. All medication was stored under secure conditions. Six residents were consulted during the inspection process, they were interviewed individually in private and were well able to express their views. Service users advised that they felt they were treated with respect and that their privacy was maintained and 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 “I am very happy hear, the girls (carers) are patient and will always help you whatever the job” another stated “I was worried when I had to leave my home, but I needn’t have, this is wonderful for me”. Grange-Lea Residential Care Home DS0000068170.V316183.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. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 and 15 Quality in this outcome area is Excellent. Residents advised that all their needs were met at the home and they enjoyed the lifestyle. There are no restrictions on visiting and residents are encouraged to maintain their contact with the local community. Great care is given to assist residents to make their own choices and exercise control over their lives. A wholesome diet is provided, meals are served in pleasant surroundings This judgement has been made using available evidence including a visit to this service. EVIDENCE: Six residents were consulted in private, individually during the inspection, they all said that they were very happy at the home and felt that all their needs were met. They were complimentary about the care team and the management of the home. An activities programme is provided for residents and entertainers are retained. When asked residents could not suggest any additions they would like. Ministers of various religions visit the home to give Holy Communion every two weeks. One resident said, “For me, there’s plenty to do and I can get peace and quiet when I want it” another remarked, “This lifestyle suits me, I should have come in years ago”. Grange-Lea Residential Care Home DS0000068170.V316183.R01.S.doc Version 5.2 Page 13 The home has an unrestricted visiting policy and procedure and residents confirmed that they could have visitors 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 is undertaken through residents’ meetings and on an individual basis. 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, that was not the case at the last place I was at” 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. 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. Grange-Lea Residential Care Home DS0000068170.V316183.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. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18. Quality in this outcome area is good. Residents were confident, when asked, that if they had an issue this would be resolved quickly by the management of the home to their satisfaction. Residents were appropriately protected from abuse. This judgement has been made using available evidence including a visit to this service. EVIDENCE: As previously stated six residents were consulted in private, individually as part of the inspection process, they were all confident that if they had a matter they wanted resolved this would be done 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.V316183.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. JUDGEMENT – we looked at outcomes for the following standard(s): 19 and 26. Quality in this outcome area is Good. Grange-Lea provides a comfortable, clean and safe environment to the people that live there. The home is clean and pleasant with high standards of hygiene evident. This judgement has been made using available evidence including a visit to this service. EVIDENCE: A complete tour of the home was undertaken as part of the inspection and all rooms were seen. The home has an active maintenance programme in place and it was well maintained and decorated to a high standard throughout. Residents advised that the home was always like a ‘new pin’ and stated that they liked their rooms and having use of more than one lounge area. Since the last inspection the kitchen of the home has been completely replaced, the room was taken back to the walls, which have then been covered, in an appropriate material and the floor covering has been replaced. Grange-Lea Residential Care Home DS0000068170.V316183.R01.S.doc Version 5.2 Page 16 Freestanding stainless steel units have been introduced and new cooking facilities with extraction provided. This comprehensive approach will help ensure that the high standards of the home are maintained. As previously stated all rooms were seen at the time of the inspection including bathrooms and toilets, high standards of hygiene were evident throughout which will ensure residents are safe. Grange-Lea Residential Care Home DS0000068170.V316183.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. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 and 30. Quality in this outcome area good. There are always adequate care staff to meet residents’ needs and carers 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. 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.V316183.R01.S.doc Version 5.2 Page 18 Grange-Lea Residential Care Home DS0000068170.V316183.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. JUDGEMENT – we looked at outcomes for the following standard(s): 31,33,35 and 38. Quality in this outcome area is good. 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 at the home has substantial experience of working in care and is well qualified, she has obtained NVQ 4 and the registered managers award. She is of good character and is fit to be in charge to ensure the home is run in the correct manner. Grange-Lea Residential Care Home DS0000068170.V316183.R01.S.doc Version 5.2 Page 20 From observations made at the time of the inspection it was clear that residents’ needs took precedence over the running routines of the home. Residents also confirmed in conversation that their needs were given priority. Good quality consultation takes place with the residents to ensure their needs are met by the service provided. Five residents records were examined of the support and assistance the home provides concerning the administration of residents’ pocket monies. These were all clear and all cash 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.V316183.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 X 3 X X 3 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 4 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 4 Grange-Lea Residential Care Home DS0000068170.V316183.R01.S.doc Version 5.2 Page 22 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.V316183.R01.S.doc Version 5.2 Page 23 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.V316183.R01.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. 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