Inspection on 24/02/06 for Grange Lea Residential Home

This inspection was carried out on 24th February 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Grange Lea Residential Home 13/11/06

Grange Lea Residential Home 08/09/05

Grange Lea Residential Home 08/02/05

Grange Lea Residential Home 17/06/04

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

CARE HOMES FOR OLDER PEOPLE Grange Lea Residential Home Grange Road Off Wigan Road Bolton Lancashire BL3 5QE Lead Inspector Rukhsana Yates Unannounced Inspection 21st February 2006 09:30 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 Lea Residential Home DS0000009287.V284178.R01.S.doc Version 5.1 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 Home DS0000009287.V284178.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Grange Lea Residential Home Address Grange Road Off Wigan Road Bolton Lancashire BL3 5QE 01204 665903 01204 665903 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) Dr A Joy Kumar Ghosh Mrs Glynis Roberts Care Home 26 Category(ies) of Old age, not falling within any other category registration, with number (26) of places Grange Lea Residential Home DS0000009287.V284178.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. The service should at all times employ a suitably qualified and experienced manager who is registered with the Commission for Social Care Inspection. That within the maximum number of 26 there can be up to 26 OP. Date of last inspection 8th September 2005 Brief Description of the Service: Grange Lea is a privately owned care home for 26 older people of either sex. The home is in a residential area close to Bolton town centre, and is close to several local amenities including shops, a park and coffee shop. Grange Lea has 22 single bedrooms and two double rooms. 6 rooms have en-suite facilities. There are two floors with a lift to the first floor. The home has a good choice of lounge areas, a small garden area and car park. Grange Lea Residential Home DS0000009287.V284178.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was unannounced and carried out over 5 hours. During the visit, discussions took place with residents, visitors, staff members and the manager. The process also included watching the ways in which staff supported residents, and looking at paperwork relating to the care and safety of residents. Staff files were also examined. What the service does well: 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 Lea Residential Home DS0000009287.V284178.R01.S.doc Version 5.1 Page 6 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 Home DS0000009287.V284178.R01.S.doc Version 5.1 Page 7 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): 1 and 3 Each person moving to Grange Lea has their needs assessed prior to admission. Written information about the home should be readily available to new residents. EVIDENCE: The home had produced a statement of purpose and a service users’ guide containing useful information for existing and prospective residents and their families. However, there were no copies of the statement of purpose and guide readily available. Copies of the statement and guide need to be available on request. At the last inspection the home was advised to have a copy of the most recent inspection report accessible to anybody visiting the home. This has been addressed. In respect of new admissions to the home, there was evidence in the residents’ files that a pre-admission assessment is carried out during a visit to the prospective resident. The information gathered is used as a basis for formulating the care plan. Grange Lea Residential Home DS0000009287.V284178.R01.S.doc Version 5.1 Page 8 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 and 10 Each resident’s personal, health needs and risk assessments are included in their care plan. However, specific needs, and actions to be taken to address risk areas should be clearly identified to promote staff understanding and to enable appropriate care to be provided. Residents feel they are treated with respect and their right to privacy is upheld. EVIDENCE: Each resident has a care plan that covers a wide range of needs, and there has been a steady improvement in the quality and level of assessment information recorded and the way the files are organised. All relevant areas are indicated as being reviewed monthly. However, the records seen said “care as plan”. Reviews should reflect the success or otherwise of the interventions identified in the care plan, and additional information gained about the resident. In terms of healthcare needs, as at the last inspection, residents were satisfied that their healthcare needs were adequately met and staff had a good knowledge of the health needs of the residents. Although some risk assessments are in place relating to falls and nutrition, ways of addressing the risks need to be clearly identified. Care plans need to address areas of high Grange Lea Residential Home DS0000009287.V284178.R01.S.doc Version 5.1 Page 9 risk. As previously required, intervention and prevention measures must be clearly recorded. One file did not have a pressure area risk assessment and another person at high risk nutritionally did not have a dietary care plan or intake chart. There must be evidence that actions are implemented and monitored via monthly reviews, in respect of moving and handling, pressure areas, falls and nutrition. Residents consulted were happy with the attitudes of staff and felt that they are treated with respect. Written and verbal guidelines are given to staff in respect of the principles of care and observations confirmed that these are understood. Grange Lea Residential Home DS0000009287.V284178.R01.S.doc Version 5.1 Page 10 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): 13 and 14 Residents benefit from open visiting arrangements and contact with the local community. Residents are helped to exercise choice in their daily routines. EVIDENCE: The home has open visiting arrangements and a relative confirmed that visitors are made to feel welcome. The home has a part-time hobby therapist who is looking at ways to increase residents’ community participation. For example, through visits to the local pub and trips out to places of interest. During good weather, as seen at the last inspection, residents are accompanied to the nearby park and café. With respect to meeting religious needs, communion takes place in the home each Sunday, and the manager will make arrangements to support residents who wish to go to church. The hobby therapist is considering ways of splitting the hours he works to accommodate more activities in the evenings. Residents, in discussion, said that they have a choice with regard to rising and retiring times, and since the last inspection, have better information about choices at mealtimes. Grange Lea Residential Home DS0000009287.V284178.R01.S.doc Version 5.1 Page 11 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): These key standards were not assessed. The standards were met at the last inspection. EVIDENCE: These key standards were not assessed. The standards were met at the last inspection. Grange Lea Residential Home DS0000009287.V284178.R01.S.doc Version 5.1 Page 12 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): These key standards were not assessed during this visit. EVIDENCE: There is an ongoing redecoration and refurbishment programme. Grange Lea Residential Home DS0000009287.V284178.R01.S.doc Version 5.1 Page 13 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): 28, 29 and 30 The home needs to ensure that staff recruitment, induction and supervision arrangements are suitable to achieve protection and a good standard of care for residents. EVIDENCE: Staffing levels and the stability of the staff group have improved since the last inspection. The manager now has 27 supernumerary hours per week. Currently 9 care staff of 15 have achieved the NVQ qualification at Level 2. Funding is being identified for the remainder. Improvement is still needed in recruitment procedures. Of the two files seen pertaining to new staff, one had unexplored gaps in employment history, a reference that did not come from the most recent employer, and lack of a second reference. The manager stated that she had spoken to the last employer but there was no evidence for this on the file. Evidence of robust recruitment procedures must be in place, as required at the last inspection. There was evidence that staff have regular mandatory training in areas such as first aid, food hygiene, medication, moving and handling and fire safety. However there was no structured induction being worked through for new staff. This must be addressed. The manager also need to make sure that supervision is carried out regularly for all staff as many had not been Grange Lea Residential Home DS0000009287.V284178.R01.S.doc Version 5.1 Page 14 completed since April / May 2005. Individual staff training and development records need to be set up and reviewed during each supervision meeting. Grange Lea Residential Home DS0000009287.V284178.R01.S.doc Version 5.1 Page 15 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, 35 and 38 The home is suitably managed. Secure arrangements are in place for administering residents’ personal monies. Regular environmental health and safety checks are carried out. EVIDENCE: Supervision (Standard 36) is covered in the previous section under Standard 30. The manager of Grange Lea is experienced and fosters a welcoming and friendly atmosphere in the home. The supernumerary hours allocated to her since the last inspection should now enable the home to meet outstanding requirements from the last inspection. The manager is part way through the Registered Manager’s Award. Grange Lea Residential Home DS0000009287.V284178.R01.S.doc Version 5.1 Page 16 The arrangements for managing residents’ personal monies were seen to be safe and secure. Written account records are kept and were accurately maintained. A of health and safety testing certificates were examined. These related to hoisting equipment, fire extinguishers, Legionella water tests, and gas and electrical installations. The electrical testing certificate from October 2005 contained details of remedial action to be taken. The home should provide evidence that the actions identified in the report have been addressed. The records relating to thermostatic blending valves stated that there is a need to plan for replacement of valves in the future to ensure compliance with current legislation. Evidence of plans to address this should also be forwarded. Grange Lea Residential Home DS0000009287.V284178.R01.S.doc Version 5.1 Page 17 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 3 X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 2 9 X 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 X 13 3 14 3 15 X COMPLAINTS AND PROTECTION Standard No Score 16 X 17 X 18 X X X X X X X X X STAFFING Standard No Score 27 X 28 3 29 2 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X X X 3 X X 3 Grange Lea Residential Home DS0000009287.V284178.R01.S.doc Version 5.1 Page 18 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 OP8 Regulation 12, 13, 14, 15 Requirement The registered person must ensure that intervention and prevention measures are clearly recorded, implemented and monitored for identified risks in respect of moving and handling, pressure areas, falls and nutrition. (Previous timescale of 2.12.05 not met). The registered person is required to implement robust recruitment procedures checks prior to appointment, and to ensure individual records contain all the information specified in Schedule 2 of the Care Homes Regulations. (previous timescale of 10.10.05 not met) The registered person is required to ensure the provision of regular, recorded supervision, and to develop training and development profiles for all staff. New staff must receive induction training. (Previous timescale of 2.12.05 not met). Timescale for action 15/05/06 2. OP29 18, 19 24/02/06 7. OP30OP36 18 15/05/06 Grange Lea Residential Home DS0000009287.V284178.R01.S.doc Version 5.1 Page 19 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 2 Refer to Standard OP1 OP7 Good Practice Recommendations A supply of copies of the statement and guide should be kept at the home so that they are available on request. Care plan reviews should reflect the success or otherwise of the interventions identified in the care plan, and additional information gained about the resident. The electrical testing certificate from October 2005 contained details of remedial action to be taken. The home should provide evidence that the actions identified in the report have been addressed. The records relating to thermostatic blending valves stated that there is a need to plan for replacement of valves in the future to ensure compliance with current legislation. Evidence of plans to address this should also be forwarded. 3 OP38 Grange Lea Residential Home DS0000009287.V284178.R01.S.doc Version 5.1 Page 20 Commission for Social Care Inspection Bolton, Bury, Rochdale and Wigan Office Turton Suite Paragon Business Park Chorley New Road Horwich, Bolton BL6 6HG 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. 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