Inspection on 15/09/05 for Grange Lea Rest Home

This inspection was carried out on 15th September 2005.

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

The inspector 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 Rest Home 15/01/09

Grange Lea Rest Home 31/01/07

Grange Lea Rest Home 08/02/06

Grange Lea Rest Home 22/11/04

Grange Lea Rest Home 06/07/04

Grange Lea Rest Home 17/02/04

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

CARE HOMES FOR OLDER PEOPLE Grange Lea Rest Home North Road Ponteland Newcastle upon Tyne NE29 9UT Lead Inspector Alan Baxter Unannounced 15 September 2005 10.00am. The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Grange Lea Rest Home B53-B03 S526 Grange Lea V221267 150905 Stage 4.doc Version 1.20 Page 3 SERVICE INFORMATION Name of service Grange Lea Rest Home Address North Road Ponteland Newcastle upon Tyne NE29 9UT 01661 821 821 01661 821 821 joyce.whaley@btinternet.com Mrs J Whaley Mrs M whaley Mr D C Whaley Mr Daniel Whaley CRH 20 Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Category(ies) of OP Old Age (20) registration, with number of places Grange Lea Rest Home B53-B03 S526 Grange Lea V221267 150905 Stage 4.doc Version 1.20 Page 4 SERVICE INFORMATION Conditions of registration: None. Date of last inspection 22/11/04 Brief Description of the Service: Grange Lea is a family owned and run care home for older persons situated on the outskirts of Ponteland. It is close to local transport facilities and community amenities which include shops, Post Office, Health Centre, Churches, public houses and restaurants.The home is a two storey, detached house, set in it’s own well maintained and mature gardens which are easily accessible to all service users, staff and visitors. The original building has been extended to the rear to provide purpose built accommodation t ground floor level. Five bedrooms are located at first floor level in the original building and can be accessed by a passenger lift.The home has achieved Investors in People Award. Nursing care is not provided. Grange Lea Rest Home B53-B03 S526 Grange Lea V221267 150905 Stage 4.doc Version 1.20 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced inspection. It took five hours. Time was spent with the manager, looking at care records and other documents. About ten residents were asked their views on the home, and the care they receive. Two relatives and a visitor were also asked their views. All the feedback was very positive. What the service does well: The home is pleasantly furnished and decorated, and is very homely. The home is warm, clean, hygienic and free from odours. Residents say that they are very happy with their care. Residents are treated with great respect by the staff. Residents’ health care needs are fully met. Residents have choice as to how they spend their day. Religious needs are fully met. The home has good relationships with, and support from, residents’ families, friends and the local community. Residents say that they feel that staff listen to them, and would take any complaint seriously. There is a low level of accidents in the home. There is a good level of staff training in most areas. Grange Lea Rest Home B53-B03 S526 Grange Lea V221267 150905 Stage 4.doc Version 1.20 Page 6 The home is safe and well maintained. The home has an experienced, stable and caring group of staff. Staffing levels are high. The home is well managed. 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 full report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Grange Lea Rest Home B53-B03 S526 Grange Lea V221267 150905 Stage 4.doc Version 1.20 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Standards Statutory Requirements Identified During the Inspection Grange Lea Rest Home B53-B03 S526 Grange Lea V221267 150905 Stage 4.doc Version 1.20 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 3. New residents are not always fully assessed before they are admitted to the home. EVIDENCE: The care records of three residents were examined. One had a pre-admission assessment completed; one assessment was undated and incomplete; the third resident was only assessed after admission. The importance of fully assessing all potential new residents was discussed, including persons seeking respite care. Grange Lea Rest Home B53-B03 S526 Grange Lea V221267 150905 Stage 4.doc Version 1.20 Page 9 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 7,8. The health, personal and social care needs are fully covered in detailed care plans, but these care plans are not being drawn up quickly enough. Residents’ health care needs are fully met. EVIDENCE: It was a recommendation of the last inspection report that the home continues to introduce the new care plan format. This is still in the process of being introduced. Where care plans have been drawn up, they are of a good standard. They are holistic, very comprehensive and provide a very good match with the residents’ assessed needs. However, two recently admitted persons had no care plans on their file, as it is currently taking up to eight weeks for care plans to be drawn up for new residents. As care plans are particularly important in the period from admission, care plans (at least in draft form) must be drawn up within a week of admission. Grange Lea Rest Home B53-B03 S526 Grange Lea V221267 150905 Stage 4.doc Version 1.20 Page 10 Clear records are kept of visits to or from General Practitioners and District Nurses, and of all contacts with dentists, opticians, chiropodists etc. Health needs are assessed using the Activities of Daily Living format. There are no current concerns about the health of any resident, and none require specialist attention at the moment. The manager, Mr Whaley, gave an example of one resident whose health had improved so much in her eighteen months in the home that she was able to return to her own home, to live independently. Grange Lea Rest Home B53-B03 S526 Grange Lea V221267 150905 Stage 4.doc Version 1.20 Page 11 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12,13. Residents are happy that they can choose their own lifestyle. Residents are encouraged to keep in contact with their family and friends. EVIDENCE: Discussion with residents and the manager confirmed that the majority of residents are sufficiently independent to be able to choose their own lifestyle and make their own choices as to how they spend their day. Some prefer to spend much of their time in their own bedrooms, joining in group activities only when they so choose. Others join in most activities. No one is forced to join in activities. There is no activities programme, as such. There is a weekly activities afternoon, led by an activities co-ordinator (this was seen in practice during the inspection, with seven residents enjoying card games). On other days, staff prompt residents’ activities. However, there is almost no record kept of such activities in the home’s diary or elsewhere. After discussion with the manager, it was accepted that this was a lack of recording, rather than a lack of social activities, and it was agreed to keep a record of all social stimulation for the next inspection. There are visiting entertainers, monthly, during the winter months. The home has weekly visits from the local ‘pat-a-dog’ service. Grange Lea Rest Home B53-B03 S526 Grange Lea V221267 150905 Stage 4.doc Version 1.20 Page 12 Religious and spiritual needs are taken seriously and appropriately met. There is an in-house religious service every four weeks, led in rotation by local Church of England, Methodist and United Reform Church ministers. The local Catholic priest visits weekly to give Communion. Most residents have good support from and contact with their families, who take them shopping and on trips out. Where there is no such family support, there are sufficient staff to escort residents to the local village amenities. There are no restrictions on visiting, although residents may choose not to see a visitor. There are good contacts with the local community, including local schools, Women’s Institute, and the University of the Third Age. Grange Lea Rest Home B53-B03 S526 Grange Lea V221267 150905 Stage 4.doc Version 1.20 Page 13 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 16,18. Residents are confident that they can bring any concerns or complaints they may have to the staff, and that appropriate action would be taken the home. Staff need further training in the protection of residents from abuse. EVIDENCE: The home keeps a complaints book, but this had no entries. The manager, Mr Whaley, advised that he responds immediately to any concerns raised by residents. He was asked to keep a brief record of any such complaints. There was verbal evidence that complaints are dealt with promptly and appropriately. The home’s complaints procedure has been given to all residents and staff. The home has policies and procedures in place for the prevention of abuse, and for responding to any allegation of abuse. No allegations of abuse have ever been made in the home. Care staff have not had training in the Protection of Vulnerable Adults (POVA). Ideally, all staff should have this training. However, it is being proposed that senior staff, only, are sent on such a training course, and that those senior staff then ‘cascade down’ the training to all other staff. For this to be effective, it is recommended that the senior staff attend the full two-day POVA course, and the manager should also attend this course. Grange Lea Rest Home B53-B03 S526 Grange Lea V221267 150905 Stage 4.doc Version 1.20 Page 14 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 19,26. The residents live in a safe, well-maintained environment. The home is clean, pleasant and hygienic. EVIDENCE: The manager has responsibility for health & safety in the home. A record of maintenance issues is kept. All staff have a responsibility for recording any repairs needed, or any hazard noted, in this book. The manager then follows up the issues and signs them off. Service records were current and up to date. The gardens are safe and accessible to residents. A full tour of the building was not undertaken on this inspection, but all those areas seen were clean and hygienic. There were no unpleasant odours. Grange Lea Rest Home B53-B03 S526 Grange Lea V221267 150905 Stage 4.doc Version 1.20 Page 15 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27,29,30. The home is well staffed, and able to meet the needs of the residents. Residents are protected by the home’s employment practices. Staff are experienced and have received a range of training, but the home has yet to meet the target of 50 NVQ qualified staff. EVIDENCE: Staff rotas were examined. There have been no changes to the agreed staffing levels, which are 4 carers (including seniors) from 8am to 1.30pm; 3 carers (including senior) from 1.30pm to 10pm; and 1 carer and 1 senior overnight. In addition, the registered manager works full time, including a weekend presence; and there is a full time officer-in-charge, who has some supernumerary hours for administration. These are relatively high staffing levels, and they allow for good one-to-one contact with residents, especially at weekends. Staff recruitment and personnel files were sampled. These were in good order, with completed application forms, written references, proof of identity, police checks all in place. All staff have a statement of terms and conditions, and evidence of induction training and staff appraisal. The staff training file was examined. All staff have been given the required statutory training in moving & handling, food hygiene and fire awareness; and there are enough trained first aiders to cover every shift. Grange Lea Rest Home B53-B03 S526 Grange Lea V221267 150905 Stage 4.doc Version 1.20 Page 16 There is a staff training plan, and signed records are kept of attendance at inhouse training events, with feedback forms. Northumberland Care Trust provides a five day induction training programme for new staff. The manager holds the D32/33 staff assessor qualification. There is a good policy statement on staff training. Part of this includes a commitment to train all staff to National Vocational Qualification (NVQ) level two in care. Unfortunately, time and financial pressures have prevented the home from achieving this aim, or even the lower standard of 50 of staff with NVQ 2, as required by the National Minimum Standards. To date, five staff have achieved NVQ 2, and two more have nearly achieved this (at which point, 35 of care staff will be qualified). The officer-in-charge has nearly achieved NVQ 3. Grange Lea Rest Home B53-B03 S526 Grange Lea V221267 150905 Stage 4.doc Version 1.20 Page 17 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 36,38. Staff are not receiving the required level of formal staff supervision. The health and safety of residents and staff are protected and protected, but care must be taken to test fire alarms every week. EVIDENCE: It was a requirement of the last inspection report that a programme for individual supervision of carers must be implemented. This has not been implemented. The registered manager supervises staff on a day-to-day basis and takes part in shift handovers. However, there is still no formal staff supervision, comprising regular, scheduled one-to-one meetings, held in private and minuted. These must take place at least six times each year for care staff, and as required for ancillary staff. Grange Lea Rest Home B53-B03 S526 Grange Lea V221267 150905 Stage 4.doc Version 1.20 Page 18 The fire logbook was examined. Emergency lighting and fire extinguishers are checked more frequently than required. Fire alarms, however, are not always being checked every week. The accident book entries are fully completed. They show a very low frequency of accidents in the home. Staff have been trained in moving & handling, fire safety, food hygiene and first aid. The officer-in-charge will be having infection control training. Service and maintenance documentation show that equipment in the home is regularly serviced. Window restrictors are in place. The risk assessment file was not able to be found during the inspection. Grange Lea Rest Home B53-B03 S526 Grange Lea V221267 150905 Stage 4.doc Version 1.20 Page 19 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. Where there is no score against a standard it has not been looked at during this inspection. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score x x 2 x x x HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 x 10 x 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 x 15 x COMPLAINTS AND PROTECTION 3 x x x x x x 3 STAFFING Standard No Score 27 3 28 x 29 3 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x 2 x x x x x 2 x 2 Grange Lea Rest Home B53-B03 S526 Grange Lea V221267 150905 Stage 4.doc Version 1.20 Page 20 Yes. Are there any outstanding requirements from the last inspection? 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 3 Regulation 14(1) Requirement No person must be admitted to the home before a full written assessment of their needs has been undertaken by the manager, for privately-funded persons, or has been received from the refering social worker or care manager. Care plans must be drawn up within seven days of a new resident being admitted to the home. All staff must receive training in the Protection of Vulnerable Adults (POVA). (This is outstanding since 31/03/05.) All care staff must receive formal, minuted supervision at least six times each year. (This is outstanding since 31/03/05.) Fire extinguishers must be checked at least once each week, and the check recorded in the fire logbook. Risk assessments must be available for inspection at all times. Timescale for action 16 september 2005. 2. 7 15(1) 16 September 2005. 31 December 2005. 30 September 2005. 16 september 2005. 16 September 2005. 3. 18 13(6) 4. 36 18(2) 5. 38 23(4) 6. 38 13(4) Grange Lea Rest Home B53-B03 S526 Grange Lea V221267 150905 Stage 4.doc Version 1.20 Page 21 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard 30 Good Practice Recommendations At least 50 of care staff should hold National Vocational Qualification level two in care by 31 December 2005. Grange Lea Rest Home B53-B03 S526 Grange Lea V221267 150905 Stage 4.doc Version 1.20 Page 22 Commission for Social Care Inspection Northumbria House Manor Walks, Cramlington Northumberland NE23 6UR 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 Lea Rest Home B53-B03 S526 Grange Lea V221267 150905 Stage 4.doc Version 1.20 Page 23 - 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. 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