Inspection on 31/01/07 for Grange Lea Rest Home

This inspection was carried out on 31st January 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 Rest Home 15/01/09

Grange Lea Rest Home 08/02/06

Grange Lea Rest Home 15/09/05

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 NE20 9UT Lead Inspector Alan Baxter Key Unannounced Inspection 09:30 31 January and 7th February 2007 st 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 Rest Home DS0000000526.V296123.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 Rest Home DS0000000526.V296123.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Grange Lea Rest Home Address North Road Ponteland Newcastle Upon Tyne NE20 9UT 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) 01661 821821 01661 821821 joyce.whaley@btinternet.com Mrs M Whaley Mr Daniel Charles Whaley, Mrs J Whaley Mr Daniel Charles Whaley Care Home 20 Category(ies) of Old age, not falling within any other category registration, with number (20) of places Grange Lea Rest Home DS0000000526.V296123.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 8th February 2006 Brief Description of the Service: Grange Lea is a family owned and run care home for older persons situated on the outskirts of Ponteland, near Newcastle upon Tyne. It is close to local transport facilities and community amenities that include shops, post office, health centre, churches, public houses and restaurants. The home is a two storey, detached house, set in its 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 at 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. Information about the home, including recent inspection reports, is available from the home. The ‘service user guides’ are being revised later in the year. The current weekly fees are £390 to £430. Grange Lea Rest Home DS0000000526.V296123.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced inspection. It took eleven hours over two days in January and February 2007. Time was spent with the service providers and the officer-in-charge, looking at care records and other relevant documents, such as staff rosters, training records, menus, and health and safety records. Twelve residents were asked their views on the home, and the care they receive. The views of relatives and visitors were the focus of a recent satisfaction survey carried by the home, the results of which are used in this report. In addition, surveys were sent out to residents (six were returned) and relatives (four were returned) as part of this inspection. Nearly all the feedback was very positive. Comments included “The management is very well intentioned and helpful” (relative) and “ I find the staff always capable and helpful. I am very happy here” (resident). The building was partly toured, with the emphasis on the new and converted parts of the home. Lunch was taken with the residents. What the service does well: Residents spoke very highly of the management and staff, said that they are very well cared for, and are happy in the home. Relatives also spoke very highly of the home. One said that the owners and staff are “always prepared to go the ‘extra mile’ for the people who live there in every aspect of their care … all homes should be like this one!”. Another said “I find all the carers very respectful and caring, nothing is too much trouble. The food is good and generally the home is extremely well run”. The care plans to meet residents’ needs are very detailed, sensitive and appropriate. Residents’ health care needs are regularly assessed and any health need is properly attended to. Grange Lea Rest Home DS0000000526.V296123.R01.S.doc Version 5.2 Page 6 Residents may keep responsibility for their own medicine, if they are able to do so, and secure storage is provided. Residents are treated with great respect at all times. Relatives are encouraged to keep contact with their family members in the home, and to visit regularly. The home always makes them welcome. Complaints are rare, but are taken seriously, and properly addressed. All the residents know how to make a complaint. Residents are encouraged and supported in keeping control of their lives and making decisions. The home is kept very clean at all times. There are good levels of experienced staff and a low staff turnover. This helps residents get to know the staff and develop good relationships with them. Staff receive good training and are competent in their work. The home is well managed by the owners, who take great pride in their work, and operate the home in the best interests of the residents. Residents’ financial interests are protected by the home. The health, welfare and safety of the residents and staff are taken seriously and properly protected. What has improved since the last inspection? There has been significant rebuilding of some areas of the home. The home has been extended to increase the size of some bedrooms, and to increase the number of rooms with en-suite facilities from nine to sixteen. Other work carried out in the home over the past year includes the retiling of the upstairs bathroom and the installation of a new bathroom suite; the redecoration of two lounges, with new curtains, soft furnishings and carpet in one and a new flat-screen television fitted in the other. The home has introduced new policies and procedures, based on those of a well-known and competent professional care advisory company, but customised to reflect the values and characteristics of Grange Lea. Following consultation with residents, a new six week menu has been introduced. This new menu has increased the variety of food available to the residents; and has introduced choice at the teatime meal. This is good practice. Grange Lea Rest Home DS0000000526.V296123.R01.S.doc Version 5.2 Page 7 The home’s assessment process has improved, and is continuing to improve. Records for short-stay residents are improving. The records of medicines are being discussed with the home’s pharmacist to see what improvements can be made. Introducing a six-week menu has increased the variety of the food available. More choice is being given for the tea meal. There has been a very recent improvement in the social activities offered to the residents. Management and staff have had extra training in protecting residents from harm. Staff supervision has been introduced and is being used to give feedback to staff about their work performance. This should improve the care by picking up any concerns quickly. New health and safety policies have been introduced. 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 Rest Home DS0000000526.V296123.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 Rest Home DS0000000526.V296123.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 adequate. This judgement has been made using available evidence including a visit to this service. The home is currently improving its assessment processes to make sure that every new resident can be sure that all their needs can be met. The home does not provide intermediate care, so this standard does not apply to Grange Lea. EVIDENCE: It was a requirement of the last inspection report that no person must be admitted to the home before a full written assessment of his or her needs has been undertaken by the manager, for privately funded persons, or has been received from the referring social worker or care manager. (This is outstanding since 16/09/05.) Grange Lea Rest Home DS0000000526.V296123.R01.S.doc Version 5.2 Page 10 This is in the process of being carried out. Permanent residents have written assessments from their care managers, and Mr and Mrs Whaley are actively working on a new and more appropriate format for pre-admission assessment for short-stay residents. It was agreed that all assessments will be clearly dated, and will be crossreferenced, where necessary, between the initial detailed assessment and later six-monthly re-assessments. Five out of the six residents who responded to a survey said that they were given enough information to decide whether the home could meet their needs (the sixth said it wasn’t relevant, as the person had lived there for years). Grange Lea Rest Home DS0000000526.V296123.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. This judgement has been made using available evidence including a visit to this service. The health, personal and social care needs of residents are now being set out in very good detail in their individual care plans. Residents’ physical and mental health needs are being fully met. Residents are supported in keeping their own medication, where they are willing and able to do so. The policies and procedures regarding medications are being revised to improve the safety of the residents. Residents and their relatives are treated with great respect at all times. EVIDENCE: It was a requirement of the last inspection report that care plans must be drawn up within seven days of a new resident being admitted to the home. (This is outstanding since 16/09/05.) Grange Lea Rest Home DS0000000526.V296123.R01.S.doc Version 5.2 Page 12 This is in the process of being carried out. Care plans for two short-stay residents were not fully in place at the start of this inspection, but both had been fully completed by the end of the inspection. The need for care plans to be drawn up promptly is understood to be as necessary for short-stay residents as for permanent residents; and that, with the improved assessment documents being drawn up, the new resident and his/her family should be able to describe the care they need before they are actually admitted to the home. The care plans for established residents were of a very good standard. They covered all the areas of care identified in the various assessments of need, and were detailed, sensitive and personalised to the individual resident. They are evaluated every month, and updated where necessary. It was agreed that care plans need to be redrawn when substantially updated. There is also a review of each residents care every six months (more often, if required). The officer-in-charge, Mrs Ann Maule, is responsible for the care plans, and she is to be complimented on their quality. She is attending a further training course on care planning in April. Residents’ health needs are included in the pre-admission assessment and in subsequent assessments. Permanent residents have detailed care plans drawn up to meet their assessed physical and mental health needs, with monthly evaluations (more frequent, where necessary). Very detailed records are kept of appointments with and visits from doctors, district nurses and other community health professionals. In a survey of residents, four out of the six who responded said that they ‘always’ receive the care and support they need; the other two said ‘usually’. One commented “Management and staff very attentive and caring”. Four said that they ‘always’ receive the medical support they need; one said ‘usually’ and one said ‘sometimes’. One resident felt that there had been some difficulty in seeing a doctor when wanted; a relative commented that they wanted to be “kept in the picture more e.g. being told when a doctor was visiting, so we can be there”. A different relative, however, said that medical problems are “dealt with professionally and successfully, contacting the doctor, ambulance and ourselves”. In a survey, all four relatives who responded said that the home always gives the support and care that they expect. The home has appropriate policies in place relating to all aspects of medications. Residents are supported in keeping personal responsibility for their own medicines, where they have been assessed as being willing and able Grange Lea Rest Home DS0000000526.V296123.R01.S.doc Version 5.2 Page 13 to do so. Four residents currently keep their own medicines, and they have been given lockable storage in their bedrooms for safe keeping of medicines. The home uses the Monitored Dosage System, provided by a local pharmacy. Good records are kept of drugs ordered, received, administered and returned. A photograph of each resident is kept on his or her dosette box, to make sure that drugs are given only to the person they have been prescribed for. No resident is currently on any ‘controlled drugs’, but the home has appropriate secure storage arrangements, should this be required. The home recognises that its Medicine Administration Record (MAR) format needs to be updated to give more space for additions and amendments without the need to delete or cover previous entries. It is taking advice from its supplying Pharmacist on how this is best done. A column for the doctor’s signature will also be included. One G.P. holds a weekly clinic in the home, and is being asked to conduct a review of medications, to make sure that all residents are on the correct medicines and doses. Approximately twelve residents were engaged in conversation in the course of the inspection. All confirmed that their privacy is respected at all times by the staff, and all said that they are always treated with respect. The results of a recent survey by the home of the views of family, friends and visitors showed that 88 rated the home as ‘excellent’ regarding the quality of care in the home, and no one rated it as being ‘poor’. Grange Lea Rest Home DS0000000526.V296123.R01.S.doc Version 5.2 Page 14 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 adequate. This judgement has been made using available evidence including a visit to this service. Residents are satisfied with their lifestyle in the home, but the range of recreational activities on offer to them has been limited until very recently. Relatives are actively encouraged to visit their family members in the home, and are made very welcome by the management and staff Residents are encouraged and supported to exercise choice and control over their lives. Residents receive a wholesome, appealing and balanced diet, and enjoy their food. Greater variety in the menu and some degree of choice are being introduced. EVIDENCE: Each resident’s assessment includes asking them their hobbies and interests, likes and dislikes, their links with family and friends, and their spiritual wishes. Individual social and spiritual care plans are drawn up to meet those needs. Grange Lea Rest Home DS0000000526.V296123.R01.S.doc Version 5.2 Page 15 Weekly events include a visit by the ‘pat-a-dog’ scheme; a scrabble and domino session, and hairdressing. There is a fortnightly church service, and a visiting entertainer every month. There is no regular daily social activities programme. Occasional activities such as hand massages and reminiscence sessions take place, and gentle exercise has just been introduced with a resident accompanying on the keyboard. However, there was no real pattern demonstrated. In answer to the question “Are there activities arranged by the home that you can take part in?” in a survey, one said ‘always’; three said ‘usually’; and two said ‘sometimes’. The issue of activities was discussed with Mrs Whaley on the first day of the inspection, and her response was very positive. By the second day of the inspection, she had introduced a half hour slot for each carer every day in which to carry out either one-to-one or group activities with residents. All staff has now been given a notebook to record all social activities and other social stimulation, such as manicures, walks or just conversations with residents. This is good practice, and must be maintained. Other ideas for activities discussed were poetry reading, ‘This is your Life’ sessions and the use of digital and/or video cameras on a regular basis. Daily records and residents’ care plans show that residents’ families and friends are actively encouraged to visit the home and are made welcome by the home. This was also confirmed by the relatives’ survey and by residents’ comments during the inspection. Many residents are either from the local village of Ponteland, or have family members who live there, and most have regular contact with family and friends. Residents also make good use of local facilities such as shops, pubs and library. Discussions with the registered manager and with residents confirmed that residents are given a good deal of choice about their daily activities and lifestyle. Examples given included choice of when to get up and go to bed; what to wear; how residents are addressed; whether to drink alcohol; when and how often they shower or bathe; which visitors they wish to see, and where; and whether to go out unattended (subject to risk assessment). It was a recommendation of the last inspection report that the opinions of residents and their relatives regarding choice of meals should be acted upon. Grange Lea Rest Home DS0000000526.V296123.R01.S.doc Version 5.2 Page 16 This has been carried out. The result was that residents did not express any strong feelings about the need for choice at mealtimes, knowing that they can request a sandwich as an alternative. Mrs Whaley has added a question about choice of different meals to the annual residents’ satisfaction questionnaire. Mrs Whaley is currently working with a dietician, and with the input of the home’s cooks and residents, with the aim of introducing a six-week menu for each season that will increase the variety of food available to the residents. This is good practice. As a result of residents’ feedback, a choice is being introduced for the tea meal, with residents’ choices being canvassed the day before. The lack of choice for the main meal (lunch) was discussed again with Mrs Whaley. She believes that the home’s emphasis on the quality of the diet (with a firm commitment to making sure all residents get the advised minimum of five portions of fruit and vegetables every day) is more important than always providing choice of menu. It was agreed that the home should amend its statement of purpose and service user guide to make the home’s position clear to people considering coming into the home. The main cook recently attended a “Safer food, Better Business” course (basically, food hygiene course). This has led to the home being able to demonstrate improved practices, including a very detailed daily kitchen diary being kept. Special diets, such as for diabetes, are catered for, with the input of a dietician, where necessary. An enjoyable lunch was taken with the residents. The tables were very nicely set, and the food was tasty and hot. Portion sizes seemed to be based on the staff’s knowledge of each individual resident, as residents were not asked. This was discussed with Mrs Whaley afterwards, who said that the introduction of gravy boats and vegetable tureens were being considered, for those able to make use of them. This is to be encouraged. In a survey of residents as part of this inspection, one said they ‘always’ like the meals at the home; four said ‘usually’; and one said ‘sometimes’. Comments made in this survey included “at times hot food could be kept hotter prior to serving” and “(Meals) usually very dull, but adequate”. However, when spoken with during and after lunch on the day of the inspection, all but one of the residents said that they were satisfied with the food. Grange Lea Rest Home DS0000000526.V296123.R01.S.doc Version 5.2 Page 17 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. This judgement has been made using available evidence including a visit to this service. Residents, relatives and friends feel confident that any concern or complaint they may express will be properly addressed by the home. Residents are protected from abuse by staff who receive appropriate training in protection. EVIDENCE: The home’s complaints book was examined. No complaints have been recorded in the past twelve months. It was agreed at the last inspection that the complaints book should be used as the focus for all feedback, good and bad, from all sources (such as complaints, questionnaires, visitors’ comments etc.). This has been carried out. A number of entries were made in the months after the last inspection, although entries have since tailed off. Residents and visitors spoken with said that they are confident that any complaint or concern that they might raise would be taken very seriously and would be quickly sorted out. All stressed, however, that they have no complaints about the home. Grange Lea Rest Home DS0000000526.V296123.R01.S.doc Version 5.2 Page 18 In a survey, all six residents who responded said that they know who to speak to if they are unhappy; and all six said that they knew how to make a complaint. In a separate relatives’ survey, all four who responded said they knew how to make a complaint, if necessary. It was a requirement of the last inspection report that all staff must receive training in the Protection of Vulnerable Adults (POVA). (This is outstanding since 31/03/05.) This is being carried out. The proprietor and officer-in-charge have attended a two day ‘investigation skills’ course, and a POVA course has been arranged for all staff in the second week in February. Mrs Whaley was able to accurately describe the home’s policy for reporting allegations of abuse to the correct lead agency (Social Services). All those residents engaged in conversation said that they feel safe in the home. Grange Lea Rest Home DS0000000526.V296123.R01.S.doc Version 5.2 Page 19 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. This judgement has been made using available evidence including a visit to this service. Residents live in a safe, well-maintained environment that is currently being extended and improved. The home is pleasant, hygienic and very clean. EVIDENCE: Since the last inspection, there has been significant rebuilding of some areas of the home. The home has been extended and internally reconfigured to increase the size of some bedrooms, and to increase the number of rooms with en-suite facilities from nine to sixteen. Other work carried out in the home over the past year includes the retiling of the upstairs bathroom and the installation of a new bathroom suite; the Grange Lea Rest Home DS0000000526.V296123.R01.S.doc Version 5.2 Page 20 redecoration of two lounges, with new curtains, soft furnishings and carpet in one and a new flat-screen television fitted in the other. Despite the ongoing building work, internal and external, the home is being maintained in a clean and tidy condition. Mrs Whaley described the ‘accelerated cleaning programme’ she has introduced to keep the home in this condition. In a survey, five out of the six residents who responded said that the home is fresh and clean; the other person said ‘usually’. One commented “Pristine!” One relative commented, “The cleanliness of Grange Lea is excellent – I’ve never called in and found my (relative) and bedroom anything other than immaculate”. Grange Lea Rest Home DS0000000526.V296123.R01.S.doc Version 5.2 Page 21 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 adequate. This judgement has been made using available evidence including a visit to this service. There are enough experienced staff to meet the needs of the residents. Residents are in safe hands at all times. Areas of the home’s recruitment practices need to be tightened up, to further protect the residents. Staff are trained and competent to do their jobs. 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 (see also standard 12, above). Grange Lea Rest Home DS0000000526.V296123.R01.S.doc Version 5.2 Page 22 The home occasionally uses agency staff to cover nights, where necessary, due to staff holidays, but is careful to use agencies they know and always ask for staff who are known to the home and the residents. 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 2 in care. To date, eight staff have achieved NVQ 2 (42 of care staff). However, four more staff are currently doing this course, and should complete it in March. The home will then have met the 50 target. The personnel and recruitment records of two recently employed staff members were examined. Both had application forms on file, and both had photographs as evidence of their identity. However, applications were not fully completed, having a record of the current/last job, only, and not the full employment history needed to challenge any gaps in employment. One carer had given two referees but neither were work referees; the second had given only one referee. Mrs Whaley was reminded that two references are always required, and wherever possible, these must be work related, including current/last employer. This is to allow the home to assess the person’s ability, honesty, reliability etc. Both carers had completed Criminal Record Bureau (CRB) checks on file. One had a ‘POVAfirst’ check on file (a check against the national register of persons unfit to work with vulnerable people). The staff training file was examined. All staff have been given (or have training arranged for) the required statutory training in moving & handling, food hygiene and fire awareness; and there are enough trained first aiders to cover every shift. There is a staff training plan, which is updated annually, in line with the staff appraisal system. This is good practice. Signed records are kept of attendance at in-house training events, with feedback forms: again, good practice. The officer-in-charge provides a five-day induction training programme for new staff. This is done to National Training Organisation standards. Induction is obviously taken seriously by all involved, and the proprietors and officer-incharge are currently looking at ways to speed up this important process. Grange Lea Rest Home DS0000000526.V296123.R01.S.doc Version 5.2 Page 23 The manager holds the D32/33 staff assessor qualification, which helps him to assess staff performance on a daily basis. Grange Lea Rest Home DS0000000526.V296123.R01.S.doc Version 5.2 Page 24 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): 31,33,35,36 and 38. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is well managed by an experienced and qualified manager. The home is run in the best interests of the residents. Residents’ financial interests are protected. Staff are given regular and appropriate supervision. The health and safety of residents and staff is taken seriously and properly protected. Grange Lea Rest Home DS0000000526.V296123.R01.S.doc Version 5.2 Page 25 EVIDENCE: The Registered Manager, Mr Daniel Whaley, has over 21 years experience in the management of care homes. He holds the Registered Manager Award and National Vocational Qualification (NVQ) level four in care. He therefore has the necessary qualifications and experience to be in charge. He is of good character and able to fully discharge his responsibilities. The home’s quality assurance systems were examined. A questionnaire was sent out to 30 relatives and friends of residents in December last year. Of these, 26 responded and the results have recently been collated. The results were generally very positive, with 88 rating the quality of care as ‘excellent’. There were no areas of care rated as being ‘poor’. Since the last inspection, the proprietors have worked on the few areas where there was a slightly less positive response, namely the comfort of bedrooms, and the choice and quality of the food. Numerous letters and cards were seen, praising all areas of care especially the sensitivity, kindness, care and respect shown to residents and their relatives by the home’s management and staff. One letter summed it up, as “You can be proud of what you do”. The home has carried a satisfaction survey for its residents, and will be repeating this survey in March 2007. This will specifically focus on the issue of meals. The results of these quality surveys will be included in the ‘service user guide’, when it is updated in June this year. The home is considering drawing up a similar questionnaire to gauge staff members’ opinions, as well. The proprietors have drawn up an annual development plan, which is relevant, achievable and positive. Advice was given to clearly record evidence of its annual review. The home holds money on behalf of three residents, only, at their request. The accounts for these monies were checked and found to be accurate and in good order. Two staff signatures are entered for every transaction. It was agreed that receipts would be kept for all hairdressing. Grange Lea Rest Home DS0000000526.V296123.R01.S.doc Version 5.2 Page 26 All other residents either handle their own money, or have family members to do this on their behalf. The home is not involved in handling residents’ pensions or personal allowances. It was a requirement of the last two inspection reports that all care staff must receive formal, minuted supervision at least six times each year. This has been carried out. Formal staff supervision now takes place regularly (every two months, on average). Supervision includes feedback about work performance, so that both parties are aware of strengths and weaknesses and can deal with any problems that have been identified.. All staff receive an annual appraisal, which again identifies strengths and weaknesses, and decides what training needs and other targets are necessary for the next twelve months. The home has improved its safe working practices over the past year by staff training and by putting new infection control policies and practices into operation. These include responses to outbreaks; laundry practices (including the introduction of alginate laundry bags that minimise contact with foul linen); hand hygiene etc. Servicing and maintenance records were in place and were up to date (other than for some items, such as bath seats, that are due to be replaced during the year. The home’s hot water system is serviced annually, minimising the risk of legionnella disease. Portable electrical appliances are checked annually. The accident book showed a very low number of entries. This was discussed with Mrs Whaley, who felt this was a fair reflection of the close supervision of residents and the staff training in the prevention of falls. However, she will be reminding all staff that all accidents (even those not resulting in injury) must always be recorded. The home’s fire logbook was fully recorded and up to date. Building risk assessments, including a fire risk assessment, are in place. Overall, the evidence showed that the health and safety of residents and staff is taken seriously and properly protected. Grange Lea Rest Home DS0000000526.V296123.R01.S.doc Version 5.2 Page 27 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 4 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 3 15 3 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 2 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 3 X 3 Grange Lea Rest Home DS0000000526.V296123.R01.S.doc Version 5.2 Page 28 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. 1. 2. Standard OP12 OP29 Regulation 16(2)(n) 19(1) schedule 2 Requirement The home must provide a daily programme of activities for the residents. Job applicants must provide a full employment history and a minimum of two referees, one of which should be the current/last employer . Timescale for action 28/02/07 28/02/07 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 OP30 OP15 Good Practice Recommendations At least 50 of care staff should hold National Vocational Qualification level two in care by 31 December 2005. The opinions of residents and their relatives regarding choice of meals should be acted upon. Grange Lea Rest Home DS0000000526.V296123.R01.S.doc Version 5.2 Page 29 Commission for Social Care Inspection Cramlington Area Office Northumbria House Manor Walks Cramlington Northumberland NE23 6UR 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 Rest Home DS0000000526.V296123.R01.S.doc Version 5.2 Page 30 - 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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