Inspection on 08/02/06 for Grange Lea Rest Home

This inspection was carried out on 8th 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 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 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 Unannounced Inspection 8th February 2006 10:15 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 DS0000000526.V273006.R01.S.doc Version 5.0 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. DS0000000526.V273006.R01.S.doc Version 5.0 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 DS0000000526.V273006.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 15th September 2005 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 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 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. DS0000000526.V273006.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced inspection of Grange Lea, which took place in February 2006. It took approximately four hours. The main focus of this inspection was to check that the home had carried out the requirements form the last inspection report. Time was spent studying residents’ care records and other relevant documentation. Lunch was taken with the residents. Residents and one visitor were spoken with. What the service does well: This is a small, well-run home that provides a personal service. The proprietors are fully involved in the day-to-day running of the home. Residents are treated with great respect and their privacy is safeguarded. There are high staffing levels. The proprietors take the opinions of its residents and their relatives seriously, and act upon them. The home provides a nutritious diet. Residents are given a good degree of choice of how they live their lives. Residents speak highly of the care they receive. Residents say they feel safe and protected in the home. DS0000000526.V273006.R01.S.doc Version 5.0 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. DS0000000526.V273006.R01.S.doc Version 5.0 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 DS0000000526.V273006.R01.S.doc Version 5.0 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 the following standard(s): 3. 3) The home is still not making sure that a full assessment of a potential new resident is carried out before he or she is admitted to the home. EVIDENCE: 3) The care records of the two most recently admitted residents were examined. It was a requirement of the last inspection report that 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. This requirement had not been implemented. Neither of the two residents whose care records were examined had had an assessment completed before being admitted to the home. One person had been in the home for ten weeks at the time of this inspection, and still had not been formally assessed. This requirement is repeated in this inspection report. DS0000000526.V273006.R01.S.doc Version 5.0 Page 9 The home is reminded, also, that persons admitted for respite or other shortterm care must also be fully assessed before being offered a service. DS0000000526.V273006.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7,9,10. 7) Residents’ health, personal and social care needs are not always being set out in an individual plan of care. 9) Policies, procedures and systems are in place to support the safe ordering, receipt, recording, handling and disposing of medications within the home. 10) Residents feel that they are treated with respect and their right to privacy is upheld. EVIDENCE: 7) 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. The study of two recently admitted residents showed that this has not been implemented. Neither had had individual care plans drawn up to meet their needs. This requirement is repeated in this inspection report. DS0000000526.V273006.R01.S.doc Version 5.0 Page 11 The home had shown, at the time of the last inspection, that it was able to demonstrate good care planning. Mr Whaley said that the lack of assessments and care plans was due to staff shortages in recent months. 9) The home has appropriate policies in place relating to all aspects of medications. 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 section of the drugs record, to ensure that drugs are given only to the person prescribed for. No resident is currently on any ‘controlled drugs’. The home is reminded that all handwritten entries in the Medicine Administration Record (MAR) should be signed and dated; and also that paper whitener should not be used in official documents. 10) Approximately ten residents were engaged in conversation in the course of the inspection, and especially over lunch. 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 90 rated the home as ‘excellent’ regarding the quality of care in the home, and 95 also rated the friendliness of staff as ‘excellent’. DS0000000526.V273006.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 14,15. 14) Residents are helped to exercise choice and control over their lives. 15) Residents receive a balanced and nutritious diet in pleasant surroundings and may eat when they choose. EVIDENCE: 14) 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; whether to go out unattended (subject to risk assessment). 15) The home does not publish menus in advance, but does keep a written record of all meals served. The records for January were studied. There was good variety and a good range of fruit and vegetables used. Menus appeared to be suitably nutritious. DS0000000526.V273006.R01.S.doc Version 5.0 Page 13 The home caters for special dietary needs, as shown by the menus, and offers light alternatives for the main course at meal times. It does not otherwise offer residents a choice of the main meals, preferring to concentrate on quality and variety rather than choice. This issue had been identified by the home, in a recent questionnaire sent to relatives, friends and visitors, as needing to be looked at. The issue of choice of meals will also be part of the next survey of residents’ satisfaction, due to be conducted soon. It is recommended that the home seriously considers such feedback, and acts upon it to improve the service being given. An enjoyable, well-cooked lunch of steak pie, mashed potatoes, peas and carrots was taken with the residents. The dining tables were attractively set, with good quality cutlery, tablecloth and napkins. Residents said that they very much enjoy their food. DS0000000526.V273006.R01.S.doc Version 5.0 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 inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16,18 16) Residents and their families are confident that any complaint would responded to properly by the home. 18) Residents are protected from abuse, but more staff training is required in this area. EVIDENCE: 16) The home’s complaints book was examined. No complaints have been entered since the last inspection. It was agreed 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.). 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. DS0000000526.V273006.R01.S.doc Version 5.0 Page 15 18) The home has policies and procedures in place to support the protection of vulnerable adults and the proprietors feel confident that their staff would respond appropriately should such an allegation be made. No allegations of abuse have been made. Residents spoken with said that they feel safe in the home, and have confidence in the staff. It was a requirement of the last two inspection reports that all staff must receive training in the Protection of Vulnerable Adults (POVA). This has not yet been implemented for all staff. Less than half the staff have had such training, to date. Two senior staff have attended a half day POVA course, and the home’s officerin-charge, Ann Maule, has applied for a two day POVA course in April, and will feed back this training to other staff after that. DS0000000526.V273006.R01.S.doc Version 5.0 Page 16 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): These standards were not inspected on this visit, but all these standards have been met on previous inspections. EVIDENCE: Mr Whaley explained that there are tentative plans to build on two new bedrooms and to convert two existing bedrooms to become en-suite facilities for four other existing bedrooms. The total number of bedrooms would remain the same, at twenty, but the number of bedrooms with en-suite facilities would be increased to sixteen. This planned improvement in residents’ facilities is welcomed. DS0000000526.V273006.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27,28. 27) There are sufficient staff to meet the needs of the residents. 28) The home has yet to achieve the required percentage of qualified staff. EVIDENCE: 27) 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. The home is currently using agency staff to cover nights, where necessary, due to staff holidays. 28) 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 DS0000000526.V273006.R01.S.doc Version 5.0 Page 18 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 (25 of care staff). Three more are ready to start this qualification. 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. 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. DS0000000526.V273006.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 33,35,36,38. 33) The home is run in the best interests of the residents. 35) Residents’ financial interests are safeguarded. 36) Staff are not being given formal supervision. 38) The health, safety and welfare of residents and staff is taken seriously and is properly addressed. EVIDENCE: 33) The home’s quality assurance systems were examined. A questionnaire was sent out to relatives and friends of residents in December last year, and the results have recently been collated. The results were generally very positive, with 90 rating the quality of care as ‘excellent’. DS0000000526.V273006.R01.S.doc Version 5.0 Page 20 A number of very complimentary comments were noted from these responses. These confirmed the comments received from one visitor in the course of this inspection. This person was keen to stress that Grange Lea is small enough to be run in a very personal way, with everyone knowing everyone, and that it is very well run by a pleasant manager and a caring staff team. There were no areas of care rated as being ‘poor’. The Proprietors have, therefore, chosen to focus their attention 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. This is good practice. The home is also about to carry out a similar satisfaction survey for its residents, and will specifically focus on the issue of meals. This survey is being carried out with the assistance of an ecumenical lay visitor, to provide an independent input and avoid any staff influence of the residents’ responses. Again, good practice. The home is reminded that the results of these quality surveys should be included in the ‘service user guide’. The home was asked to consider drawing up a similar questionnaire to gauge staff members’ opinions. The Proprietors are working on drawing up an annual development plan, which will be discussed on the next inspection. 35) The home holds money on behalf of one resident, only, at this person’s request. The accounts for this money were checked and found to be accurate and in good order. Two staff signatures are entered for every transaction. 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. 36) 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 not been implemented, and this requirement is repeated in this inspection report. It is accepted that the manager, Mr Whaley, works alongside care staff on a daily basis, knows his staff very well, is always available to them and provides informal daily supervision of staff. However, formal, recorded supervision, DS0000000526.V273006.R01.S.doc Version 5.0 Page 21 which takes place in private and ‘off the floor’, is also required, to allow a more considered, longer term overview of staff work performance, and to provide written evidence that any issues are being addressed. Since this inspection, the home has submitted a supervision form that is broken down into the required two monthly periods and should provide a useful starting point for supervision. 38) It was a requirement of the last inspection report that fire alarms must be checked at least once each week, and the check recorded in the fire logbook. The fire logbook was examined. Fire alarms are now being checked at the required weekly pattern. Other checks and tests of fire safety equipment are also recorded as being carried out at the variously required frequencies. It was a further requirement of the last inspection report that risk assessments must be available for inspection at all times. This has been implemented. Both general risk assessments and fire risk assessments have been conducted, and were available for inspection. DS0000000526.V273006.R01.S.doc Version 5.0 Page 22 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X 2 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 X 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 X 13 X 14 3 15 2 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 2 X X X X X X X X STAFFING Standard No Score 27 3 28 2 29 X 30 X MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score X X 3 X 3 2 X 3 DS0000000526.V273006.R01.S.doc Version 5.0 Page 23 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 OP3 Regulation 14(1) Requirement 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.) 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.) 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.) Timescale for action 09/02/06 2. OP7 15(1) 09/02/06 3. OP18 13(6) 30/04/06 4. OP36 18(2) 31/03/06 DS0000000526.V273006.R01.S.doc Version 5.0 Page 24 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. DS0000000526.V273006.R01.S.doc Version 5.0 Page 25 Commission for Social Care Inspection Cramlington Area Office 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 DS0000000526.V273006.R01.S.doc Version 5.0 Page 26 - 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. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!