Inspection on 16/05/06 for Grange Nursing Home

This inspection was carried out on 16th May 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 Nursing Home 25/11/08

Grange Nursing Home 17/05/07

Grange Nursing Home 14/11/05

Grange Nursing Home 12/05/05

Grange Nursing Home 16/11/04

Grange Nursing Home 16/04/04

Grange Nursing Home 19/08/03

Grange Nursing Home 17/09/02

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

CARE HOMES FOR OLDER PEOPLE Grange Nursing Home Grange Drive Heswall Wirral CH60 7RU Lead Inspector Andrea Morris Key Unannounced Inspection 16th May 2006 10:00 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Grange Nursing Home DS0000020907.V295422.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 Nursing Home DS0000020907.V295422.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Grange Nursing Home Address Grange Drive Heswall Wirral CH60 7RU 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) 0151 342 6461 0151 342 8299 Grange Nursing Home Course Change Limited Helen Stringer Care Home 30 Category(ies) of Old age, not falling within any other category registration, with number (30) of places Grange Nursing Home DS0000020907.V295422.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 14th November 2005 Brief Description of the Service: Grange care home is situated in Heswall on the Wirral Peninsular. The home is located close to amenities such as shops, pubs, and a public library. The home provides nursing care for 30 residents. All residents have their own GP. Specialist nurses visit the residents when needs arise; all residents have access to their NHS entitlements. There are comfortable lounges and a dining room; residents may entertain their visitors in the communal lounges or in their own bedrooms. Ample car parking space is available to the front of the home, well cared for gardens to the front and rear of the home. Therapeutic diets can be catered for in the home, for residents who have a medical condition. Grange Nursing Home DS0000020907.V295422.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection was an unannounced inspection that took place over 5.5 hours. During the inspection the inspector spoke to several residents, some staff, the home manager and Proprietor. A selection of documentation was examined including, care file documentation, staff personnel files, health and safety records, training records. What the service does well: What has improved since the last inspection? What they could do better: Care files lack documentation to support what care needs are required, new residents must have documented care plans and risk assessments to ensure all care needs are recorded and reviewed on an at least monthly basis. Medication records need to be recorded accurately, to ensure residents’ safety is maintained. All medication administered must be signed for and all medication not administered must indicate the reasons for omission. Stock held in the home must be recorded accurately to demonstrate the exact medication held in the home, this promotes safety for residents. Grange Nursing Home DS0000020907.V295422.R01.S.doc Version 5.2 Page 6 Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Grange Nursing Home DS0000020907.V295422.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Grange Nursing Home DS0000020907.V295422.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 2, 3, 4, 5, 6. All residents entering the home are pre-assessed prior to admission, this helps to ensure the residents needs can be met. EVIDENCE: The statement of purpose contains all the relevant information to assist a potential resident and their families to make an informed choice. All residents entering the home receive a written contract which clearly details their terms and conditions of residency. All residents prior to entering the home are assessed to ensure their needs can be met. The home manager or a suitably qualified designated person completes pre-admission assessments. All visits from other healthcare professionals are recorded in the residents care file, records are well maintained and up to date. Grange Nursing Home DS0000020907.V295422.R01.S.doc Version 5.2 Page 9 The home encourages all potential residents to visit the home prior to admission, any person who wishes can stay for an afternoon or a meal at no extra cost. The home does not provide intermediate care. Grange Nursing Home DS0000020907.V295422.R01.S.doc Version 5.2 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9, 10, 11. Not all residents have care plans in place, this places residents at risk of potential harm. EVIDENCE: A selection of residents care files were examined, several of these did not have any care plans documented despite residents being in the home for several weeks. All residents require care plans to be created, and regular reviews to be taken to ensure their needs are documented and that the correct care is delivered. Risk assessments for some residents were also not documented, the trained staff must ensure all risk assessments are completed and reviewed appropriately. Medication records were examined and it was noted that several medication records had signatures missing, all medication administered must be recorded on the drug sheets. Medication records must contain information of all medication held in the home along with quantities of each medication. The home’s Controlled drugs records were recorded accurately. Grange Nursing Home DS0000020907.V295422.R01.S.doc Version 5.2 Page 11 The home records all communication with families to a high standard. Records are kept within the residents’ care file. The home has an adequate policy for caring for the dying resident, some staff have received some training in care for the dying. Grange Nursing Home DS0000020907.V295422.R01.S.doc Version 5.2 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14, 15 Residents are encouraged to lead a socially stimulating life as they choose, this assists in maintaining residents a fulfilling life. EVIDENCE: The home has a variety of activities that enables residents to participate if they choose. Some residents stated they enjoyed the activities and looked forward to the regular visitors, other residents stated they chose not to participate in activities. They all confirmed that whatever choice they made staff respected their decisions. The home operates an open visiting policy, all residents can receive their visitors in private if they wish. All residents confirmed they could choose how and where they spent their day, some residents stated they preferred to spend time in their rooms and this decision was honoured. Residents are able to receive spiritual visits as they prefer, visitors from the Christian Reform Church visit the home weekly, both Roman Catholic and Church of England churches visit on a monthly basis to administer communion to those who want it. Grange Nursing Home DS0000020907.V295422.R01.S.doc Version 5.2 Page 13 Any person who was from an alternative faith to those listed above the home would seek access to ensure their rights were maintained. The menus were examined, they are rotated on a four weekly cycle, alternative choices are documented for each day, residents also confirmed that other food would be provided if they did not want the two documented options. All residents who spoke with the inspector stated the food was good and they enjoyed the meals. The kitchen was found to be well-organised and daily fridge temperatures were documented. Stock control was well managed and rotated as required. Grange Nursing Home DS0000020907.V295422.R01.S.doc Version 5.2 Page 14 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16, 17, 18 All staff need to receive training in POVA (Protection of Vulnerable Adults) to assist in protecting residents from harm. EVIDENCE: The home has an adequate complaints procedure that is displayed in the entrance are of the home. Complaints are recorded and action taken is also recorded. There have been no complaints made to the Commission for Social Care Inspection since the last inspection. All residents have their legal rights protected, residents who wish to vote can do so by the home registering them on the postal voting system, or if they choose they can be taken to the local polling station. The home has not had an incident of Adult Protection since the last inspection. Some senior staff have received training in Adult protection but it is essential that all (including ancillary) staff receive training in adult protection. Grange Nursing Home DS0000020907.V295422.R01.S.doc Version 5.2 Page 15 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 20, 21, 23, 24, 25, 26 The home is well maintained, this helps promote resident safety and provides a homely environment. EVIDENCE: The home is maintained to a good standard. All areas of the home were found to be in a good state of repair, and well decorated. The gardens of the home are maintained to a high standard, residents commented to the inspector they enjoyed looking out on to the garden. The home has in the past 6 months have re-done the bathrooms, new tiling creates a pleasant environment and promotes safety. All residents’ rooms are personalised with their own effects. The home actively encourages residents to bring in small items for their rooms so to assist with creating a homely environment and to assist with helping them to settle in. Grange Nursing Home DS0000020907.V295422.R01.S.doc Version 5.2 Page 16 The home is accessible by wheelchair by the side entrance. The interior of the home allows all residents to move around the home safely. The home has an adequate supply of hoists to ensure the safety of residents is promoted. Grange Nursing Home DS0000020907.V295422.R01.S.doc Version 5.2 Page 17 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29, 30 Staff personnel files lack all the documentation required to promote the safety of residents. EVIDENCE: The home’s staffing rota was examined and found to be recorded appropriately. The home does not need to use agency staff as there is adequate staff. 50 of care staff have completed their NVQ2 in care. Some staff are waiting to commence on the course in the near future. The home has an adequate recruitment policy in place. The procedure is followed, however it was noted on one recently appointed staff member that a second reference was not available for the inspector to view. All staff were noted to be checked both against CRB (Criminal Bureau Records) and POVA (Protection of Vulnerable Adults). Staff training records were not all present, all training records must be retained for inspection and all training undertaken recorded. The home accesses training from external sources as required. Grange Nursing Home DS0000020907.V295422.R01.S.doc Version 5.2 Page 18 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 32, 33, 34, 35, 36, 37, 38 The home manager provides leadership and guidance, this assists in promoting a safe environment for residents. EVIDENCE: Both the manager and Proprietor have completed their NVQ4 in management. They provide good leadership and guidance to staff and residents. Mulberry House provide Quality Assurance for the home, they last audited the home 3 years ago, since then the Proprietor completes an audit on an annual basis to monitor the home’s performance. The home also sends out quality questionnaires, some residents complete or if required family members complete on behalf of their relatives. The home’s financial policies are adequate to protect residents from abuse. The home does not hold money for any resident. All money passed through the home is recorded appropriately. Records seen where found to be correct. Grange Nursing Home DS0000020907.V295422.R01.S.doc Version 5.2 Page 19 Not all staff receive regular supervision. The records maintained identified this omission, all care staff must receive 6 sessions of supervision and ancillary staff four times per year. Records were found to be not up to date. The home’s Health and Safety records were examined including fire records all were found to be in date and appropriate. All staff were noted to have received fire evacuation training. Grange Nursing Home DS0000020907.V295422.R01.S.doc Version 5.2 Page 20 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 3 3 3 3 3 N/a HEALTH AND PERSONAL CARE Standard No Score 7 1 8 1 9 2 10 3 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 3 18 2 3 3 3 N/a 3 3 3 3 STAFFING Standard No Score 27 3 28 3 29 3 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 3 3 3 3 2 3 Grange Nursing Home DS0000020907.V295422.R01.S.doc Version 5.2 Page 21 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. Standard OP29 Regulation 18 Requirement Timescale for action 30/06/06 2. OP7 15(1) 3. OP9 13(2) The registered person must ensure that all new staff appointed to the home has authentic documentation and two references, one from the previous employer. (previous timescale 31/12/05) The registered person shall 31/05/06 prepare a written plan as to how the service users needs in respect of his/her health and welfare are to be met. The registered person shall make 31/05/06 arrangements for the recording, handling, safekeeping, safe administration and disposal of medicines received into the care home. The registered person shall make 01/08/06 arrangements, by training staff or by other measures, to prevent service users being harmed or suffering abuse or being placed at risk of harm or abuse. The registered person shall 30/06/06 ensure that persons working in the care home are appropriately supervised. 4. OP18 13(6) 5. OP36 18(2) Grange Nursing Home DS0000020907.V295422.R01.S.doc Version 5.2 Page 22 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Grange Nursing Home DS0000020907.V295422.R01.S.doc Version 5.2 Page 23 Commission for Social Care Inspection Liverpool Satellite Office 3rd Floor Campbell Square 10 Duke Street Liverpool L1 5AS 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 Nursing Home DS0000020907.V295422.R01.S.doc Version 5.2 Page 24 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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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