Inspection on 01/02/07 for Grange Park Nursing Home

This inspection was carried out on 1st February 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 Park Nursing Home 04/05/10

Grange Park Nursing Home 24/02/10

Grange Park Nursing Home 21/10/09

Grange Park Nursing Home 27/10/08

Grange Park Nursing Home 11/12/07

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

CARE HOMES FOR OLDER PEOPLE Grange Park Nursing Home 133 Himley Road Himley Dudley West Midlands DY1 2QF Lead Inspector Mr Richard Eaves Key Unannounced Inspection 1st February 2007 09:00 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 Park Nursing Home DS0000066743.V327823.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 Park Nursing Home DS0000066743.V327823.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Grange Park Nursing Home Address 133 Himley Road Himley Dudley West Midlands DY1 2QF 0121 550 7308 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) Grange Park (Dudley) Nursing Home Limited Janice Williams Care Home 51 Category(ies) of Old age, not falling within any other category registration, with number (50), Physical disability (10), Terminally ill (10) of places Grange Park Nursing Home DS0000066743.V327823.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 Park is a purpose built care home offering nursing & personal care mainly to older people, though it is able to offer some nursing beds to younger adults. The home changed ownership during May 2006. It is situated just outside Dudley town centre and has good public transport links with Dudley and other local shopping centres. There is a car parking area at the front of the premises. To the rear there are patio and lawned areas, bordered by fencing and mature trees in places and presenting a very pleasant outlook. The interior of the home provides single and double occupancy bedrooms on two floors, some of which are en-suite. The ground floor offers a reception area, offices, communal lounges, a dining room, two conservatories, a small smoking room, kitchen, laundry and a range of bathing and showering facilities. Fees range from £350 to £450. Grange Park Nursing Home DS0000066743.V327823.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This key unannounced inspection visit was undertaken by a single Inspector from the Commission for Social Care Inspection using the following information: the action plan submitted by the home to the unannounced inspection during February 2006, reports from the organisation relating to the conduct of the home, the pre-inspection questionnaire and records held at the home. The inspection involved a full tour of the home including, bedrooms, communal rooms, service areas and provided an opportunity to speak with many service users, visitors and staff. What the service does well: What has improved since the last inspection? What they could do better: Generally care planning at the home is very good but providing separate care plans for each wound such as pressure sores would provide clarity and better inform progress on each site. The home has recently received a second medicines trolley and this requires to have an attachment to fix it to the wall when not in use. Meals at the home are well received but the manor of providing choice at lunchtimes does not easily show that an opportunity to make a choice was given and the record showing that most service users accept the main choice Grange Park Nursing Home DS0000066743.V327823.R01.S.doc Version 5.2 Page 6 consistently leads one to believe that most are not accessing the alternatives menu. Adult protection training is undertaken currently in-house, this would be improved by accessing training offered by Social Services. Other training requiring regular updating is infection control and this should be undertaken using an accredited source. As with all homes storage room is at a premium but staff must not store bulk incontinence pads in bathrooms even if only for a short period. 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 Park Nursing Home DS0000066743.V327823.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 Park Nursing Home DS0000066743.V327823.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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 1 – 5. Quality in this outcome area is good. Service users, prospective clients and their supporters are provide with good sources of information about the home and are invited to spend time at the home prior to admission to enable them to make an informed decision about entering the home. The staff group are stable well established and collectively have the knowledge and skills to assess needs and to meet the needs of the current service users. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The statement of purpose and service users guide were reviewed at the change of ownership with a copy of the latter issued to each service users room, large print copies are available. A further review will be required on the appointment of a new manager. All service users receive a statement of terms and conditions/contract at the point of admission to the home. This document meets all aspects of this standard such as fees, services offered and notice periods. Grange Park Nursing Home DS0000066743.V327823.R01.S.doc Version 5.2 Page 9 Three service users were case tracked and the assessment process shows that service users are admitted on the basis of assessments undertaken by qualified nursing staff using a document that covers a wide range of personal details and physical needs and preferences. This document is supplemented in most cases by a community care management assessment and further developed on admission by an in-depth, activities of daily living assessment and a range of clinical risk assessments such as pressure areas, nutrition and falls, these are kept under regular review, the assessment evidences the involvement of the service user and their relatives as appropriate. Risk assessments are also undertaken for individual known risks such as smoking or liable to wander. One contradiction was observed in a pressure risk assessment in that the dependency summary identified a high risk where the pressure specific assessment identified the risk as very high, it was noted that the risk addressed was for the very high assessment. Prior to admission the prospective client receives a letter of confirmation that their agreed needs can be met at the home. They are also invited to visit and trial the home prior to accepting a place. The home does not offer an intermediate care service presently. Grange Park Nursing Home DS0000066743.V327823.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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 7 – 10. Quality in this outcome area is good. Care plans are derived from a comprehensive range of assessments and provide the basis for the delivery of care and detail the actions required of staff to meet the identified needs. Health care needs of service users are fully met. Administration of medication practice is good and service users medication needs are safely met. Service users are treated with respect and their privacy upheld. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The case files of three service users were case tracked in depth and showed that they comprehensively identified problems requiring nursing and personal care interventions. A range of risk assessments including pressure, falls and nutrition were included and plans derived to address these. It was observed that wound care plans were prepared for multiple wounds, these require to be prepared for each wound separately and a diagram to show location size and description There is a plentiful supply of equipment to assist in providing care and reducing risk. Plans of care are subject to monthly reviews. All service users are registered with a GP and other allied medical and chiropodist visits regularly. Grange Park Nursing Home DS0000066743.V327823.R01.S.doc Version 5.2 Page 11 The Home has a policy and procedure for dealing with medicines and these are robust and observed to be implemented by staff in all aspects of medicines management, it is recommended that the MAR charts are audited weekly. At the time of the inspection no service users were self-medicating. Arrangements have been made to implement the new regulations for the disposal of waste medications. The homes pharmacist visits and monitors practices and gives advice on a regular basis. The care staff involved in the administration of medicines on the personal care side receive accredited training. A second medicine trolley has been obtained, this requires an attachment to secure it to the wall. Temperature readings of the refrigerator are recorded daily and are consistently 5°c. Records of the medicine room temperatures taken occasionally show these to be 23 or 24°c, this recording should be undertaken daily and a plan developed to respond to a risk of the temperature exceeding 25°c. The induction programme includes a section on treating service users with respect and their privacy is upheld with locks fitted to bedroom doors, in addition staff were observed to knock before entering and interact in a friendly and open way using the service users choice of name. One room is occupied by a husband and wife and a screen is available should there be a need for it. Grange Park Nursing Home DS0000066743.V327823.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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 12 – 15. Quality in this outcome area is good. The home provides well-organised and varied social and recreational activities that provide interest and pleasure for the residents. Visitors are welcome and help to keep service users informed about the wider community. Many aspects of care evidences that service users exercise choice and control over their lives. The meals at Grange Park nursing home are good, offering both choice and variety and catering well for special dietary needs. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Since the last inspection a senior carer has taken on the lead for organising activities and events at the home. Activities include, musical movement and exercise, sing-a-longs, crafts, quiz nights and games, reminiscence and one to one chats, parties for occasions, themes and birthdays and entertainers visit regularly. A number of service users have been out shopping and some have participated in trips to the pub and one attends a club twice a week. It was noted that records of activities and individual participation were not being maintained. Grange Park Nursing Home DS0000066743.V327823.R01.S.doc Version 5.2 Page 13 The Home practices an open visiting arrangement and this was noted to function well with many visitors coming and going during the period of the inspection. Clergy and church visitors attend the home on a regular basis. Service users are encouraged to exercise choice over their lives with such elements as managing their own affairs, choice of meals, clothing to wear and times of rising and retiring, one gentleman had spent the morning in bed including taking breakfast and had risen in preparation for lunch. Information is available on advocacy services. Many service users have brought small items of personal possessions, including some furniture such as display case and chair, with them and made their rooms very personal to themselves. The 4-week rotating menu provides for a nutritious diet, arrangements for ensuring choice is included on a separate chart and contains a selection of good alternatives, the system does not however show that service users are accessing that menu. Meals taken up by individual service users is monitored and recorded. Cooked options are available at breakfast, lunch and high tea and snacks are available at all times. Special diets, religious and cultural dietary needs are catered for. Cakes are provided for birthdays and other special occasions. Supper is now included in the menu, the availability of snacks are noted. Grange Park Nursing Home DS0000066743.V327823.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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 16 & 18. Quality in this outcome area is good. The home complaints and protection policies are robust providing a safe environment in which service users feel they can voice concerns and that these will be listened and responded to. Service users rights are protected and staff demonstrate good knowledge and understanding of adult protection issues which contributes in providing an environment safe from abuse. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home has a complaints policy and procedure; it is included in the statement of purpose and referred to in the service users guide. Records are kept of complaints including outcomes two have been received since the last inspection and these were responded to the satisfaction of the complainants. Adult protection and whistle blowing policies were seen and these now require review to show the name of the new company. Staff have received in-house training in protection from abuse and in discussion with staff they demonstrated a good knowledge of how they would respond to suspicion or evidence of abuse and a flow chart is available to guide senior staff. It is recommended that social service training be sourced. Grange Park Nursing Home DS0000066743.V327823.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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 19 & 26. Quality in this outcome area is good. The home provides a good standard of accommodation, décor, furnishings and managed services providing a safe environment and an attractive, comfortable and homely place to live. The home is clean, free from odours and hygienic. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home provides a good standard of accommodation, décor, furnishings and managed services providing a safe environment and an attractive, comfortable and homely place to live. Decoration remains in good condition followings refurbishment programme that included bedrooms and the 5 lounges, decoration continues to maintain appearance. On the day of inspection the grounds were found to be tidy and appropriate to season. The building is subject to safety monitoring and at the time of this inspection the home complies with fire and environmental health requirements. It was Grange Park Nursing Home DS0000066743.V327823.R01.S.doc Version 5.2 Page 16 observed that a bathroom (210) had a supply of pads, these are to be removed or the room adapted. The home is clean, free from odours and hygienic. Hand-washing facilities for staff were sited around the home and adequately stocked with liquid soap and disposable towels. The laundry is appropriately sited and equipped and the washing machines have cycles for sluicing and disinfection. Policies for infection control procedures and waste disposal were available. The home has a sluice disinfector on the ground floor, subject to usage the manager should assess if the location is adequate. Grange Park Nursing Home DS0000066743.V327823.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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 27 – 30. Quality in this outcome area is good. The home has a good mix of staff allocated in sufficient numbers to provide consistency of care that meets service users needs. The home has been proactive in developing a skilled staff group with understanding of service users needs. Recruitment and selection processes are to a good standard protecting vulnerable people. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home is consistently staffed with appropriate numbers and skill mix of nurses and carers over the 24 hour period. Staff met and spoken with were enthusiastic and those who were recently employed have received formal induction that meets TOPPS standard, this now requires review and amendment to the Skills for Care standard. The standard of 50 of care staff being trained to NVQ level 2 standard has been exceeded, currently 71 . All staff have an individual training record and a training matrix of statutory and other regular training required, it was noted that no infection control training has been undertaken in recent times and this was confirmed by the acting manager. A full list of all staff training was provided and includes equality and diversity, dementia, prevention of abuse and death, dying and bereavement. Grange Park Nursing Home DS0000066743.V327823.R01.S.doc Version 5.2 Page 18 A sample of 3 staff files were checked and were completed to a good standard with all elements of good recruitment practice included and necessary checks of CRB, POVA and Nurse registration undertaken. Grange Park Nursing Home DS0000066743.V327823.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 31, 33, 35, 36 & 38. Quality in this outcome area is excellent. Leadership of this home is good and staff demonstrate an awareness of their roles and responsibilities and service users benefit from this consistency. The home regularly reviews its performance, which includes consultation and seeking the views of service users and their families and evidenced that it is acted upon. The arrangements for safekeeping of service users money safeguards their interests personal and financial. Staff receive supervision and direction to ensure that the service users receive consistent quality care. The safety and welfare of service users is protected. This judgement has been made using available evidence including a visit to this service. Grange Park Nursing Home DS0000066743.V327823.R01.S.doc Version 5.2 Page 20 EVIDENCE: The manager post is currently vacant and has been appointed, the acting manager is an experienced senior nurse. An extensive range of audits are undertaken including service user surveys and other stakeholders views sought and the results and action plans published on the notice board. A senior manager undertakes monthly unannounced visits in line with regulation 26 requirements, the reports of which are copied to the Commission. Families mostly manage service users personal allowances although a small number manage their own affairs. Where money is left for safe keeping full records are maintained of all transactions. The home gives high priority to the induction and ongoing training of its staff and has well-established formal supervisions, which informs the training and development requirements of individual staff. The home has an up to date health and safety policy for safe working practice with a range of risk assessments. Staff receive training and regular updates in health and safety and fire safety. A fire risk assessment was available and this is subject to review as changes occur. Certification of a range of servicing and annual inspections undertaken of all utilities and equipment in the home are maintained and up to date. Grange Park Nursing Home DS0000066743.V327823.R01.S.doc Version 5.2 Page 21 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 3 8 3 9 2 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 2 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 3 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 Park Nursing Home DS0000066743.V327823.R01.S.doc Version 5.2 Page 22 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 OP7 Regulation 15(1) Requirement The responsible person must ensure that a separate plan of care is prepared for each separate wound. The responsible person must arrange for the safe keeping of medicines by providing a secure wall fixing for the second medicine trolley. The responsible person must demonstrate how the alternative menu is brought to the attention of service users at lunchtimes. The responsible person must ensure areas of the home not adapted for storage are not used for storage. Timescale for action 31/03/07 2. OP9 13 (2) 31/03/07 3. OP15 16(2)(i) 31/03/07 4. OP19 23(4)(a) 31/03/07 Grange Park Nursing Home DS0000066743.V327823.R01.S.doc Version 5.2 Page 23 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. 3. 4. Refer to Standard OP9 OP18 OP26 OP27 Good Practice Recommendations The manager should monitor the medicines room temperature daily and prepare a contingency plan to prevent overheating. The manager should source staff training in adult protection procedures from Social Services. The manager is recommended to relocate the sluice disinfector machine to improve its accessibility. The manager should provide regular up date training in infection control procedures. Grange Park Nursing Home DS0000066743.V327823.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Halesowen Record Management Unit Mucklow Office Park, West Point, Ground Floor Mucklow Hill Halesowen West Midlands B62 8DA 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 Park Nursing Home DS0000066743.V327823.R01.S.doc Version 5.2 Page 25 - 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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