Inspection on 16/03/07 for Grangefield Residential Home

This inspection was carried out on 16th March 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

Grangefield Residential Home 04/03/09

Grangefield Residential Home 25/11/05

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

CARE HOMES FOR OLDER PEOPLE Grangefield Residential Home 60 Northampton Road Earls Barton Northants NN6 0HE Lead Inspector Irene Miller Unannounced Inspection 16th March 2007 10:00 16/03/07 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 Grangefield Residential Home DS0000065529.V332925.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. Grangefield Residential Home DS0000065529.V332925.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Grangefield Residential Home Address 60 Northampton Road Earls Barton Northants NN6 0HE 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) 01604 812580 01604 812580 grangefieldrch@hotmail.co.uk Mr Nikul Odedra Peter Daniels Care Home 20 Category(ies) of Old age, not falling within any other category registration, with number (20) of places Grangefield Residential Home DS0000065529.V332925.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. No one falling within the category of OP may be admitted to the home where there are 20 persons of category OP already accommodated in the home Date of last inspection Brief Description of the Service: Grangefield is a privately owned care home providing personal care for up to twenty men and ladies over the age of 65 years. Nursing care is not provided in this home. Grangefield stands in its own extensive grounds and offers ample car parking to the front of the house. It is a large detached building that has been significantly extended to the rear of the building on the ground floor. The extension provides a further eight bedrooms, two bathrooms and a hairdressing/chiropody/treatment room. The home is located on the outskirts of Earls Barton set back from the main road, and is on the main bus route. The current fees range from £335 to £365 all fees are inclusive of fortnightly hairdressing and bi monthly chiropody. Grangefield Residential Home DS0000065529.V332925.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The focus of inspections undertaken by the Commission for Social Care Inspection (CSCI) is based upon outcomes for service users and their views of the service provided. This inspection was a ‘Key Inspection’ that focused on the key standards under the National Minimum Standards and the Care Standards Act 2000 and the Care Homes Regulations 2001, for homes providing care for older people. The primary method of inspection used was ‘case tracking’ which involved selecting three residents, reviewing their health, social, emotional and physical needs and tracking the care they receive. Three care plans were looked at (a care plan sets out how the home aims to meet the, personal, health, social and emotional needs of the resident), and discussion took place with residents and staff and general care practices were observed. The homes policies, procedures and records in relation to staffing recruitment and training, concerns and complaints, medication management, and general maintenance and upkeep of the home were viewed. The inspector spent approximately two hours planning the areas to focus on at this inspection, based upon information gained from reviewing the homes previous inspection reports and other information relating to the home. The registered manager Peter Daniels was available at the home on the day of inspection; the inspection took place over a period of approximately six hours. What the service does well: Residents live in a home where their rights to privacy dignity and independence is fully recognised and promoted and their lifestyle preferences acknowledged and accommodated. The culture and the philosophy of the home is that the home is run in the resident’s best interests, where residents are recognised as unique individuals with differing needs and aspirations. Grangefield Residential Home DS0000065529.V332925.R01.S.doc Version 5.2 Page 6 There is a loyal staff team employed at the home and there is good staff support systems in place. Residents were very pleased with living at the home, they expressed great satisfaction with being able to exercise their independence, and of living in such a pleasant well maintained home. 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. The summary of this inspection report can be made available in other formats on request. Grangefield Residential Home DS0000065529.V332925.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 Grangefield Residential Home DS0000065529.V332925.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): Standard 3 (Standard 6 is not applicable for this service) Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Residents can be assured that they will be fully informed on the range of services that the home provides, and that their needs will be met. EVIDENCE: Residents spoken with said that they had been fully involved with the process of their admission, saying that the registered manager had visited them within their own home prior to moving in, and that that they had visited the home to meet the staff and residents before moving into the home. One resident said that prior to moving into the home they had been seriously ill and underweight, they praised the staff saying that they had done a terrific job in helping them to regain their health and strength back again, this was verified by their relative who was visiting the home at the time of inspection. Grangefield Residential Home DS0000065529.V332925.R01.S.doc Version 5.2 Page 9 The care records viewed demonstrated that full pre-admission assessments had taken place prior to admission, which had formed the basis of the personal care plans, staff spoken with said that when a prospective resident is due to move into the home they were fully informed of the level of support required to meet their care needs, through written and verbal communication from the registered manager. The statement of purpose, service users guide and most recent inspection reports were available within the lounge for residents and relatives to access at any time. There were some information that required amending regarding the new inspection processes conducted by the Commission for Social Care Inspection, such as the frequency of inspection and the contact details. Grangefield Residential Home DS0000065529.V332925.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 7,8,9 & 10 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents can be assured that their health and personal care needs will be met, however shortfalls in the handling of medication has the potential for residents not to be fully protected in this area. EVIDENCE: The care plans viewed had identified the residents health and personal care needs however, when speaking with staff and the registered manager it was identified that there were some information within the care plans that was no longer current and required review and updating. Within the care plans there was information available of the involvement of the district nurse and visits by general practitioners, and other healthcare professionals such as the chiropodist and optician and there was information available on the residents choices and daily lifestyle routines. The residents living at the home have the ability to communicate and express their needs and wishes and therefore the information within the care plans was Grangefield Residential Home DS0000065529.V332925.R01.S.doc Version 5.2 Page 11 not required to be written down in the finest detail, there was sufficient basic information available for staff to follow. Residents were observed to exercise their independence and said that the staff were very helpful in providing support with personal care, washing and bathing. The homes medication was sample checked and in general well managed, however when checking the prescribed controlled medication held within the home, there was a discrepancy within the controlled medication record and the medication was not stored securely. Staff training on medication safety and management had taken place with the dispensing pharmacy and further training was planned to take place with Northampton College. There was a medication policy in place and staff had signed to evidence that they had read and understood the policy. Grangefield Residential Home DS0000065529.V332925.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 12,13,14 & 15 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Residents can be assured that they will be supported to exercise choice and control and lead the lifestyle that matches their expectations and preferences. EVIDENCE: There was a programme of planned activities such as flower arranging, card making, and visiting PAT dogs (pets for active therapy). The registered manager stated that the over the Christmas period the home had been very active and that during the early months of the year the home tends to take stock and use the time to plan for the forthcoming months. The home employs an activity person who spends time with residents on a one to one and a group basis, and a shop is available in the form of a trolley that which residents can purchase items such as toiletries and sweets. Recent activities had included card making, bingo and quizzes and a list of dates was posted on the resident’s notice board of forthcoming events to include visiting musical entertainers, and a garden party planned to take place in June. The home produces a monthly newsletter and a copy was posted on the resident’s notice board articles included in the newsletter were residents and Grangefield Residential Home DS0000065529.V332925.R01.S.doc Version 5.2 Page 13 staff forthcoming birthdays, seasonal news such as the clocks going back, shrove Tuesday events, and memorial of a residents who had passed away, a garden party was planned to take place in July in celebration of their life. Residents said that they could receive visitors at any time of the day and spoke of going out to lunch at local restaurants and public houses and of visiting their families. Several of the female residents were looking forward to spending mother’s day with their families. The home has strong links with the local community, one of the residents said that he regularly likes to walk up to the local pub and enjoy a pint. One resident spoken with said that they liked to sit and do crosswords, and read their newspaper, the registered manager said that he was considering introducing residents to computer technology, the resident said that they would be keen to give this go if they could be shown how to use a computer. Religious services were made available and residents spoke of receiving Holy Communion every two weeks, and of carol singing taking place at the home over Christmas by parishioners from the local church and local school children. Records within the resident’s daily notes had entries of when relatives had been invited to have lunch with their resident. Observations made over the lunchtime meal demonstrated that the mealtimes were unhurried and a time for residents to interact and socialise with one another, the atmosphere within the dining room was congenial and comments received from residents were very positive, saying the food was first rate, that they had never had any cause to complain about the quality of the food on offer and that there was plenty of choice available. Residents spoke of joining friends for lunch and some choosing to eat their evening meal within their personal bedroom. They expressed how they enjoyed having fish and chips from the local fish shop each Friday, saying that if they did not want this then an alternative was always available. This was confirmed during the lunchtime meal when residents were observed to receive alternatives to the meal available. The kitchen was clean and tidy, there was some repairs needed to the cupboard next to the oven and the kick board under the work units that had the wooden veneer peeling away due to the heat and condensation within this environment, the manager said that this would be receiving attention during the next few weeks. The food stock cupboard contained a good supply and variety of quality branded foods and there was a variety of fresh fruit available for residents to access within the dining room. Grangefield Residential Home DS0000065529.V332925.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. This judgement has been made using available evidence including a visit to this service. Residents can be assured that any concerns or complaints they may have will be taken seriously, listened to and acted upon by the manager and that they will be protected from abuse. EVIDENCE: The complaints procedure was available on the resident’s notice board and also within the statement of purpose and the service users guide located within the lounge Since the last inspection visit the home or the Commission for Social Care inspection had received no concerns or complaints. Training on the Protection of Vulnerable Adults (POVA) was available and the registered manager stated that he had also endeavouring to enrol staff on an Internet training programme on Safeguarding Adults. The Staff spoken with were fully aware of what action they should take in response to suspecting any abuse within the home. The home’s adult protection policies and procedures included guidance from the Northamptonshire’s Inter Agencies POVA (Protection of Vulnerable Adults) team. Grangefield Residential Home DS0000065529.V332925.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): Standard 19, 20, 21, 23, 24, 25 & 26 Quality in this outcome area is excellent. Residents live in a home that is pleasant, well maintained, clean and furnished to a high standard. This judgement has been made using available evidence including a visit to this service. EVIDENCE: During a limited tour of the building all areas were seen to be light and airy clean, hygienic and maintained to a high standard. The décor was traditional and in keeping with the period of the house. The garden was maintained to a very high standard, borders containing lots of spring bulbs and raised flowerbeds available where residents could participate in some light gardening if they choose. The communal areas were clean and furnished to a high standard with homely touches such as fresh flowers and reading materials throughout the house. There was communal space were residents could enjoy each other’s company Grangefield Residential Home DS0000065529.V332925.R01.S.doc Version 5.2 Page 16 and quite areas where residents could sit and enjoy the views to the immaculately kept garden. The manager had supplied information prior to the inspection-taking place on the frequency of safety checks and the maintenance and upkeep of the home. Redecoration and refurbishments had taken place to several bedrooms, and residents confirmed that they had been fully consulted when purchasing new bedding and curtains, the bedrooms contained personal items of furniture and electrical equipment such as TV’s, video and DVD players, Radios and CD players, personal paintings and photographs, one bedroom had a sewing machine which the resident had brought with them. All of the bedrooms viewed had pleasant views either to the open countryside or the front and rear gardens. Residents spoke of their satisfaction with their bedrooms saying how much they liked living at the home and how lucky they were to live there. The laundry was well clean and cross infection policies and procedures were followed. The laundry equipment was under a service/maintenance contract, the tumble dryer had been out of order for several days, the manager said that an engineer had been out and a part had to be placed on order which the home was awaiting the delivery. As an additional measure to reduce the risk of cross infection there was a hand sanitising gel available in a dispenser within the sun lounge for residents, staff and visitors use. Grangefield Residential Home DS0000065529.V332925.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 27,28,29 & 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents are supported by a loyal staff team that are trained and competent to fulfil their duties. EVIDENCE: Records were available of staff training that had been undertaken, such as health and safety, health and nutrition, medication. The home is not registered to care for people living with Dementia, however the registered manager had made arrangements for staff to attend training on dementia care as some residents may develop Dementia related illnesses. Training on NVQ (National Vocational Qualification) levels 1 and 2 in care was available to all staff. There was a loyal and committed staff team, many of whom had worked at the home for several years and the staffing rota demonstrated that there was sufficient staff on duty and flexible working arrangements in place. Two staff files were viewed, which contained all the necessary information to demonstrate that staff were fully vetted on recruitment and that ongoing training and support was provided. Grangefield Residential Home DS0000065529.V332925.R01.S.doc Version 5.2 Page 18 Observations of care practices evidenced that staff treated residents with respect and that their rights to choice privacy and independence were facilitated. Grangefield Residential Home DS0000065529.V332925.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 & 38 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. The culture of the home ensures that the resident’s health, safety and welfare is promoted and protected EVIDENCE: Discussion with the registered manager demonstrated that he has the skills, experience and knowledge to manage a home for older people and is currently undertaking the NVQ (National Vocational Qualification) in care management level 4 and the Registered Managers Award. Records were available to demonstrate that formal one to one staff supervision takes place regularly, and that staff receive annual appraisals to access their performance and development needs, and that staff meetings are held on a frequent basis. Grangefield Residential Home DS0000065529.V332925.R01.S.doc Version 5.2 Page 20 In discussions with staff they expressed that the registered manager was supportive, and that they could speak with him at any time, the staff rota had been revised and the registered manager had made changes to their working hours to ensure that their was a balance between time spent with residents and in completing managerial responsibilities and administrative tasks. The home does not hold any monies for the residents and the residents are encouraged to maintain their own finances. Quality Assurance is monitored through resident survey questionnaires and residents meetings taking place. The findings from the most recent residents satisfaction survey carried out in February 2007 was available on the residents notice boards as were the minutes of a recent residents meeting. The registered manger was aware that all medications must be handled in accordance with the homes medication policies and procedures and the Royal Pharmaceutical Society guidelines on the safe management of controlled medications. The registered manager works hard to move the home forward and to further improve on the quality of care provided at the home. From the care and administrative records viewed and through discussion with residents, staff, visitors and the registered manager, it was evidenced that the health safety and welfare of residents underpins the philosophy of the care provided at the home. Grangefield Residential Home DS0000065529.V332925.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 X X 3 X X 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 4 13 4 14 4 15 4 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 4 3 X 4 4 3 4 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 4 X 3 4 X 3 Grangefield Residential Home DS0000065529.V332925.R01.S.doc Version 5.2 Page 22 No 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 OP9 Regulation 13 (2) Requirement Controlled drugs held within the home must be stored securely and accurate records maintained within the controlled drugs register. Timescale for action 30/04/07 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Grangefield Residential Home DS0000065529.V332925.R01.S.doc Version 5.2 Page 23 Commission for Social Care Inspection Lincoln Area Office Unity House, The Point Weaver Road Off Whisby Road Lincoln LN6 3QN National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Text phone: 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 Grangefield Residential Home DS0000065529.V332925.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. 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