Inspection on 25/11/05 for Grangefield Residential Home

This inspection was carried out on 25th November 2005.

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 16/03/07

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 Mrs Judith Sansom Unannounced Inspection 25th November 2005 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 Grangefield Residential Home DS0000065529.V268291.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. Grangefield Residential Home DS0000065529.V268291.R01.S.doc Version 5.0 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 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.V268291.R01.S.doc Version 5.0 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 14/04/05 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. Grangefield Residential Home DS0000065529.V268291.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The focus of inspections undertaken by the Commission of Social Care Inspection is upon the outcomes for residents and their views of the service provided. The methodology of case tracking is used to find out if the care being provided to the residents is of an acceptable standard and meets their individual needs. ‘Case tracking’ involves the review of resident’s records, meeting with them and talking with the care staff who provide the personal care to the selected residents. The inspection also includes a review of the homes’ procedures and processes to ensure that all practices carried out by the staff protect the residents. The inspection process includes the collation of information from residents, relatives and visitors to the home. The manager submits a completed preinspection questionnaire. From these information sources an inspection plan is developed. The inspection in the home was carried out on an unannounced basis during the morning and early afternoon. The inspection process that included the preparation and inspection took approximately five hours. The primary method of inspection used was ‘case tracking’ which involved selecting 3 residents and tracking the care they receive through review of their records, discussion with the residents, the care staff and observation of care practices. Since the last inspection there has been a change in ownership of the home, with the retirement of the previous owners from the care industry. The new owner was taken through the registration process that included ensuring that he was competent to become the registered owner. Mr N Odedra is the new registered provider of Grangefield residential care home. What the service does well: The staff group under the guidance and leadership of the registered manager is stable. The staff team are motivated and committed in providing a high level of care to the residents of the home. Relatives and friends are made welcome in the home and are invited to stay for meals. Relatives and friends are invited to join in with any specific events such as theme days, garden party and bonfire party. Grangefield Residential Home DS0000065529.V268291.R01.S.doc Version 5.0 Page 6 The manager is committed in moving the home forward and is constantly looking for alternative activities and interests for the residents to become involved in. The month of December promises to be a very busy one for the residents with a high number of activities having been organised that includes visits to the local garden centre, a Christmas meal at the golf course, the making of Christmas decorations and cards, cake and mince pie making and baking. These activities sit alongside the usual visitors from the local Brownies and school, bell ringers and carol singers. The home is tastefully decorated and maintained to a high standard. There are plans to address the ongoing need of re-decoration and replacement of some items of furniture. What has improved since the last inspection? What they could do better: Ongoing work should be undertaken in the further development of the care plans and risk assessments. This is very important when a resident has changing needs. Detailed assessments such as nutrition and waterlow risk assessments should be undertaken and used to develop the care plans of the residents and should be in place prior to any resident moving into the home. Grangefield Residential Home DS0000065529.V268291.R01.S.doc Version 5.0 Page 7 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. Grangefield Residential Home DS0000065529.V268291.R01.S.doc Version 5.0 Page 8 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Grangefield Residential Home DS0000065529.V268291.R01.S.doc Version 5.0 Page 9 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 3. Standard 6 does not apply to this home. The assessment processes are robust and detailed thus ensuring that the new residents can be confident that the care staff of the home will meet their individual needs. EVIDENCE: One resident stated that although he had not been able to be involved in the full process of his admission as his relatives took on that role they had been able to guarantee that the staff would look after him. He said that although he was sorry to have left his home he was really happy at Grangefield and the staff really had helped him a lot to settle in. The registered manager is currently in the process of reviewing the Statement of Purpose and the service users guide to ensure that all the information contained in these documents is current, relevant and written in a manner that can be easily understood by the reader. Grangefield Residential Home DS0000065529.V268291.R01.S.doc Version 5.0 Page 10 The pre-admission assessment information is used to develop the resident’s initial care plan so that at the time of arrival care staff have a basic understanding of what the resident’s personal needs are. Grangefield Residential Home DS0000065529.V268291.R01.S.doc Version 5.0 Page 11 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8 & 11 All staff take the responsibility of recording information relating to the resident’s health, personal and social needs within the records maintained for each resident. This system provides assurance to the residents that their care needs will be met. EVIDENCE: Improvements have been made to the care plans and risk assessments since the last inspection. Discussions exploring ways in which these basic care plans could be improved further took place during the inspection. Currently the staff writes valid information in the daily records log about each resident. However this daily information is not very detailed and is limited in its content. Staff would benefit from receiving instruction and guidance about how to write this information to provide a pen picture of each resident. From the files reviewed no risk assessments were in place. This is because they were not necessary as each of the residents had life styles that did not pose a risk. However the Inspector discussed with the manager the anticipated admission of a new resident who had short term memory loss but enjoyed being as independent as possible and liked to walk into the town unescorted. It Grangefield Residential Home DS0000065529.V268291.R01.S.doc Version 5.0 Page 12 was agreed that a risk assessment detailing different aspects of this resident’s life would be necessary. One resident talked about how the district nurse comes in regularly to the home to re-dress his legs, and how sympathetic and understanding the care staff are towards him. Resident’s records confirm that health care professionals visit the home on a regular basis. One resident told the inspector how sensitive the staff were when they were providing personal care, and encouraged her to be as independent as possible. Another resident confirmed that this was the same for him. The home has in place a detailed policy and procedure for staff to follow in the event of ensuring that specific care will be given to any resident who is dying. The manager confirmed that in this event a detailed care plan would be written for staff to follow to would guarantee that the last wishes of the resident would be met. Grangefield Residential Home DS0000065529.V268291.R01.S.doc Version 5.0 Page 13 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): 15 Menu planning and mealtimes are well managed with input from the residents being sought. Residents have the assurance that their personal likes and dislikes will be catered for. EVIDENCE: Residents were talking about the proposed Christmas activities. For all of the residents spoken with this will be the first Christmas they have experienced in the home. Two of the residents told the Inspector that they would be going to their relatives for Christmas Day. The activities that are planned for the month of December try to encompass a wide range of interests. For the first time a member of staff will be encouraging residents to make and bake Christmas cakes and mince pies. A group of bell ringers have been invited into the home. During their visit the residents are invited to take part and try to play the bells. Residents were very positive about the meals that they enjoy in the home. Changes have been made to the way in which breakfasts are served, which enables residents to choose more easily what they would like to eat. Consideration is being made about the introduction of food being served in tureens on each dining table to encourage the residents to serve themselves. This action will promote individual choice. Frequently the teatime meal is Grangefield Residential Home DS0000065529.V268291.R01.S.doc Version 5.0 Page 14 served around all parts of the home, wherever the resident wants to eat it. The manager has also responded to comments made by the residents and has introduced the provision cups of tea at different times of the day. Residents commented that they are encouraged to eat their meal where they want. One resident said that although he goes down to the dining room for his dinner he likes to have his teatime meal in his room. The residents expressed how much they enjoyed being offered fish and chips cooked at the local fish shop each Friday. However if a resident does not want this an alternative is always provided. There was a good stock of a wide variety of foods in the stock cupboard. The manager oversees this to ensure that there are always sufficient food stocks available. Grangefield Residential Home DS0000065529.V268291.R01.S.doc Version 5.0 Page 15 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 The complaints and protection processes and procedures in the home are robust. This robust system ensures safety and protection for all vulnerable people in the home. EVIDENCE: The commission has not received any complaints about any aspect of the home since the last inspection. The manager has not received any grumbles or complaints. The complaints procedure that is made known to all people visiting or living in the home is comprehensive. The manager stated that he is currently reviewing all policies and procedures to ensure they are written in a manner that can be understood easily by the reader. Staff, to date, have not received direct training about the protection of vulnerable adults in line with the Northamptonshires’ agreed procedures. However this topic is covered for all staff that are undergoing their NVQ (National Vocational Qualifications). The manager stated that this specific training is booked to be delivered to all staff in January 2006. The home’s policies and procedures are written in a manner that includes the current guidance from the Northamptonshire’s POVA (Protection of Vulnerable Adults) team. One resident stated that he felt very safe in the home. Grangefield Residential Home DS0000065529.V268291.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): 19, 20, 21, 22, 23, 24, 25 & 26 The environment provides safe comfortable surroundings and is maintained to an acceptable standard. This offers all residents with a homely and welcoming atmosphere. EVIDENCE: The home continues to be maintained to a very high standard. However the manager advised that there were plans in place to revamp the dining room and replace all the furniture in that room. This is partly due to the residents finding the dining room chairs very uncomfortable. Further plans are being discussed with the registered provider to find ways in which the home can be improved. The domestic staff are successful in maintaining a very clean, hygienic and pleasant environment. Residents expressed how much they like the home. One resident said that he liked being asked about how he would like the home to look in the future. Grangefield Residential Home DS0000065529.V268291.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, 29, 30 Staff are enthusiastic and positive in their approach to their work and work together as a team to improve the quality of life for the residents. EVIDENCE: A comprehensive training programme has been developed that ensures that all staff receives any updated training as deemed necessary. A number of staff are undertaking varying levels of NVQ. Some members of staff are undertaking complementary training such as Safe Handling of Medicines and Dementia. Although the registration category does not include this category of need, (Dementia) the manager has recognised that some residents are developing dementia related illnesses and he wants the staff to know how to recognise and meet their individual needs. The staff group is very stable and there have been no changes for some considerable time. All files contain the necessary information as detailed in Schedule 2 of the National Minimum Standards. There were sufficient numbers of staff on duty at the time of the inspection. Residents stated that they liked talking to the staff who always had time for them, and that if they had to use the call bell the staff always responded. Grangefield Residential Home DS0000065529.V268291.R01.S.doc Version 5.0 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, 35, 36 There is good leadership, guidance and direction to staff from the Registered Manager that ensures the residents receive consistent quality care. EVIDENCE: There has been a change in the ownership of the home since the last inspection. However the registered manager remains in post and has maintained stability through the changes for the staff and the residents. The manager contributes to bringing improvements to the home and works hard to move the home forward. Since the last inspection there has been recognition that the manager must spend more time undertaking the managerial tasks. However if necessary he will cover a limited number of shifts and works one weekend in six. Grangefield Residential Home DS0000065529.V268291.R01.S.doc Version 5.0 Page 19 The home does not hold any monies for the residents and the residents are encouraged to maintain their own finances. A shopping trolley is taken around the home each week from which the residents are able to buy a variety of items. The manager has designed a Christmas card that depicts the home covered in snow for residents and relatives to buy. The proceeds made from this sale is placed into the resident’s fund. The newly developed care plans and risk assessments are indicative of the way in which the manager works with the commission. Through discussions the manager is aware of how these are to be developed further to advance their content thus providing the staff with clear and concise information in the provision of the care that is delivered. The registered manager has taken on the responsibility of all formal supervisions to ensure consistency. Staff’s appraisals were undertaken in the summer and supervisions are conducted on a bi-monthly basis. One staff member commented about how useful she found her supervisions and was able to talk easily to the manager, knowing that he would listen and respond to any concerns. Full staff meetings are held on a frequent basis, to which about 98 of the staff group usually attend. Grangefield Residential Home DS0000065529.V268291.R01.S.doc Version 5.0 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 X X 3 X X X HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 X 10 X 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 X 13 X 14 X 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 3 3 3 3 3 3 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 X X 3 3 X X Grangefield Residential Home DS0000065529.V268291.R01.S.doc Version 5.0 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. Standard Regulation Requirement Timescale for action 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 Refer to Standard OP7 Good Practice Recommendations The development of the care plans should be continued. These plans must contain sufficient information and guidance that instructs staff in their provision of care to the resident Grangefield Residential Home DS0000065529.V268291.R01.S.doc Version 5.0 Page 22 Commission for Social Care Inspection Northamptonshire Area Office 1st Floor Newland House Campbell Square Northampton NN1 3EB 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 Grangefield Residential Home DS0000065529.V268291.R01.S.doc Version 5.0 Page 23 - 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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