Inspection on 05/02/08 for Grangewood Care Centre

This inspection was carried out on 5th February 2008.

CSCI found this care home to be providing an Good service.

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

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

CARE HOMES FOR OLDER PEOPLE Grangewood Care Centre Chester Road Shiney Row Houghton le Spring DH4 4RB Lead Inspector Mrs Elsie Allnutt Unannounced Inspection 09:30 5 and 6 February 2008 th th 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 Grangewood Care Centre DS0000070539.V356944.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. Grangewood Care Centre DS0000070539.V356944.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Grangewood Care Centre Address Chester Road Shiney Row Houghton le Spring DH4 4RB 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) 0191 385 6644 0191 385 6688 Southern Cross OPCO Ltd Mrs Lesley Langton Care Home 50 Category(ies) of Dementia - over 65 years of age (25), Mental registration, with number Disorder, excluding learning disability or of places dementia - over 65 years of age (10), Old age, not falling within any other category (50), Physical disability over 65 years of age (4) Grangewood Care Centre DS0000070539.V356944.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The registered person may provide the following category of service only: Care home only - Code PC To service users of the following gender: Either Whose primary care needs on admission to the home are within the following categories: Old age, not falling within any other category - Code OP, maximum number of places: 50 Dementia, over 65 years of age - Code DE(E), maximum number of places: 25 Mental Disorder, over 65 years of age, excluding learning disability or dementia - Code MD(E), maximum number of places: 10 Physical Disability, over 65 years of age - Code PD(E), maximum number of places: 4 The maximum number of service users who can be accommodated is: 50 2. Date of last inspection Brief Description of the Service: Grangewood Care Centre is a purpose built detached home standing in its own grounds in what could be described as the centre of the local community of Shiney Row. It has a patio and shrubbery to 3 sides of the building and has its own driveway and parking spaces. The accommodation consists of 50 single bedrooms offered over the ground and first floors, all of which have their own en suite toilet and a range of communal facilities. A passenger lift offers easy access to the first floor and the rear of the home has a patio area. All areas of the home, including the entrance offers good disabled access. Grangewood Care Centre DS0000070539.V356944.R01.S.doc Version 5.2 Page 5 Personal care is provided to people over the ages 65 years, some people may also have a physical disability, diagnosed dementia or mental health. Easy access is available to the local shops, post office and the GP surgery is adjacent to the home. A local bus service, which offers access to the city centre, Chester le Street and Washington, is nearby. The home has developed a Service User Guide to inform interested people about the services offered. The range of fees charged by the home is from £381.00 to £460.00 per week. Additional charges are made for hairdressing, chiropody, newspapers and toiletries. Grangewood Care Centre DS0000070539.V356944.R01.S.doc Version 5.2 Page 6 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 2 star. This means the people who use this service experience good quality outcomes. Before the visit: We looked at: • Information we have received since the last visit. • How the service dealt with any complaints & concerns since the last visit. • Any changes to how the home is run. • The provider’s view of how well they care for people. • The views of people who use the service & their relatives, staff & other professionals. The Visit: Two unannounced visits were made on 5th and 6th February 2008. During the visits we: • • • • • • Talked with people who use the service, relatives, staff, the manager & visitors. Looked at information about the people who use the service & how well their needs are met, Looked at other records which must be kept, Checked that staff had the knowledge, skills & training to meet the needs of the people they care for, Looked around parts of the building to make sure it was clean, safe & comfortable, Checked what improvements had been made since the last visit. We told the manager/provider what we found. What the service does well: The home has developed good information about the service that they deliver to help people to make an informed decision about moving there and people are encouraged to visit the home so that they can see the facilities available. One resident said: “My relative and I visited several homes. I was able to visit here and see all around before we decided how pleasant it was.” Grangewood Care Centre DS0000070539.V356944.R01.S.doc Version 5.2 Page 7 The manager makes sure that the home can effectively meet the resident’s needs. She receives important information about people who wish to use the service and also carries out the home’s assessment of need, before she confirms that the person can move in. There are good arrangements in the home for meeting the residents’ healthcare needs. Residents are supported to see their GP, visit outpatient appointments and are also able to access other healthcare services such as dentist, optician, chiropody and district nursing services when there is a need. There are good procedures in place to make sure people get their medicines at the right time. This means that residents are supported to take the medication that they need at the time the doctor advised. Residents and relatives spoke very highly about the quality of the care provided and the support offered by the staff to allow this to happen. Relatives said: “I know that my X is looked after well and the good thing is that I am kept informed of their progress.” “All staff are very friendly and always seem to go beyond their call of duty.” “We as a family feel the choice we made was the right one in every way, our X not only appears physically better but also seems to be content and happy in her/himself.” Residents said: “The girls are very kind and gentle when they help me with my bath.” Residents are supported and encouraged to exercise control over their lives and to maintain their preferred lifestyle. Some said: “I can go to bed when I like and get up at what ever time I please.” “If you don’t want to go into the dining room to eat you don’t have to.” “I don’t like joining in with other people all of the time, I sometimes prefer to read in my own room.” The food at the home is very good and the chef demonstrates a great interest in the satisfaction and need of the residents. This means that residents receive food that they like and that is suitable to their dietary needs. Grangewood Care Centre DS0000070539.V356944.R01.S.doc Version 5.2 Page 8 The residents are supported to maintain contacts with their families and friends. Relatives are encouraged to visit at times convenient to them and to stay as long as they want. The home’s standard of cleanliness is excellent and the standard of the décor and furnishings is very good. This means that residents live in an environment that is safe and very comfortable. When referring to the clean home one resident said: “It is very fresh, the cleaners are very good and towels get changed regularly and my bathroom gets cleaned.” A relative commented: “The cleaners are always cleaning and keep on top of cleaning the carpets and spills.” Staff receive a lot of training to make sure that they are up to date with good care practices and are motivated to develop their skills. This means that residents receive the right sort of care by skilled staff. The home is good at checking that the quality of the service is maintained at a good standard by checking that care practices are carried out in the correct way, which means that residents receive a good standard of care consistently. What has improved since the last inspection? Staff are now aware of good practices regarding pressure relief care. This means that residents receive the appropriate appliances such as mattresses and cushions that will prevent the development of pressure sores, and the appropriate sort of care in the event of sores developing. Imaginative work is now being directed to making the area in the home used by people with dementia care needs more accessible and stimulating. The handrails around the walls have been painted in a contrasting colour to the walls and doors to the bedrooms have been fitted with brass knockers and painted individual colours that the individual residents can relate to. Thought is now going into how activity and different sorts of support work with people with dementia can stimulate memory and motivate interest. A garden area has been developed and rummage boxes are placed within the unit. The home’s risk assessment process now includes risks relating to the storage of oxygen. This means that the risks have been identified and plans have been put in place to ensure that residents live in an environment that is safe. The home’s recruitment procedures are now always followed correctly and the appropriate information is received about each person that applies to work Grangewood Care Centre DS0000070539.V356944.R01.S.doc Version 5.2 Page 9 here. This means that the right sort of person, with the qualities and skills needed, is employed to support residents. So that residents are not put at risk of eating contaminated food all food transported to the dining rooms from the kitchen is protected with the appropriate sort of cover. 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. Grangewood Care Centre DS0000070539.V356944.R01.S.doc Version 5.2 Page 10 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 Grangewood Care Centre DS0000070539.V356944.R01.S.doc Version 5.2 Page 11 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): 1,3,4,6 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents are provided with good information about the service including a contract. This helps people to make an informed decision about where to live, while at the same time they are informed of the home’s terms and conditions. Pre-admission assessments demonstrate residents’ needs and assists the home to make informed judgements as to whether they can meet these needs. This ensures that the resident receives the appropriate sort of care and support from the home. EVIDENCE: The home has developed a Statement of Purpose and a Service User Guide. Both documents have recently been reviewed and updated to reflect a new company taking over the home and to ensure that the information included is Grangewood Care Centre DS0000070539.V356944.R01.S.doc Version 5.2 Page 12 current. However the Service User Guide does not inform residents or other interested parties about the range of fees charged by the home. Residents are given the opportunity to sign contracts that describe the home’s terms and conditions and include the cost of the fees to be paid. Residents described how they had looked around the home before making a decision to move in and a relative stated: “As soon as we had looked around the home we knew that X would be happy and well cared for here.” The manager confirmed that married couples wishing to move into the home together are provided with two rooms close together, one providing living space and the other sleeping accommodation. Residents’ files include comprehensive information about them from the referring agency and other people involved in their care. For example assessments from the referring care manager or information from the discharging hospital is received. The home also carries out a full assessment of need that includes addressing risks. The home’s comprehensive assessment process includes gathering information about the person’s life history, however this area was not always fully completed. This profile is used as an important piece of information for carers to refer to when working with individual residents and when assisting them to make decisions and choices about their lives. The residents’ needs are addressed by competent staff who have received training regarding different issues and illnesses relating to old age. The manager is also a Registered Nurse and is particularly well experienced in working with people with dementia type illnesses and is able to guide staff in this area and others, in relation to good practice. When the decision is made that the home can meet a prospective resident’s needs, a letter is sent out to the person to confirm this. Grangewood Care Centre DS0000070539.V356944.R01.S.doc Version 5.2 Page 13 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): 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. Suitable and effective arrangements are in place to meet residents’ healthcare needs and good procedures are in place for the safe administration of medicines. This promotes the health and welfare of the service users and ensures that a consistent service is delivered. EVIDENCE: A new care plan document is now in place that reflects the corporate image of the company. It is used with the assessment document to ensure that the identified care needs and any identified risks are addressed. The manager and staff, who have been trained in their use, are quite happy with the new care plan format and feel they can use it to record clear information. Grangewood Care Centre DS0000070539.V356944.R01.S.doc Version 5.2 Page 14 The care plans are written clearly and include good information about the residents’ needs and how they are supported to maintain independence. They are person centred and guide staff to address individual needs and the individuals’ preferred ways of daily living and the way they like to be supported. For example, details of how one resident likes to have breakfast in their room and the time they prefer this is recorded. For another resident details of the clothing they prefer to wear and what exact support they need to dress, are stated very clearly, including what the person can manage independently. Specialist advice is sought from healthcare specialists and this is used in the care plans to inform staff how to address clinical issues and how to promote the health and welfare of the resident effectively. Specialist appliances to support such issues are available. A pressure mat that alerts staff when a resident with dementia, who is also at risk of falls, gets out of bed at night is in place and has reduced the actual number of falls. A pressure relief mattress and cushion are in place as a precautionary measure for a resident who is frail and at risk of developing pressure sores. Staff are well informed and receive the necessary training regarding residents’ diverse needs. This is reflected in the standard of care practices carried out and the competent and sensitive approach to residents. Staff training is given a high priority and staff show their enthusiasm about this. They have attended training regarding dementia care and plans are in place for staff to attend training regarding pressure area care within the next month. One senior member of staff is a moving and handling facilitator and has attended training regarding “falls prevention train the trainer”. It was noted that one care plan includes a comment that the resident “could lose their temper” but no further details are included nor is there guidance for staff to follow on how to deal with it. The manager agreed to address this. Risk assessments, that are signed by the resident, are in place in relation to individual residents’ assessed needs and in relation to any specialist equipment used and clear risk strategies guide staff to minimise the identified risk. There are suitable arrangements in place regarding the administration of medication and staff receive appropriate training regarding this. Residents who wish to manage their own medicines are supported to do so safely. Medicines are safely stored and managed. Grangewood Care Centre DS0000070539.V356944.R01.S.doc Version 5.2 Page 15 The manager and the senior staff undertake a weekly audit of medicines to make sure there are no discrepancies in the way the medication system is managed. Grangewood Care Centre DS0000070539.V356944.R01.S.doc Version 5.2 Page 16 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): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Staff encourage residents to exercise and maintain choice and control over their lives by arranging activities and other forms of stimulation, while also maintaining contact with family and friends. This means that residents are provided with different opportunities to lead fulfilling lifestyles and do not become socially isolated. Residents’ individual dietary needs are met by being served food that is appropriate to their needs, healthy, nutritious and attractively served. EVIDENCE: An activity organiser is employed to arrange and coordinate activities throughout the home. Residents are informed about these from posters, detailing individual events and from daily activity sheets displayed around the home, including in each resident’s bedroom. A large well ordered photograph album is usefully placed in the entrance hall where residents and visitors can be informed and reminded of recent and past events and activities that have taken place, entertained residents, friends and Grangewood Care Centre DS0000070539.V356944.R01.S.doc Version 5.2 Page 17 families in the home. The last event recorded was a Burns Night Supper where residents and staff dressed in tartan outfits, enjoyed a Scottish supper and were entertained with Scottish music and dance. Further photographs were displayed on a notice board with the aim of attracting residents into joining the organised craft sessions lead by the activities organiser. The photographs show residents enjoying making soft toys, some active and others enjoying the chat and humour of the group. Some residents talked about visits to the theatre and tea dances, while others described how they enjoy television and the quiet of their own room, where they read or entertain visitors. The activities organiser works closely with the manager to coordinate the planning of theatre trips, entertainment events and trips into the local community. The chef plays an active part in the home, mixing with residents to find out their views and preferences regarding the food served, monitoring residents’ needs regarding utensils and cutlery, while also monitoring the standard of the table linen, crockery and condiments. The chef leads a competent kitchen staff team and is aware of the diverse dietary needs of the residents and the training needs of the staff to address these. The home received the Healthy Food Award 2007 run by Sunderland Environmental Health department and is working towards the award for 2008. A midday meal was taken with the residents which was attractively presented and nutritious in content. Some comments from residents include: “The food is always good here.” “We get lots to eat.” “If you don’t like something you just have to say.” Visitors to the home commented that they are always made to feel welcome and are kept up to date regarding their relatives’ health and welfare. Grangewood Care Centre DS0000070539.V356944.R01.S.doc Version 5.2 Page 18 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): 16,18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Effective arrangements are in place to help protect residents from abuse and to address complaints and concerns about the service seriously. EVIDENCE: The home has a comprehensive complaints procedure of which service users and their representatives are aware. Residents were confident that their concerns or complaints would be addressed appropriately. Residents and their representatives are encouraged to discuss their concerns on a daily basis and these are addressed directly. The complaints file includes complaints from residents and their families and demonstrates that the complaints have been taken seriously and addressed appropriately. Staff receive training regarding the local authority’s safeguarding adults procedures and they are aware of the action they would take if an abusive incident was observed or reported to them. The home has used these procedures appropriately and competently in response to the allegation that staff failed to request advice and guidance in the appropriate timeframe, regarding the care of a pressure sore. Grangewood Care Centre DS0000070539.V356944.R01.S.doc Version 5.2 Page 19 The outcome of the alert has meant that plans are now in place to train staff in the prevention and management of pressure care and to monitor the practice of the home’s policies and procedures in relation to this. Service users are encouraged to look after their own finances when appropriate. For those who need support with this, comprehensive procedures are in place for staff to follow and these help safeguard service users from the possibility of financial abuse. The records are kept by the home’s administrator and monitored by the manager. A monthly reconciliation report is carried out and submitted to the head office. Grangewood Care Centre DS0000070539.V356944.R01.S.doc Version 5.2 Page 20 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): 19,22,25,26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is clean, warm and well maintained, offering residents a homely environment in which to live, while at the same it promotes their general welfare, dignity and comfort. EVIDENCE: The home is decorated and furnished to a very high standard and the cleanliness throughout reflects effective cleaning routines that are discreetly and safely carried out by the domestic staff team. Staff receive training relating to infection control and this is evident in practice. The well-kept, safe and comfortable environment reflects a comprehensive maintenance programme. Grangewood Care Centre DS0000070539.V356944.R01.S.doc Version 5.2 Page 21 A competent maintenance person is employed to deal with maintenance issues around the home, including day-to-day repairs and the monitoring of the maintenance contracts for the home’s gas, electric and water supplies. In addition to this he is responsible for monitoring health and safety issues including fire safety and hot water checks. Clear records of this are in place. Access into and within the home is good and meets the needs of those residents who have mobility difficulties and who use walking aids such as zimmer frames or wheelchairs. Residents’ independence and privacy is promoted throughout the home. There is a variety of bathing facilities, some with lifting appliances and all bedroom and bathroom doors have locks. Bedrooms are individually decorated to reflect individual taste. Residents are encouraged to furnish their rooms with personal items, resulting in this area being familiar to them, as well as having the opportunity to express their individual personalities. The bedrooms are large and spacious and allow residents to accommodate their personal belongings without the rooms looking cluttered. Good progress is being made to develop the dementia care unit so that residents can orientate themselves effectively and be content and independent in their environment. Grangewood Care Centre DS0000070539.V356944.R01.S.doc Version 5.2 Page 22 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): 27,28,29,30 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. The home has a competent and qualified staff complement who effectively meet the residents’ care needs and the robust recruitment procedures ensure that their welfare and interests are protected. EVIDENCE: The home employs a team of staff with diverse experience and qualifications. The number on duty meets the needs of the residents currently living at the home. However at the moment there are several vacancies in the home, therefore as new residents move in, the staffing numbers required must be reviewed and this includes the number of staff working night shift. Eight carers, including two senior staff were on duty. This number was divided between the two floors and in addition to this the manager and her deputy were also available. A sufficient number of domestic and kitchen staff are employed and a member of staff in a senior position leads each team. There is an excellent innovative approach to training in this home. The manager is in contact with different training organisations and funding agencies, resulting in well-established training programmes that have resulted Grangewood Care Centre DS0000070539.V356944.R01.S.doc Version 5.2 Page 23 in a well-qualified staff team. received. Comments include: Staff spoke positively about the training “Our manager is the one who sees that we get plenty of training.” “Yes I have attended lots of training courses, you are well motivated here, it’s interesting.” Care practices observed in the home reflect the skill and dedication of a well trained and motivated staff team. Staff were observed sensitively interacting with service users and working as a team. Staff files demonstrate comprehensive induction systems as well as other training courses attended. Appropriate recruitment records of staff recently employed demonstrate that the home’s robust recruitment procedures are followed. Application forms identifying a clear, up to date record of employment, two written references and a satisfactory CRB (Criminal Records Bureau) checks are in place for three newly employed staff. Grangewood Care Centre DS0000070539.V356944.R01.S.doc Version 5.2 Page 24 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): 31,33,35,38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. A competent well-qualified senior team and an effective quality assurance system supports the manager to maintain good management routines that deliver a service to residents that is in their best interests. EVIDENCE: The manager has worked at the home in this role since September 2005. She is registered with the CSCI (Commission with Social Care Inspection), has the Registered Managers Award (RMA) and the Diploma in Management and is also a Registered General Nurse (RGN). Grangewood Care Centre DS0000070539.V356944.R01.S.doc Version 5.2 Page 25 The manager is supported well by a senior staff team and the administrator for the home. Arrangements are in place for her to receive monthly visits from a senior company manager to assist her with monitoring the quality assurance systems in the home. The quality assurance system in place is good and effective and ensures that the home’s policies and procedures are put into practice and that the service is delivered in the best interests of the service users. There are clear systems in place that reflect the manager’s competent leadership skills. Senior staff have delegated responsibilities, that as an outcome, supports the manager in her role. The deputy manager also has the Registered Managers Award (RMA) and one of the senior carers is qualified as a moving and handling facilitator and has the “Train the Trainer” award for falls prevention. Staff are empowered to fully accept their responsibilities and as a result carry out their roles competently and with confidence. Every three months the manager has a meeting with relatives to inform them and discuss issues related to the development of the service. Relatives referred to these and one commented that it was a good way of keeping up with the home’s policies and procedures. Good arrangements are in place to safeguard residents’ monies held in the home. Comprehensive procedures are followed and recorded appropriately. Risks identified throughout the home are monitored and addressed well. Fire safety is practiced appropriately and accidents to both residents and staff are recorded and addressed satisfactorily. Grangewood Care Centre DS0000070539.V356944.R01.S.doc Version 5.2 Page 26 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 2 X 3 3 X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 X 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 X 18 3 3 X X 3 X X 3 3 STAFFING Standard No Score 27 3 28 4 29 3 30 4 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 4 X 3 X 3 X X 3 Grangewood Care Centre DS0000070539.V356944.R01.S.doc Version 5.2 Page 27 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 OP1 Regulation 5(1)(b) Requirement The manager must ensure that the Service User Guide includes the range of fees charged by the home and the method by which they can be paid. Timescale for action 31/03/08 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 OP3 Good Practice Recommendations Although the home’s assessment process includes important information about the residents’ life history it was agreed that in some files more information could be gathered about the person. Guidance for staff to follow regarding how challenging behaviour is addressed should be included in residents’ care plans. It is strongly recommended that, as vacancies are filled and the number of residents in the home increase, the number of staff working night shift increases and furthermore the home reviews the number of staff needed overall to address the assessed needs of the residents living there. DS0000070539.V356944.R01.S.doc Version 5.2 Page 28 2 3 OP7 OP27 Grangewood Care Centre Commission for Social Care Inspection Darlington Area Office No. 1 Hopetown Studios Brinkburn Road Darlington DL3 6DS 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. 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