Inspection on 07/07/05 for Grangewood Lodge

This inspection was carried out on 7th July 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 found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Grangewood Lodge 16/08/06

Grangewood Lodge 07/12/05

Grangewood Lodge 07/12/04

Grangewood Lodge 06/07/04

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

CARE HOMES FOR OLDER PEOPLE Grangewood Lodge Care Home Netherseal Swadlincote Derbyshire DE12 8BH Lead Inspector Claire Williams Unannounced 7 July 2005 9.15am 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 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 Lodge Care Home D52-C02 S19996 Grangewood Lodge V235141 070705 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Grangewood Lodge Address Netherseal Swadlincote Derbyshire DE12 8BH 01827 373577 Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Mr John Frederick Fisher Ms Amanda Fay Hatfield Care Home with Personal Care 30 Category(ies) of 30 places OP Older People registration, with number of places Grangewood Lodge Care Home D52-C02 S19996 Grangewood Lodge V235141 070705 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: Plus three (3) day care place not regulated by Commission for Social Care Inspection. Date of last inspection 7/12/04 Brief Description of the Service: Grangewood Lodge is a Care Home registered to provide Personal care and Accommodation for up to 30 people in the category of older persons. Grangewood Lodge is located near to the village of Netherseal. Grangewood Lodge has extensive grounds, a patio area, and a care park area. Grangewood Lodge has 26 single room, of these 17 have en-suite facilities, and 2 double rooms, with en-suite facilities. A variety of lounge and dinning space is provided. There are sufficient bathing facilities to meet the needs of the service user group; the Registered Provide is currently changing the function of the bathroom areas and upgarding them by removing the baths and installing showers. Service users accommodation is located on the ground and first floor of the building, and there is a stair lift for access. The Registered Person is currently working on a rolling programme in order to upgrade certain areas of the home. On the day of inspection there was 25 service users living at the home. Grangewood Lodge Care Home D52-C02 S19996 Grangewood Lodge V235141 070705 Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection was unannounced and started at 9.30am. The visit lasted 6 hours. Care files and associated documents, and medication were inspected. Time was spent observing service user and staff interaction. The inspector spoke with 13 service users, 3 staff members, and the senior care staff and was kindly invited to have lunch with the service users. The Registered Manager, deputy and head of care staff were not available as it was there day off, therefore a senior care assistant assisted the inspector, and then a senior arrived at midday to take over and assist the inspector with the inspection. The inspector used case tracking methodology during the inspection process which involves the examination of records/documents discussion with the individual service users, and staff and evidence in relation to individual service users to determine how the National Minimum Standards work for them in practice. Three service users were case tracked during this inspection visit. What the service does well: What has improved since the last inspection? The medication practices have improved ensuring that service users healthcare needs are met. The Registered Manager has updated the staff application form as requested to request an applicant’s full employment history; this is to safeguard service users from harm. Grangewood Lodge Care Home D52-C02 S19996 Grangewood Lodge V235141 070705 Stage 4.doc Version 1.40 Page 6 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. Grangewood Lodge Care Home D52-C02 S19996 Grangewood Lodge V235141 070705 Stage 4.doc Version 1.40 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 Standards Statutory Requirements Identified During the Inspection Grangewood Lodge Care Home D52-C02 S19996 Grangewood Lodge V235141 070705 Stage 4.doc Version 1.40 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 1, 3, 4, and 5 Prospective service users have the information they need to make an informed choice about where to live. Service users receive a full assessment prior to moving into the home in order to ensure that the home can meet their support needs. EVIDENCE: The inspector examined three service users files, and spoke with these service users. All of these service users have recently moved into the home. The files contained the appropriate pre-admission assessments and correspondence concerning whether the home can meet the individuals support needs. The service users informed the inspector that their family had visited the home on their behalf to ‘check the home out’. One service user was admitted under the emergency admission procedures, therefore did not have an opportunity to visit the home before admission. This service user is currently having respite at the home, and stated “it’s a good way to test drive the home, and see what it actually is like to live there”. Although the service user would like to return home in the community, the comments made confirmed that the staff were able to meet his needs, and that the care was “satisfactory”. Grangewood Lodge Care Home D52-C02 S19996 Grangewood Lodge V235141 070705 Stage 4.doc Version 1.40 Page 9 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 standard(s) 7, 8, 9, 10, The care plans examined did not ensure that all of the health, personal and social care needs of service users were identified and met. Service users feel that they are treated with respect and dignity. EVIDENCE: The inspector examined three files of the service users whose care was case tracked. Two out of the three files contained full care plans covering all of the required areas, in sufficient detail to inform staff on how to meet their individual needs. These plans were signed and agreed with the service users. The files contained the required risk assessments in relation to Moving and handling, falls and tissue viability. All of which had been reviewed on a regular basis up until April 2005. There was evidence of six monthly and monthly reviews up until April 2005, however the outcome of the monthly reviews stated ‘no change’ and did not fully detail why, there was no changes to the care plan. The inspector has noticed two significant changes in a service users support needs that had not been identified at the monthly review therefore these changes have not been recorded on the service users care plan. There was evidence in the files that service users had been consulted and involved in the development of their plan of care. Grangewood Lodge Care Home D52-C02 S19996 Grangewood Lodge V235141 070705 Stage 4.doc Version 1.40 Page 10 The third file examined was for the individual who was admitted as an emergency, the care plan was incomplete with only few sections detailing his support needs, therefore insufficient information was available in order to direct care staff on how to deliver the care and meet his support needs. The pre-admission assessment requested for this service user to have his weight checked on his arrival, to date this had not been achieved and there was comments in the daily care notes that his appetite was poor and that food was being refused, but no monitoring tool has been implemented to monitor this. In the care notes there was also two requests on different occasions for a referral to the district nurse to visit, but there was no evidence that this was carried out although the inspector was informed that a District Nurse had been to see this service user. The Registered Manager has devised and implemented a falls risk assessment, which is now completed on all service users. Service users who are mobile and able to weight bear have their weight monitored on a regular basis, however the service users who cannot weight bear do not currently have their weight monitored as the home does not have chair scales. The medication practices at the home have improved since the previous inspection. The medication records and practices were satisfactory at the time of the inspection. The Registered Manager has devised an assessment of medication competence in response to the previous inspection report. Service users commented to the inspector that the staff team were “good”, “caring” “attentive” and always treated them with dignity and respect. One service user spoken to did state that the “care was good when the home is not short staffed”. Other service users spoken with did make positive comments about the home and the care provided. Grangewood Lodge Care Home D52-C02 S19996 Grangewood Lodge V235141 070705 Stage 4.doc Version 1.40 Page 11 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 standard(s) 13, 14, 15. Service users have the opportunity to access recreational activities of their choice, and are encouraged to maintain contact with their family and friends. Service users exercise choice and control over their lives. EVIDENCE: Service users spoken to informed the inspector of the recent outings they have been supported to attend. These included meals and trips out to the local community facilities. Service users also confirmed that they have had entertainers visit the home. The home employs an activities co-ordinator that works three days a work to organise and facilitate activities within the home. All service users spoken to made positive comments about the activities available. The activities coordinator was not working at the time of the inspection, and no activities was observed during the inspection, service users occupied their time by reading, listening to music, and watching the television due to the events of the day and the situation in London. Service users confirmed that the staff team encourage and assist them to maintain contact with their relatives or representatives and the records supported this. One service user is currently on holiday with their family. Discussions with service users confirmed that they are encouraged to exercise their personal choice and autonomy in the home. Service users choose how they wish to spend their day, and stated that routines are flexible within the Grangewood Lodge Care Home D52-C02 S19996 Grangewood Lodge V235141 070705 Stage 4.doc Version 1.40 Page 12 home. The inspector observed some service users requesting to have alternatives for their main meal, which was facilitated. Service users spoke positively about the standard of the food, and the choices available. The inspector was invited to stay for lunch. The food was served to service users in large serving dishes to enable service users to help themselves and be selfmanaging. The food was well presented and the some service users commented on how nice it tasted, however one service users did state that the “meat was too tough to chew”. The mealtime was unrushed and was relaxed with service users talking to staff and each other. Grangewood Lodge Care Home D52-C02 S19996 Grangewood Lodge V235141 070705 Stage 4.doc Version 1.40 Page 13 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 standard(s) These standards were not assessed on this occasion. EVIDENCE: Grangewood Lodge Care Home D52-C02 S19996 Grangewood Lodge V235141 070705 Stage 4.doc Version 1.40 Page 14 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 standard(s) These standards were not assessed on this occasion. EVIDENCE: Grangewood Lodge Care Home D52-C02 S19996 Grangewood Lodge V235141 070705 Stage 4.doc Version 1.40 Page 15 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 considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27, 28, and 30 The deployment and the experience of the staff team are sufficient to meet the service users needs. The recruitment practices safeguarded service users from harm. EVIDENCE: Service users spoken to confirmed that the staff team are “always around to assist them in their daily lives”. Service users commented positively about the staff team and stated that they are “very caring and supportive”. Discussions and observations of the staff team confirmed that they have a good knowledge of the service users support needs and preferences. The rota for the previous week and the dependency levels for the service users currently living at the home were obtained. A calculation of the service user dependency levels was used to calculate the required staffing levels. (The Department of Health Residential Staffing Forum guidelines for Older Persons were used to collate the data). Based on the figures provided, the home is staffing the home to appropriate levels to meet the dependency levels of the service users. Catering and Domestic hours were satisfactory. The inspector was informed that 7 staff members including 2 relief staff have completed their National Vocational Qualification (NVQ) at level 2 or above. There are currently 10 staff members who are currently undertaking or enrolling in an NVQ level 2 or above, therefore the home have at least 50 of the staff team already qualified to this level or working towards this qualification as required by the regulations. Grangewood Lodge Care Home D52-C02 S19996 Grangewood Lodge V235141 070705 Stage 4.doc Version 1.40 Page 16 The staff files were not checked on this occasion, as the staff on duty did not have access to the keys. The staff application form was examined and it has been updated to request for an applicants full employment history and written explanation of any gaps. Grangewood Lodge Care Home D52-C02 S19996 Grangewood Lodge V235141 070705 Stage 4.doc Version 1.40 Page 17 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 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31, 32 Service users benefit from a well managed home EVIDENCE: The Registered Manager has an NVQ level 4 qualifications in management, and regularly attends training courses to update her knowledge and skills. Both staff and service users spoken with felt that Registered Manager was accessible and approachable. Service users stated that the Registered Manager listened to them and acted on what she was told. Staff said they felt confident that the Registered Manager would always act appropriately when concerns/problems arose, and that she was supportive and enabling. Grangewood Lodge Care Home D52-C02 S19996 Grangewood Lodge V235141 070705 Stage 4.doc Version 1.40 Page 18 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score 3 x 3 3 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 2 9 3 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 x 13 3 14 3 15 3 COMPLAINTS AND PROTECTION x x x x x x x x STAFFING Standard No Score 27 3 28 3 29 x 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score x x x 3 3 x x x x x x Grangewood Lodge Care Home D52-C02 S19996 Grangewood Lodge V235141 070705 Stage 4.doc Version 1.40 Page 19 Yes 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 7 Regulation 15 (1) Requirement The Registered Persons must ensure that all service users have a detailed care plan that specifically states the staff action required in order that identified needs are met. The Registered Person must provide evidence to support that care plans have been evaluated, preferrably monthly as recommended in this standard, inconsultation with the service user and/or representative and detail why the care plans remain the same or needs to be amended The Registered Person must ensure that when a service users needs have changed the care plan is updated. The Registered Person must ensure that individual risk assessments are completed on all service users and reviewed accordingly. The Registered Person must ensure that service users records reflect the contact made with healthcare professionals, and the outcome. Timescale for action 31st October 2005 2. 7 15 (2) (b) 31st October 2005 3. 7 15 (1) (b) 31st October 2005 31st October 2005 31st October 2005 4. 8 13 5. 8 17 (1) (a) 6. Grangewood Lodge Care Home D52-C02 S19996 Grangewood Lodge V235141 070705 Stage 4.doc Version 1.40 Page 20 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. 2. Refer to Standard 8 8 Good Practice Recommendations The Registered Persons should consider purchasing chair scales to enable all service users to be weighed regularly. The Registered Person should ensure that all service users weight is monitored and recorded in their file. If a service users is losing weight this should be monitored and appropriate action taken. Grangewood Lodge Care Home D52-C02 S19996 Grangewood Lodge V235141 070705 Stage 4.doc Version 1.40 Page 21 Commission for Social Care Inspection South Point Cardinal Square Nottingham Road Derby DE1 3QT 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 Grangewood Lodge Care Home D52-C02 S19996 Grangewood Lodge V235141 070705 Stage 4.doc Version 1.40 Page 22 - 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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