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Inspection on 12/10/05 for Granville

Also see our care home review for Granville for more information

This inspection was carried out on 12th October 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 no outstanding requirements from the previous inspection report, but made 6 statutory requirements (actions the home must comply with) as a result of this inspection.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

The home places a lot of emphasis in providing service users with a place to live that is well maintained. The home has a relaxed homely atmosphere; it is also bright and clean. Staff confirmed that the admission process involves the potential service user and their relatives/advocates to make sure that the care plans they put in place will fully meet the needs of the individual. Planned programmes of day care are maintained whilst residents are on periods of respite. The home caters for special diets for cultural or medical reasons. There is always plenty to eat and drink offering alternatives at meal times. The home also continues to meet its promise to provide service users with a wide range of opportunities for social and leisure activities, making sure they fully participate in the community. For example, at the time of the visit some of the service users were really looking forward to going out with staff into on planned trips.

What has improved since the last inspection?

The home is working hard to make sure the service users are protected by putting procedures and guidelines in place for dealing with the protection of vulnerable adults. They have also put quality-monitoring tools in place to enable them to identify any concerns the service users may have.

What the care home could do better:

The health and safety of the home must improve to ensure residents are provided with a safe living environment. This is in relation to the fire prevention at the home. The home is required to ensure that all fire extinguishers are service in the period immediately following this inspection. The home is also required to evidence that training in adult protection procedures had been provided to all staff. Discussions were held with senior staff on the day of the inspection in relation to this matter.

CARE HOME ADULTS 18-65 Granville 10 Victoria Road Ellesmere Park Eccles Manchester M30 9HB Lead Inspector Joe Kenny Unannounced Inspection 12th October 2005 12:00 Granville DS0000038835.V255246.R01.S.doc Version 5.0 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 Granville DS0000038835.V255246.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 Adults 18-65. 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. Granville DS0000038835.V255246.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Granville Address 10 Victoria Road Ellesmere Park Eccles Manchester M30 9HB 0161 789 1041 0161 789 7096 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) City of Salford Community & Social Services Ms Francine Laurukenas-Sproston Care Home 12 Category(ies) of Learning disability (0), Learning disability over registration, with number 65 years of age (0) of places Granville DS0000038835.V255246.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. The number of service users accommodated for personal care only at any one time shall not exceed 12 service users whose primary reason for needing care is learning disability, but who may also have associated physical disability. Service users are accommodated for a maximum stay of three weeks. The service should, at all times, employ a suitably qualified and experienced manager who is registered with the Commission for Social Care Inspection . That dependency levels of service users are assessed on a continuous basis and staffing levels adjusted where appropriate to ensure continued compliance with the Residential Forum`s guidance on `Care staffing in Care Homes for Younger Adults`. 13th December 2004 2. 3. 4. Date of last inspection Brief Description of the Service: Granville is a residential care home operated by Salford Social Services. The home provides respite care for up to twelve (12) adults with learning disabilities. The home is situated in a residential area of Eccles in a large Victorian house. The house has been adapted for the purpose of providing respite care. The grounds offer secure landscaped gardens to the side and rear of the property. The garden to the rear is fully enclosed. Internally, there are large communal lounges and dining areas offering spacious and suitable furnished facilities. Accommodation is offered in single rooms. Three bedrooms are adapted for wheelchair users. There are adaptations in the bathrooms that allow assisted bathing. Placements are booked three months in advance and the maximum stay for a service user is three weeks at a time. Granville DS0000038835.V255246.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The unannounced inspection took place on the 12th of October 2005. During the inspection time was spent speaking with both the staff and some of the service users. Although most of the service users at the time of the inspection didn’t communicate verbally, direct observations were made as to how the staff interacted and supported the service users. A tour of the home was undertaken and files and records relating to residents and management procedures at the home were examined. The Commission for Social Care Inspection (CSCI) had not received any complaints about the home since the last inspection. Most of the requirements identified at the last inspection have now been met. The home continues to provide planned period respite support to residents referred to the home. It was evident that a review of placements taken on a rotational basis was being undertaken by the home. This process would extend to all users of the service to ensure the home was meeting its intended objectives. This inspection only looked at a limited number of standards, therefore, this report should be read together with previous and any future reports to gain a full insight into how Granville residential respite home is meeting the needs of the service users. What the service does well: The home places a lot of emphasis in providing service users with a place to live that is well maintained. The home has a relaxed homely atmosphere; it is also bright and clean. Staff confirmed that the admission process involves the potential service user and their relatives/advocates to make sure that the care plans they put in place will fully meet the needs of the individual. Planned programmes of day care are maintained whilst residents are on periods of respite. The home caters for special diets for cultural or medical reasons. There is always plenty to eat and drink offering alternatives at meal times. The home also continues to meet its promise to provide service users with a wide range of opportunities for social and leisure activities, making sure they fully participate in the community. For example, at the time of the visit some of the service users were really looking forward to going out with staff into on planned trips. Granville DS0000038835.V255246.R01.S.doc Version 5.0 Page 6 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. Granville DS0000038835.V255246.R01.S.doc Version 5.0 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Granville DS0000038835.V255246.R01.S.doc Version 5.0 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 2, 3, 4 The home ensures that service user’s needs were assessed before offering a service to them. EVIDENCE: It was quite clear after looking through records of recent admissions that a qualified person with the support of the individual’s relatives makes assessments before they are offered services. Staff understood the importance for potential service users to have the opportunity to visit the home before they are admitted. A service user guide is also available to the service users and their relatives/advocates. The process of reviewing referrals and rotational placements had commenced and would be extended to all residents who used the service in order to ensure the home met its intended aims and objectives. Senior staff indicated that the review process had determined alternative services for some residents. The review process was seen as a positive process undertaken by the home. There were three residents in the home at the time of the inspection. Four residents were attending day service and a further admission would take place that evening. The referral process continues to be monitored by the manager of the service and by her line manager. Referrals are planned in advance to assist in determining what staffing arrangements were required to meet residents needs. Granville DS0000038835.V255246.R01.S.doc Version 5.0 Page 9 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7, 8, 9, 10 Systems and arrangements were in place to identify the changing needs and goals of the service users. The home actively encouraged residents to participate in the community and were supported to maintain their independence. EVIDENCE: There were good care plans in place for those who have recently been admitted. This cannot be said for the majority of the service users who have been accessing the service for some time. Although there are care plans in place they need reviewing to reflect each individual service user’s needs and aspirations. The service users are assisted by their relatives and staff to make choices, making sure their independent lifestyles are maintained at all times. All information about the service users was kept safe and secure at the time of the visit to maintain confidentiality. Risk assessments were in place to promote service users independence by taking up activities of daily living and participating in the community. Granville DS0000038835.V255246.R01.S.doc Version 5.0 Page 10 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 11, 12, 13, 14, 15, 16, 17 The home assists individuals to participate in social and leisure activities based in the community. EVIDENCE: During the visits some of the service users were getting ready to visit the local community (shopping). Others were attending training centres for personal development. Apart from the service users going out for leisure activities, entertainment was also provided at the home. There is also a games room with a pool table. During the visit, staff were seen interacting respectfully and appropriately with the service users. It was evident during the visit that adequate and varied meals and drinks are available and served at all times. Healthy diets are offered, including those on special diet for health reasons such as diabetes. Snacks are also offered throughout the day and night when requested. Granville DS0000038835.V255246.R01.S.doc Version 5.0 Page 11 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19, 20 There are policies, procedures, systems and arrangements are in place to meet individual’s medication and healthcare needs. However some shortfalls were evident in policies and procedures for safe handling of medication. EVIDENCE: Although the home has a general social service policy on the administration of medicines, a local procedure must be put in place. Since the turnover of the service users is high, it will be appropriate to have photograph of the service users placed on the medication records to maximise safe administering of medication. There were no service users who self medicate at the time of inspection. There was evidence in care plans that the home uses a person centred approach, respecting service users wishes and preferences. The service users were also assisted to access their GPs, and other professionals whenever necessary. In the event of an admission to hospital, each resident has an Emergency Card which holds information the receiving hospital may require on the individual, such as medication they are currently on. Granville DS0000038835.V255246.R01.S.doc Version 5.0 Page 12 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 22, 23 There are policies and procedures in place to respect the views of the service users and protect them from abuse. However staff were not sufficiently trained in adult protection procedures which could potentially place residents at risk. EVIDENCE: Individual files had evidence of meetings held between staff, service users and their relatives to listen and discuss the views of the service users and how they want to be supported. Even though there is a policy on protection of vulnerable adults in place, there is a need for all staff members to attend Protection of Vulnerable Adults (POVA) Training to maximise the protection of the service users. There is a complaint procedure available to the service users and their relatives/advocates. Granville DS0000038835.V255246.R01.S.doc Version 5.0 Page 13 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 24, 30 The home provides the service users with a clean homely environment but is not adequately protected from fire. EVIDENCE: At the time of the inspection the home was very clean and free from malodours. The environment felt homely and welcoming. The bedrooms were in a reasonable decorative condition. There are a few concerns regarding the safety of the premises. There were hot water pipes in one in of the bathrooms that required covering to reduce any risk to residents. The small gate to the rear of the home is locked for security reasons but it may present as a risk in relation to agreed plans of evacuation as one would not be able to escape to the front of the house if there is a fire. It was suggested to staff that a combination lock may be used but using a simple and easy to remember combination. This must be incorporated into the fire evacuation procedure. The fire extinguishers had not been checked since 7 September 2003. The home must request that these appliances are serviced. Granville DS0000038835.V255246.R01.S.doc Version 5.0 Page 14 There was a bolt and receiver on one of the fire evacuation doors and this must be removed. The bell connected to the telephone is very loud and during the visit one of the service users was noticed covering her ears when the bell rang. The home is advised to look to an alternative system such as hands free phone system. The metal external fire stair way required cleaning to remove the algae which was slippery under foot. . Granville DS0000038835.V255246.R01.S.doc Version 5.0 Page 15 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 34, 35 The staff members at the home are aware of their roles, and experienced and trained staff meets the needs of the service users. EVIDENCE: The home has a good staff skill mix and is managed by an experienced manager and senior staff team. There was evidence of 1:1 supervision of staff but it has to be sustained to ensure staff receive ongoing support on a regular basis. There were no records at the home of the staff having POVA and CRB checks but the inspector was informed that these are carried out before anyone is employed. Summary of CRB and POVA checks must be sent to the home and kept on individual staff files. At the time of the inspection there were two carers, an assistant manager, one domestic and one cook on duty. The staffing arrangements for the evening were appropriate to meeting the needs of residents as they returned from day services. The management hours for the week covering the inspection were equal to 119.5 hours. The day care hours for the same week 10 to 16 October were equal to 259 day care hours. The arrangements at night are, two staff on waking duty. The staffing arrangements were appropriate to meeting the needs of residents at the time of the inspection. Granville DS0000038835.V255246.R01.S.doc Version 5.0 Page 16 Training and development is undertaken by designated assistant manager, each having responsibility for supervision of named carers. Personal Development Plans are set up for each member of staff and a sample of records were examined on the day of the inspection. Records confirmed that programmes of supervision are well established for those staff whose records were examined at the time of the inspection. This must be extended and sustained for all staff. Information on the date also indicated that 64 of the staff team had completed NVQ level 2 or above in care. Staff were advised to develop and expand records relating to Induction. The induction sheets for staff were completed as a tick box against a named topic. The home is advised to expand upon the topic covered i.e. refer to the policy covered and have staff and supervisor sign against each topic covered. Granville DS0000038835.V255246.R01.S.doc Version 5.0 Page 17 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. 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 are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39, 42, 43 The home is run well by an experienced manager and ensures that interest of the service users is safeguarded by the home’s policies and procedures. EVIDENCE: The home is run well. It was clear during the visit that the senior staff, were aware of their responsibilities and there was evidence of good leadership. The manager and the staff team ensure the service users rights and best interest are respected by involving them and their relatives in all decision making, making sure their wishes are upheld at all times. The home had commenced the process of gathering residents views about the service they receive and a three monthly news bulletin is produced by the home. The home was advised to publish the outcomes of the questionnaire to residents. There are also policies and procedures in place to safeguard the interest of the service users. Granville DS0000038835.V255246.R01.S.doc Version 5.0 Page 18 Although the responsible person visits the home from time to time, there were no reports available to inspect at the time of the visit. A sample Regulation 26 report was forwarded to the home following the inspection to assist in compliance to this requirement. Granville DS0000038835.V255246.R01.S.doc Version 5.0 Page 19 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 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 CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score 3 3 3 3 X Standard No 22 23 Score 3 2 ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score 2 3 3 3 3 Standard No 24 25 26 27 28 29 30 STAFFING Score 1 X X X X X 3 LIFESTYLES Standard No Score 11 3 12 3 13 3 14 3 15 3 16 3 17 Standard No 31 32 33 34 35 36 Score X 3 X 3 3 X CONDUCT AND MANAGEMENT OF THE HOME 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Granville Score 3 3 2 X Standard No 37 38 39 40 41 42 43 Score 3 X 3 X X 2 2 DS0000038835.V255246.R01.S.doc Version 5.0 Page 20 13 and 15 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 2 3 Standard YA6 YA20 YA23 Regulation 15 13 13 Requirement Care plans must be kept under review and updated to reflect changing needs. Arrangements must be made for safe handling and administering of medicines. Staff must be trained to prevent service users being harmed or suffering abuse, or being placed at risk of harm or abuse. Steps must be taken to provide adequate means of escape. Tests of fire equipment must be maintained. All exit routes must offer safe egress from the building. The registered provider must visit the care home at least once a month. A written report must be made and copies sent to the commission and the registered manager. Summary of CRB and POVA checks must be kept on individual staff files. Timescale for action 05/12/05 05/12/05 05/12/05 4 YA24 23 14/11/05 5 YA43 26 05/12/05 6 YA34 19 schedule 2 02/01/06 Granville DS0000038835.V255246.R01.S.doc Version 5.0 Page 21 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 YA6 Good Practice Recommendations It was noted during the inspection that erasable pencil and blue coloured marker were used in some records. It is recommended that black permanent marker be used in all documentation. Staff should have regular supervisions at least six times a year with their senior/manager. 2 YA36 Granville DS0000038835.V255246.R01.S.doc Version 5.0 Page 22 Commission for Social Care Inspection CSCI, Local office 9th Floor Oakland House Talbot Road Manchester M16 0PQ 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 Granville DS0000038835.V255246.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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