Inspection on 16/09/05 for Grassington House

This inspection was carried out on 16th September 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Poor. 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

Grassington House 15/08/06

Grassington House 15/12/05

Grassington House 01/02/05

Grassington House 06/07/04

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

CARE HOMES FOR OLDER PEOPLE Grassington House 50 Prince of Wales Road Dorchester Dorset DT1 1PP Lead Inspector Rosie Brown Unannounced 16 September 2005 10:30 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. Grassington House D55 S56436 Grassington House V236425 160905 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Grassington House Address 50 Prince of Wales Road, Dorchester, Dorset, DT1 1PP 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) 01258 837514 Mrs Marion Jennifer Franklin PC Care Home only 11 Category(ies) of OP - 11 registration, with number of places Grassington House D55 S56436 Grassington House V236425 160905 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: Grassington House has one bedroom which may accommodate two service users; this is bedroom 5. Date of last inspection 01 February 2005 Brief Description of the Service: Grassington House is a residential care home, which provides accommodation and personal care for up to eleven service users in the category of old age, not falling within any other category. Mrs Marion Franklin is the registered provider and manager of the service. Her sister, Mrs Sally Drake who jointly owns Grassington House, and her husband, Mr Franklin, support her. The home is established in a large Victorian semi-detached house situated in a residential area of Dorchester, close to the town centre and associated facilities. To the front of the premises there is a small parking area.The service users’ accommodation is available over two floors, and bedrooms situated on the first floor can be accessed by a small two-person passenger lift. The home is currently being extended. It now has one front lounge and a conservatory and a separate dining room. An assisted bathroom is available on each floor.The rear garden is enclosed by walls and fencing and is also being developed. It currently has a paved terrace with garden furniture and a grassed area with attractive flower borders. Grassington House D55 S56436 Grassington House V236425 160905 Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place on the 16th September 2005 between the hours of 10:30am and 2:00pm. The purpose of the visit was to review the progress with requirements and best practice recommendations from the previous inspection. It was one of two statutory unannounced inspections planned to take place this year. Information was gathered through discussion with the manager/owner Mrs Franklin, Mr Franklin, two service users, five visitors (including the Environmental Health Officer who visited the home unannounced on the same day) and the staff on duty at the time. The inspector used observation skills to access some of the findings. The communal areas and a selection of residents’ rooms were seen during the visit, certain records were examined and the home’s policies provided further information. The opportunity was also taken to review progress with the home’s extension and other planned improvements. What the service does well: Grassington House is a relatively small residential home where a friendly family style atmosphere is achieved: residents and visitors verbally confirmed this is always the case. Each service user has a care plan drawn up that identifies their care needs and these provide instructions for staff to follow to demonstrate how the needs will be met. Care related risk-assessments are also in place, these are subject to monthly review and evidenced review at times of significant change, e.g. following a fall or hospital admission. Social care provision is central to residents’ daily lives and is considered an important feature of home life, e.g. a visitor confirmed that residents are taken out individually each week for a walk or to the shops by staff but clarified this is also their choice. The standard of food supplied to service users is good wholesome and freshly baked by staff in the home. The main meal includes fresh locally grown seasonal vegetables each day. Grassington House D55 S56436 Grassington House V236425 160905 Stage 4.doc Version 1.40 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. Grassington House D55 S56436 Grassington House V236425 160905 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 Grassington House D55 S56436 Grassington House V236425 160905 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 and 6 The home’s current statement of purpose does not provide up to date information about the home’s environment because of recent improvements. Therefore an informed choice cannot be made by a prospective resident before moving into the home from the information available. The home does not provide intermediate care. EVIDENCE: The statement of purpose and guide is out of date and Mrs Franklin agreed to forward an updated version. A number of improvements including an extension have been made to the environment and information about these changes and alterations must be included in the home’s statement of purpose and guide. Grassington House D55 S56436 Grassington House V236425 160905 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 and 10. Each service user has a care plan that identifies the care being provided to meet identified needs. Service users’ health needs are monitored and responded to appropriately with support from community services. Visitors and service users confirmed that staff working in the home ensure their privacy is protected and known wishes are respected. The home’s medication arrangements are satisfactory and staff are now appropriately trained thereby ensuring the safe handling and administration of resident’s medicines. Grassington House D55 S56436 Grassington House V236425 160905 Stage 4.doc Version 1.40 Page 10 EVIDENCE: Care plans for three residents were examined and included details of personal hygiene, elimination, nutrition, mobility, sleeping, communications, safety, social activities, health, foot care and oral hygiene. Care plans must include more information concerning the care and wishes of service users when they become critically ill or are dying. Care related risk-assessments are documented and subject to regular review. Records also evidenced that care reviews are undertaken regularly and involve the service users and/or their representative. Visitors confirmed they are consulted and informed about their relative’s care. Two service users also confirmed they are include when decisions are made about their care and staff were observed consulting with residents about their care and preferences during the visit. Comments included: ‘The home provides very good care’. ‘Our sister is well looked after and we are kept informed of changes’. ‘My friend is very happy and feels safe in this home’. Since the previous inspection all staff that handle and administer residents’ medication have undertaken accredited training and certificates were shown to the inspector. Residents’ medication is no longer left with service users to take in their rooms and the medication administration record (MAR) charts are being signed by staff at the point of administration. Grassington House D55 S56436 Grassington House V236425 160905 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) 12 and 13 Visitors commented that the social care provision is creatively organised to include individual resident’s preferences, group needs and other interests. Visitors are welcomed and encouraged by the home and this was confirmed by the residents and visitors spoken with. EVIDENCE: The home provides regular and varied social activities. This includes residents being taken out for walks or to the shops by staff, going on outings to places of interest or local shows and in house entertainment. One resident said how much they enjoy being taken out to the shops while a visitor confirmed they would be attending a fund raising event in the home the following day. Two visitors said how much their relative enjoys the gentle exercises organised on Friday mornings. One resident was seen listening to the radio in her room, another was knitting her grandson a jumper while another said she likes to help prepare the fresh vegetables for lunch. Another service user commented about enjoying a glass sherry with her visitor. Grassington House D55 S56436 Grassington House V236425 160905 Stage 4.doc Version 1.40 Page 12 The home keeps a visitors book in the hallway of the home and this indicated that a steady flow of visitors call into the home. One visitor confirmed that he calls in to see his friend each day while two others said they visit at least once a week. Comments included, ‘we are always made to feel at home and enjoy chatting in the lounge’ ‘I call in at any time of the day, there are no restrictions here’ ‘My friend is happy and loves being taken out by staff to the shops and going on outings to Weymouth’. Grassington House D55 S56436 Grassington House V236425 160905 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) 18 The home has policies and procedures concerned with the recognition of abuse and the protection of vulnerable adults so that staff are aware of the proper response to make to any suspicion or allegation of abuse to residents although four of the eleven staff employed have yet to undertake training in this subject. EVIDENCE: The home keeps a copy of the local ‘No Secrets’ and a procedure to following regarding the identification of abuse and the appropriate response to allegations of abuse. The staff training record identifies that four staff remain untrained in the subject of abuse and the ‘No Secrets’ procedures. Notifications of untoward events are forwarded to the Commission as required. Each resident is provided with a key to their bedroom. A lockable facility is supplied so that any valuables and small amounts of money can be safely locked away by residents’ should they choose to do so. Grassington House D55 S56436 Grassington House V236425 160905 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) 19,20 and 26 The home is generally clean and attractively decorated with comfortable furnishing that provides a homely environment. Level access is achieved to the back garden via the home’s new conservatory. Until the building works are complete and written confirmation of satisfactory completion received from the Building Control Officer, resident’s safety is at risk. The kitchen facilities have been upgraded since the previous inspection but some further improvements were recommended by the Environmental Health Officer to ensure that residents’ health and safety is not compromised. The home’s laundry facilities are not satisfactory and until the new laundry is completed and in use in the home, residents’ are exposed to a risk of infection. EVIDENCE: It was quite evident that the new owners are spending a great deal of time and money to upgrade the home’s environment both internally and externally. The home is currently being extended and improved in many areas and the majority of the planned work is almost complete. For example: a bedroom has Grassington House D55 S56436 Grassington House V236425 160905 Stage 4.doc Version 1.40 Page 15 been created from the old dining room: this room has been completely redecorated and furnished to a high standard. The home’s back lounge has been converted in a single bedroom: this room was not ready for use at the time of the inspection. A new dining room has been created next to the new conservatory. Mrs Franklin said that floor covering for the conservatory was on order and some decoration needed to be finished off. The extension has provided more communal space within the home: the home now has a front lounge, a separate dining room and a large conservatory. The communal areas and the majority of service users rooms were viewed: all occupied bedrooms were highly personalised. The home has now has 11 bedrooms most of which are available on the ground floor. There is small passenger lift that provides level access to the four bedrooms situated on the first floor. An assisted bathroom is available on the ground floor while a conventional bathroom with portable seat is situated on the first floor: most bedrooms have en-suite facilities and those without have wash basins/vanity units in the room. The home’s kitchen has been upgraded with new units fitted. The Environmental Health Officer inspected the kitchen and made certain recommendations that must be remedied on the day of the inspection. The home’s laundry is being relocated on the ground floor but the work to this facility has yet to be completed. Meanwhile the laundry is not ideally situated in the home’s basement, which is accessed by a steep flight of stairs. The floor and wall surfaces in this area cannot be effectively cleaned to prevent spread of infection. The washing machine does not meet disinfection standards. Mr Franklin explained that the new laundry will be completed and decorated shortly and will be properly equipped. Risk-assessments concerned with the laundry and the prevention of crossinfection are in place in accordance with the Health & Safety Executive. When the extension works are complete the home must supply the Commission with a Building Control completion certificate. In addition, the requirements identified in the letter from the Commission dated 25th April must be complied with and these matters will be subject to review during the next inspection at the home. Grassington House D55 S56436 Grassington House V236425 160905 Stage 4.doc Version 1.40 Page 16 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 and 29 The home is staffed each day by management, care and domestic staff in order to meet residents’ needs. The procedures for recruitment of staff are robust and therefore protect the people living in the home. EVIDENCE: A copy of the staff rota was supplied to the inspector. This demonstrates that there are always two care staff on duty throughout the day between the hours of 8:00am-10:30pm. During the night shift one wakeful member of staff is on duty with another sleeping in on call. The staff rota should detail the full names and designations of staff. The recruitment records for two new members of staff were examined and these detailed that all necessary checks and information was obtained before these persons commenced working in the home. Records showed that new staff are subject to induction training but it was not clear if this meets with NTO specifications. Grassington House D55 S56436 Grassington House V236425 160905 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) 38 Until the homes extension and building works are complete residents’ health and safety is being compromised. EVIDENCE: Mr Franklin provided a record of staff mandatory training and this included the topics of fire safety, health and safety, basic food hygiene, first aid and moving and handling. The home’s fire records were examined and demonstrated that regular inhouse tests of the fire precautionary system are undertaken. Certificates indicating that the equipment and fire safety system have been serviced and tested were dated July 2005: the faulty fire panel identified must be replaced. The home’s fire risk-assessment must make clear which cupboards and ensuites have extractor fans fitted: Mr Franklin takes responsibility for cleaning Grassington House D55 S56436 Grassington House V236425 160905 Stage 4.doc Version 1.40 Page 18 and checking that the fans are in working order and records evidence they are serviced annually. The building works associated with the extension have yet to be completed but the work appears to be progressing well with a high standard being achieved. Grassington House D55 S56436 Grassington House V236425 160905 Stage 4.doc Version 1.40 Page 19 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 2 x x x x N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 3 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 x 15 x COMPLAINTS AND PROTECTION 2 2 x x x x x 1 STAFFING Standard No Score 27 3 28 x 29 3 30 x MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score x x 2 x x x x x x 1 x Grassington House D55 S56436 Grassington House V236425 160905 Stage 4.doc Version 1.40 Page 20 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 OP1 Regulation 4 Requirement The homes statement of purpose and guide mst be updated to reflect the changes that have been made to the environment with a copy supplied to the Commission. Care plans must include more information concerning the care and wishes of service users when they become critically ill or are dying. All staff employed to work in the home must be supplied with training in the recognition of abuse and local No Secrets procedures as planned. The alterations and extension must be completed in accordance with the requirements set out in the letter from the Commission dated 25th April. Once complete a Bulding Control Completion certificate must be obtained and supplied to the Commission. Confirmation that all works are satisfactory must also be received from the Fire Safety Officer. An action plan detailing how a programme of guarding or protecting central heating Timescale for action 31/10/05 2. OP7 15 31/10/05 3. OP18 18 (1) 31/12/05 4. OP19 23 31/12/05 5. OP25 13 (4) 31/10/05 Grassington House D55 S56436 Grassington House V236425 160905 Stage 4.doc Version 1.40 Page 21 6. OP26 13 (3) & (4) 7. OP26 13 (3) & (4) 8. OP38 13 (4) radiators according to individual risk-assessments will be progressed must be supplied to the Commission. The walls and the floor of the laundry must be readily cleanable and impervious to fluids. The timescale has again been extended to allow the new provider to address this issue. (previous timescale of 31/8/05 not met). Washing machines should have the specific programming ability to meet disinfection standards or the home must be able to provide evidence that alternate processes for disinfection of soiled linen are adequate. The timescale has again been extended to allow the new provider to address this issue: a new laundry is being built. (previous timescale of 31/8/05 not met). The homes fire risk-assessment must clearly detail where extractor fans are situated in cupboards and en-suites. In addition, the faulty fire panel must be replaced as planned. 31/12/05 31/12/05 31/12/05 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 OP27 Good Practice Recommendations The staff rota should cetail the complete name of each staff member and their designation, note the management arrangements for each day and who is responsible for first aid on each working shift. Grassington House D55 S56436 Grassington House V236425 160905 Stage 4.doc Version 1.40 Page 22 Commission for Social Care Inspection Unit 4, New Fields Business Park Stinsford Road Poole BH17 0NF 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 Grassington House D55 S56436 Grassington House V236425 160905 Stage 4.doc Version 1.40 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. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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