Inspection on 23/09/05 for Gratwick House

This inspection was carried out on 23rd September 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Gratwick House 06/03/07

Gratwick House 16/12/05

Gratwick House 07/12/04

Gratwick House 07/09/04

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

CARE HOMES FOR OLDER PEOPLE Gratwick House 55 Norfolk Road Littlehampton West Sussex BN17 5HE Lead Inspector Mrs H Church Announced Inspection 23rd September 2005 09:30 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 Gratwick House DS0000014535.V252743.R01.S.doc Version 5.0 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Gratwick House DS0000014535.V252743.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Gratwick House Address 55 Norfolk Road Littlehampton West Sussex BN17 5HE 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) 01903 716022 Mr Michael John Hitchens Mrs June Alice Hitchens Mrs Lorraine Barclay Care Home 22 Category(ies) of Old age, not falling within any other category registration, with number (22) of places Gratwick House DS0000014535.V252743.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 7th December 2004 Brief Description of the Service: Gratwick House is a care establishment registered to provide accommodation for up to twenty-two residents over 65 years of age. Mr and Mrs M and J Hitchens privately own the service and Mrs Lorraine Barclay is the registered manager in charge of day to day management of the establishment. Gratwick House is situated in a quiet residential area approximately ½ a mile from the town centre and the seafront. The care home is a large, well converted detatched property with a paved front garden and a large secluded rear garden with flower borders and shrubs. The accommodation is arranged in three double and sixteen single rooms on two floors with a lift providing access between all but one room. Six of these rooms have en-suite facilities. A large lounge and separate smoking lounge and a dining room provide trhe communal space. Gratwick House DS0000014535.V252743.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This announced inspection, one of two required under the Commission for Social Care Inspection was planned to take part in the morning. A CSCI pharmacist reviewed medication handling and accompanied the inspector. The manager was available to assist both inspectors with their inspection. To prepare for this announced inspection, previous reports and letters were examined together with the pre-inspection questionnaire completed by the manager giving up-to-date information. Two documents, the Statement of Purpose and Service Users Guide form a contract of service of how the home is run or how residents can change this to improve their lives there. The inspector also received fourteen positive feedback forms from residents, one of which stated “I’m glad to be living here” and eight feedback forms from relatives, one of which stated “Our sister…. seems very happy at Gratwick”. The inspectors noted that a number of residents were either in their rooms or using the lounge. During the inspection, a district nurse, ten residents and four visitors gave their views to the inspector. The majority of these were seen privately in their rooms. Four records were examined to see if the care being provided was as residents described. All residents were able to give a clear account of their life at Gratwick House and the majority of the comments were enthusiastic about the staff and the way care was provided. It was clear that residents are encouraged to say what they like or don’t like about the home. The residents were cheerful and it was clear that they were happy there. The three staff members spoken with were unanimous in their support of the manager and her leadership skills. The care plans showed that the care provided is appropriate according to the needs of the residents and the right amount of support to maintain independence and ensure resident’s lives continue to improve was given. There were no requirements made at this inspection but the pharmacy inspector gave some advice relating to medication. Gratwick House DS0000014535.V252743.R01.S.doc Version 5.0 Page 6 What the service does well: 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. Gratwick House DS0000014535.V252743.R01.S.doc Version 5.0 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 Outcomes Statutory Requirements Identified During the Inspection Gratwick House DS0000014535.V252743.R01.S.doc Version 5.0 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 the following standard(s): 1,2,3,4,5. All residents had been assessed before moving into the home. The staff at the home are meeting the residents identified needs. Relatives were given enough information to help them decide the home would be suitable. EVIDENCE: The manager has provided the Statement of Purpose and Service Users Guide for all their residents and representatives and this is currently being updated. Four care plans showed that residents had been assessed to ensure the home would be able to meet their needs. Risk assessments were in place and care plans to instruct staff how to meet identified needs had been written from the assessments. It was clear from the staff member that they were well informed about the care needed and were updating records accordingly. Gratwick House DS0000014535.V252743.R01.S.doc Version 5.0 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 the following standard(s): 7,8,9,10,11. All residents had an individual care plan set out for staff to follow with policies and procedures when residents elect to manage their own medication. The home’s medication procedures were followed and staff were keen to improve practice where possible. Staff members are meeting the health care needs of the residents in a respectful manner. EVIDENCE: Four care plans gave good, clear information of care needed with risk assessments giving staff information about the risks and how to minimise these. Medication sheets were completed accurately and according to the district nurse, care staff were referring to and following up any care directed by the representative of the primary health care team. Staff receive training in the home’s medication policies and procedures and assessment before administering medicines. Residents are able to retain responsibility for some or all of their medicines. It was discussed that trained staff should have the residents permission to access medicines stored for selfadministration, as part of the risk management framework. Gratwick House DS0000014535.V252743.R01.S.doc Version 5.0 Page 10 Records of receipt, administration, supply for self- administration were well maintained. Disposal records did not include the name of the resident to whom the medicine belonged. Lockable storage for medicines was tidy. Staff were not aware of the shelf life of the monitored dose system in which some medicines are supplied. An open trolley was used to transport medicines around the home. Care staff were observed speaking to and caring for the residents and treating them with respect. Staff knocked on doors before entering and spoke to residents in a caring manner. A number of residents comments about the home were similar and these included “ Very happy here”, “Looked after well” and “its a happy home”. One of relatives said, “We are made very welcome here, it’s like home from home. “The care staff couldn’t be more helpful”. Gratwick House DS0000014535.V252743.R01.S.doc Version 5.0 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 the following standard(s): 12,13,14,15. Activities are suited to the conditions and dependency levels of each of the current residents. Visiting is positively encouraged. Residents are served meals that are nutritious and appetising. EVIDENCE: One relative and four residents said, “The gardens are a delight.” Activities are clearly well thought out and are based on the resident’s wishes and abilities. They range from individual activities to group activities to local outside places of interest. Formal activities include musical entertainers and trips out. There are twenty-one residents living in the home at present but this did not prevent staff being able to spend individual time with them. According to the manager, visitors are always made welcome and it was clear from the visitor’s book that visitors come every day at different times. The resident’s comments included high praise for the home cooked food. The inspector noted the high quality of the meal prepared and served, all provided from fresh ingredients. The menus are changed regularly according to feedback. Where residents prefer an alternative, this is provided and it was clear that relatives coming from a distance are welcomed to a meal. Gratwick House DS0000014535.V252743.R01.S.doc Version 5.0 Page 12 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16,17,18. Residents are confident that any complaints they may have are taken seriously and acted upon appropriately. Care staff are trained in adult protection procedures so are equipped to protect residents from abuse. EVIDENCE: The home has a complaints procedure contained in the Statement of Purpose and Service Users Guide and displayed in the entrance to the home. Residents appeared to be encouraged to voice their opinions and relatives know who to complain to, but there were no records of any complaints. The West Sussex Multi Agency guideline in protecting vulnerable adults was available. The manager has provided Protection of Vulnerable Adults training for all care staff with other mandatory training. Training on this subject is also included in the induction and foundation training programme. Gratwick House DS0000014535.V252743.R01.S.doc Version 5.0 Page 13 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19,20,21,22,23,24,25,26. The indoor and outdoor areas used by residents are clean, safe and homely with good access to the rear garden. The resident’s rooms are suitable for their needs and are homely. EVIDENCE: During a tour of the home it was clear that residents are encouraged to move around the home as they wish and have access to the dining room and lounges which are comfortably furnished. The dining room table accommodates up to six residents to retain a family atmosphere. The rear feature garden has been designed to assist residents to walk independently or use a wheelchair and is furnished with occasional garden furniture. There are enough toilets and assisted baths to meet the needs of residents and thermostatic valves protect residents from scalding water temperatures. Radiators are guarded and locks have been provided on all doors. The home was clean and hygienic throughout. Resident’s rooms were homely and comfortably furnished with their own possessions around them. Training in fire safety procedures and fire risk assessments were in place. Gratwick House DS0000014535.V252743.R01.S.doc Version 5.0 Page 14 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27,28,30. There were sufficient care staff on duty over the 24 hours period to meet needs and recruitment processes robust to ensure residents are protected. EVIDENCE: The inspector joined the staff and manager as they assisted residents during the morning and over the lunch period. The numbers and skill mix of staff was appropriate to meet their needs. Staff said they were happy working at the home and felt well supported by the manager. From the two records seen, recruitment records were consistent and staff received induction, supervision and training which meets the National Training Organisation workforce training targets. Currently 7.6 of care staff have achieved the National Vocational Qualification at level 2 with two others planning to undertake this. Care staff have information about the structure of working roles throughout the home. Gratwick House DS0000014535.V252743.R01.S.doc Version 5.0 Page 15 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31,32,33,36,38. The home is run in the best interests of the residents whose health, safety and welfare is promoted and protected. EVIDENCE: Both Mr and Mrs Hitchens and the manager, Lorraine Barclay, provide a high profile at Gratwick House. Mrs Barclay has achieved the Registered Managers Award and her two deputies are considering taking this award too. Mrs Barclay is well supported by her two deputies and the owners. All are actively involved in the care of residents on a daily basis and have many years of experience in managing a care home. The care staff praised Mrs Barclay’s leadership style and said she supports them to carry out their roles, providing a good clear sense of direction that puts residents at the centre of all activities. Recruitment, induction and supervision records confirmed that the resident’s best interests were safeguarded. The resident’s needs are well met and their Gratwick House DS0000014535.V252743.R01.S.doc Version 5.0 Page 16 health, safety and welfare promoted and protected. As an existing care home, all rooms meet the National Minimum Standards in useable space giving residents sufficient space for personal possessions or any necessary equipment to support their care needs and move around their rooms safely. Gratwick House DS0000014535.V252743.R01.S.doc Version 5.0 Page 17 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 3 3 3 3 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 2 10 4 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 4 14 3 15 4 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 3 18 3 3 3 3 3 3 3 3 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 4 3 3 3 3 3 3 3 Gratwick House DS0000014535.V252743.R01.S.doc Version 5.0 Page 18 Are there any outstanding requirements from the last inspection? NO STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 2 Refer to Standard OP 9.2 OP 9.3 Good Practice Recommendations Trained staff should have access, with the residents permission, to their lockable storage for medicines, as part of the risk management framework. Medicines in monitored dose system blisters should be disposed of eight weeks after the date of dispensing. When medicines are transported around the home this should be done in a secure manner. Care should be taken that medicines can be quickly and securely locked away in an emergency. Trained staff should have access, with the residents permission, to their lockable storage for medicines, as part of the risk management framework. 3 OP 9.4 Gratwick House DS0000014535.V252743.R01.S.doc Version 5.0 Page 19 Commission for Social Care Inspection Worthing LO 2nd Floor, Ridgeworth House Liverpool Gardens Worthing West Sussex BN11 1RY 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 Gratwick House DS0000014535.V252743.R01.S.doc Version 5.0 Page 20 - 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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