Inspection on 06/03/07 for Gratwick House

This inspection was carried out on 6th March 2007.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is (sorry - unknown). 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 16/12/05

Gratwick House 23/09/05

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 A Taggart Unannounced Inspection 6th March 2007 09:00 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.V328704.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Gratwick House DS0000014535.V328704.R01.S.doc Version 5.2 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.V328704.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 16th December 2005 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 the 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, wellconverted detached 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 of the rooms. Six of these rooms have en-suite facilities. A large lounge and separate smoking lounge and a dining room provide the communal space. Gratwick House DS0000014535.V328704.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. In preparation for this visit a pre-inspection questionnaire was sent to the manager for completion, survey forms were sent to residents and comment cards to families and professionals involved with the home. A telephone interview was also carried out with the friend of a current resident. Comments both from the surveys received back and from the telephone interview were very positive all saying that Gratwick House offered a high standard of care. The last inspection report was also read along with any relevant documentation or correspondence relating to the service and a planning document was completed. The unannounced visit was carried out at 10am and lasted for 4.5 hours. During the visit the inspector spent time with all of the people currently receiving a service in the home, interviewed the staff on duty and spoke with two visitors. Four care plans were tracked with any issues being discussed with the relevant resident or the manager and the inspector observed staff practice. A tour of the building was undertaken during which time all communal areas and private bedrooms were seen. Lunch, which was the main meal of the day, was seen being prepared and served and there were many positive comments made about the meals provided in the home. Four staff files were seen and all contained the required documentation including references and Criminal Bureau Checks. Records for the running of the home including the fire book, accident and incident forms and maintenance records were current and in good order. The system for administering and recording medication was tracked and was found to be very well managed. The Registered Manager, Mrs. Barclay had completed the pre-inspection questionnaire and this document has also been used to inform the visit. Mrs. Barclay was present in the home and received feedback. What the service does well: Gratwick House offers a warm, homely and comfortable environment for the people who live there. Needs are assessed and there are comprehensive care plans in place to direct the staff team to the care needs of the people they are supporting. In order to provide good healthcare services the home works closely with other professionals and regular resident meeting minutes show that people have an active say in the running of the home. Gratwick House DS0000014535.V328704.R01.S.doc Version 5.2 Page 6 Activities are provided for interest and stimulation and residents are very complimentary about the meals provided. The people living in their home, families and other professionals speak highly of the skills and competence of the manager and say that the staff team are efficient, kind and caring. An example of comments from a resident about the home included, “It’s really lovely here, I like it very much and wouldn’t want to be anywhere else. The staff are always so very kind and Lorraine (the manager), is lovely, always so helpful and cheerful. The food is great and we can always have a choice. We can join in the activities in the lounge if we want but sometimes we prefer to sit in our room and be quiet”. What has improved since the last inspection? What they could do better: To ensure that residents have full information about the terms and conditions of residency, the number of the room being occupied and the fee paid should be completed in contracts. The schedule of refurbishment underway in the home should ensure that the laundry is improved as soon as possible. To ensure the safety of residents and other people in the home should a fire occur, risk assessments should be carried out for people who wish to keep their doors open and action should be taken to fit suitable automatic closures or other safety devices. Gratwick House DS0000014535.V328704.R01.S.doc Version 5.2 Page 7 Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Gratwick House DS0000014535.V328704.R01.S.doc Version 5.2 Page 8 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.V328704.R01.S.doc Version 5.2 Page 9 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 1 2 3 5 and 6 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. There is current information available about the home. In order to ensure that individual needs can be met, pre-admission assessments are carried out and visits to the home encouraged. Contracts of terms and conditions could be improved. EVIDENCE: The Statement of Purpose and Service user Guide have recently been reviewed and updated and the home has designed a website in order to provide current information for prospective residents. In order to ensure that the home can meet individual needs, pre-admission assessments are carried out and recorded by the registered manager and visits to the home to see the facilities on offer are encouraged. During the visit, the family of a prospective resident came for a visit. They were able to meet some of the people currently living in the home, were given Gratwick House DS0000014535.V328704.R01.S.doc Version 5.2 Page 10 a tour of communal areas and given written information including a Service User Guide. Each person living in the home has a contract of terms and conditions in place, signed by the resident or their representative. In the samples seen, the room to be occupied or fee to be paid had not been completed and the manager Mrs. Barclay said she would attend to this immediately. Gratwick House does not provide intermediate care. Gratwick House DS0000014535.V328704.R01.S.doc Version 5.2 Page 11 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 7 8 9 and 10 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. To ensure that the staff team are aware of the needs of the people they are supporting, good care planning processes are in place, regular reviews and updates are undertaken and medication is very well managed. EVIDENCE: For each person living in the home a comprehensive plan of care is in place, which gives detailed information to the staff team on how each person wishes to be supported. Plans include background information, health and social care needs, interests and hobbies and personal preferences. A new improved system of care planning has recently been introduced and all plans had recently been reviewed and updated. There were also detailed daily reports in place and the staff on duty completed a handover sheet for staff coming on shift, ensuring continuity of care. Records show that in order to ensure that healthcare needs are met, the home works with a variety of healthcare professionals including local doctors, district nurses chiropodists and physiotherapists. Residents confirmed that they were Gratwick House DS0000014535.V328704.R01.S.doc Version 5.2 Page 12 well cared for and said that they were treated in a respectful manner. Comments included, “This is a very nice home and we are quite happy. The staff are jolly good, very kind and very caring. When I asked they made an appointment for me with my G.P”. and also from a family member, “My relative has been here for five years now and the care is absolutely splendid. My relative’s needs are very well met and the care is given in a homely, kind but very efficient way”. A new medication storage trolley has been purchased and medicines are safely stored in a locked room. The home uses a monitored dose system supplied by a local pharmacist and all members of staff who administer medication have received training. Medication was very well managed with a weekly audit being carried out and recorded. Controlled medication is stored in a separate locked container and a record book is in use. One person’s controlled medication was checked and found to be correct. Medication Recording Sheets were in good order and all medications including those in the blister packs, packets or bottles had a photograph of the resident for whom they were prescribed displayed so that errors can be avoided. Gratwick House DS0000014535.V328704.R01.S.doc Version 5.2 Page 13 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12 13 14 and 15 Quality in this outcome area is Excellent. This judgement has been made using available evidence including a visit to this service. In order to ensure that the people living in the home have a choice of lifestyle, activities are available, residents meetings are held on a regular basis and a variety of fresh, home cooked meals are provided. EVIDENCE: A programme of activities is available, which includes visits from outside entertainers, occasional trips out and regular “coffee and chat” afternoons. There is also a regular residents meeting held and minutes of these meeting showed people are encouraged to give their views on the running of the home and ideas and suggestions are recorded and acted upon. During the visit one person was painting and there was time for staff members to spend with residents after personal care tasks had been completed. One resident was having a hand massage and having their nails painted and in the smoking lounge a member of staff was reading a book to four people. There were books and magazines around the home and some people said they preferred to be in their rooms and quiet. There is also a very attractive and well-maintained garden that people said they enjoyed sitting in during better weather. Gratwick House DS0000014535.V328704.R01.S.doc Version 5.2 Page 14 Visitors are made welcome at any time, a friend of a current resident said, “I visit the home sometimes two or three times a week and feel that the care there is very good. I am very pleased with the home and I know that my friend’s family are too. Everyone is very friendly and the staff can’t do enough to help. If you ask for help with anything they will always leave what they are doing and attend to you”. Menus and food records show that a variety of fresh, home cooked meals are provided. Lunch, which was the main meal of the day, was cottage pie with buttered swede and strawberries and cream to follow. Several people chose the alternative, which was freshly made omelettes. The people living in the home were very complimentary about the food provided and comments included, “ At mealtimes you get plenty of food and there are always fresh vegetables”, “ The food is great and we can always have a choice” and “ At mealtimes we get lovely food and there are fresh vegetables. At night before bed I have a milky drink and could have something else to eat if I wanted to”. A recommendation made at the last visit has been addressed and the menu of the day is now displayed in the dining room. Gratwick House DS0000014535.V328704.R01.S.doc Version 5.2 Page 15 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents and their families can be confident that any complaints or concerns will be recorded and acted upon and the ethos of the home and staff training are designed to protect residents from risk of abuse. EVIDENCE: The home has a complaints procedure in place, a copy of which is included in the Statement of Purpose and also displayed in the hall of the building. Records show that complaints are taken seriously, recorded and acted upon by the manager in a timely manner. The people living in the home said that they would feel very comfortable approaching the manager or staff team with any concerns and a visitor said, “If I had a complaint I would speak to the manager and I know without a doubt it would be acted upon. I cannot speak highly enough of this home”. A resident also said, “If I had a complaint I would talk to the manager. She always comes to visit each of us to see if we are o.k. and she always asks if there are any complaints”. Staff attend training in the protection of vulnerable adults from abuse and all of the staff members on duty were aware of their responsibilities should they suspect any abuse had occurred. One staff member said, “ I would report any abuse immediately. I would not listen to any excuses, just report it to the manager or owner straight away”. Records show that adult protection issues are also discussed at staff meetings and in supervision sessions. Gratwick House DS0000014535.V328704.R01.S.doc Version 5.2 Page 16 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 19 20 24 25 and 26 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Although the home is comfortable, homely and clean, there are risks to residents and the staff team in the event of a fire occurring by doors being wedged open. EVIDENCE: Gratwick House offers a homely, warm and comfortable environment for the people who live there. There are two lounges, one of which is a smoking room, a large dining room and attractive, accessible gardens to the rear of the building. During the past year the outside of the house has been painted, some bedrooms have been refurbished, new chairs purchased and an ongoing programme of redecoration and refurbishment is underway. Private bedrooms are warm and comfortable and all had been personalised with belongings and pieces of furniture brought to the home by residents and people said they were very happy with their private space. Gratwick House DS0000014535.V328704.R01.S.doc Version 5.2 Page 17 The laundry is in need of redecorating and the floor needs to be covered with an impermeable covering. Mrs Barclay showed a plan that said that this was due to be addressed in the near future as part of the refurbishment of the home. In the lounge and in several bedrooms, doors were wedged open with wooden or plastic wedges, which could constitute a safety hazard to residents and staff in the event of a fire occurring. When this was pointed out to Mrs. Barclay the wedges were removed but this caused distress to some residents who wanted the doors left open. A Requirement has been made to ensure that risk assessments are carried out for people who wish to leave their doors open and a safe way of ensuring this, such as fitting suitable closures must be addressed. The home was clean and hygienic throughout. Gratwick House DS0000014535.V328704.R01.S.doc Version 5.2 Page 18 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 27 28 29 and 30 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. The people living in the home are supported by a committed, caring and well trained staff team and are protected by a robust recruitment process being in place. EVIDENCE: The staffing rotas showed that there are sufficient numbers of staff to support the needs of the residents currently living in the home. On the early morning shift there was a deputy manager, senior carer and carer on duty and there was also the cook and a cleaner. At night two waking staff are available. The manager’s hours are in addition to the rota but the staff on duty said that Mrs Barclay took an active part in the day-to-day tasks in the home. Records show that there is a high level of commitment to staff training and as well as all mandatory training 50 of the staff team hold the NVQ award and attend courses such as infection control, person centred care planning approaches, risk assessment and abuse awareness. There is also a documented programme of in-house training provided by the manager Mrs. Barclay. The staff on duty showed a commitment to their work and had a good knowledge of the people they were supporting. Interactions with residents were cheerful, patient and kindly and there was lots of chatting and encouragement going on. One staff member said, “I stay here because Gratwick House DS0000014535.V328704.R01.S.doc Version 5.2 Page 19 everyone is treated very well and there is that extra care for people here that I have not found in other homes I have worked in”. The people living in the home and their families were full of praise for the commitment and care offered by the staff team and comments included, “The staff are so very kind and Lorraine (the manager,) is lovely, always so helpful and cheerful” and “The staff are good, they will sit and discuss things in my past. I am looked after very well, indeed, if anything over looked after. We have good meals and I have just enjoyed having a bath”. There is a robust recruitment process in place and the manager said it was very important to employ the right calibre of staff to provide good care. Four staff files were seen and all contained the required documentation including a current Criminal Bureau Checks and two references. Gratwick House DS0000014535.V328704.R01.S.doc Version 5.2 Page 20 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31 32 33 36 37 and 38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The manager of the home is competent kind and caring and runs the home in an open and inclusive manner. To ensure the safety of residents at all times the manager must ensure that doors are not wedged open. EVIDENCE: The manager of the home is qualified and competent and runs the home in the best interests of both residents and the staff team. Mrs. Barclay works in the home on a day-to-day basis and attends further courses and seminars in order to update her skills and training. Residents, the staff on duty and families spoke very highly of Mrs. Barclay’s management style and said she was approachable, kind and fair. Comments Gratwick House DS0000014535.V328704.R01.S.doc Version 5.2 Page 21 from the staff on duty included, “ The manager is very approachable helpful and supportive. I have supervision monthly and can go to her with any issues” and “It is very homely here and the staff are very well supported by the manager. I have completed NVQ 2, which was funded by the home, I have supervision monthly and have attended a lot of training”. Records show that there is a real commitment to staff development and training and supervisions and staff meetings are held and recorded on a monthly basis, which is to be commended. An annual quality assurance process is carried out in the form of questionnaires being sent to service users, staff, families and professionals involved with the home. Replies are collated and used to inform an improvement plan for the home. Records of the outcomes are kept in the hall of the home and are accessible to visitors. Records for the running of the business were seen including fire records, the maintenance book, gas certificate and electrical appliance testing and all were current and in good order. One requirement regarding health and safety was made as a result of this visit. Gratwick House DS0000014535.V328704.R01.S.doc Version 5.2 Page 22 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 X 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 4 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 4 13 4 14 3 15 4 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 2 3 X X X 3 3 3 STAFFING Standard No Score 27 4 28 3 29 3 30 4 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 3 3 X X 3 2 Gratwick House DS0000014535.V328704.R01.S.doc Version 5.2 Page 23 Are there any outstanding requirements from the last inspection? No STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1 Standard OP19 Regulation 13 (4)( C) Requirement To ensure that residents and other people in the home are protected in the event of a fire occurring, The Registered Manager should ensure that risk assessments are carried out for those people who wish to keep their doors open and suitable automatic closures fitted. Timescale for action 30/04/07 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Gratwick House DS0000014535.V328704.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Hampshire Office 4th Floor Overline House Blechynden Terrace Southampton SO15 1GW National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Gratwick House DS0000014535.V328704.R01.S.doc Version 5.2 Page 25 - 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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