Inspection on 28/11/06 for Gravers Care Home Ltd

This inspection was carried out on 28th November 2006.

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

Gravers Care Home Ltd 13/11/07

Similar services:

Larch Avenue

Alderson Road 12

Cranworth Close Registered Care Home

The Cornerstone

John Street Nursing Home

Pennine Camphill

Whitwood House

Whitwood Hall

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

CARE HOME ADULTS 18-65 Gravers Care Home Ltd 17 Wigginton Road York YO31 8HG Lead Inspector David White Key Unannounced Inspection 28th November 2006 09:30 Gravers Care Home Ltd DS0000065690.V318061.R01.S.doc Version 5.2 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 Gravers Care Home Ltd DS0000065690.V318061.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 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. Gravers Care Home Ltd DS0000065690.V318061.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Gravers Care Home Ltd Address 17 Wigginton Road York YO31 8HG 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) 01904 645510 01904 676323 Gravers Care Home Limited Mr Dale Andrew Graver Care Home 17 Category(ies) of Learning disability (17), Learning disability over registration, with number 65 years of age (17), Mental disorder, excluding of places learning disability or dementia (17), Mental Disorder, excluding learning disability or dementia - over 65 years of age (17) Gravers Care Home Ltd DS0000065690.V318061.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. Service Users to include up to 17 LD, up to 17 LD(E), up to 17 MD and up to 17 MD(E) up to a maximum of 17 service users. N/A Date of last inspection Brief Description of the Service: The Gravers Care Home provides personal care and accommodation for up to 17 adults with mental health needs and/or mild learning disabilities. Gravers Care Home Limited took over the ownership of the home in October 2005. The home is located close to the centre of York and is within walking distance of the city centre and local amenities. The accommodation provided is mainly single bedrooms although there is one double bedroom, there are four bedrooms situated within two cottages at the rear of the property and a selfcontained maisonette in an adjoining property. There is a single bed sitting room with its own kitchenette and bathroom on the ground floor and a two bedroom self-contained flat on the first floor. The home has a large front garden with a summerhouse, and there is a paved patio area to the rear of the building. At the time of the site visit on 28 November 2006 the fees for the home ranged from £450 per week upwards. These fees do not include costs for hairdressing, private chiropody and transport. Gravers Care Home Ltd DS0000065690.V318061.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This report follows an unannounced site visit undertaken on 28 November 2006. This visit was carried out by one Regulation Inspector and took 6.5 hours with 5 hours preparation time. The home was able to return the requested information before this site visit, and surveys were sent out to relatives and other professionals who had contact with the home. Surveys were received from three relatives and three health/social care professionals. The report includes information from the Regulation Inspector’s inspection record, which details the history of the home and relevant information about what has been happening in the home since Gravers Care Home Ltd took over the ownership in October 2005. The site visit included an inspection of the premises. The visit involved looking at three residents’ care records, including the assessments, care plans and medication records for each resident. Staff rotas and health and safety documentation were inspected. There was discussion with four residents, three members of care staff and the proprietors of the home, one of whom is also the manager of the home and time was spent observing the interaction between residents and staff. The focus of the inspection was on a number of key standards and inspecting the case records of a number of residents to establish whether they corresponded with their experiences of life in the home. The manager was available throughout the inspection and the findings were discussed at the end of the inspection. What the service does well: Residents are encouraged to be independent and to make their own decisions. Residents receive a good standard of care from a caring, well-equipped, wellmotivated and understanding staff team. Relative surveys state that people living at the home are well looked after. Residents enjoy a wide range of activities both in and outside of the home and have opportunities to pursue their educational and occupational needs through having access to the local community facilities. Residents live in homely and comfortable surroundings and are involved in the daily running of the home. Gravers Care Home Ltd DS0000065690.V318061.R01.S.doc Version 5.2 Page 6 Staff receive up to date training and are provided with the supervision and support to enable them to deliver the required care and support to the residents. The home is well managed and this ensures that concerns are addressed, resident interests are safeguarded and good standards of care are maintained. 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. The summary of this inspection report can be made available in other formats on request. Gravers Care Home Ltd DS0000065690.V318061.R01.S.doc Version 5.2 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 Gravers Care Home Ltd DS0000065690.V318061.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 2 and 5. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Proper pre-admission arrangements are in place to make sure that people’s needs would be fully assessed prior to admission so the individual and the home can be sure the placement is appropriate. EVIDENCE: There have been no admissions to the home since Gravers Care Home Ltd took over its ownership in October 2005. The home has in the past had good pre-admission systems in place for prospective residents. This includes the prospective resident and their representatives being sent a range of information about the care and services on offer at the home. Information has been obtained from other sources such as placing authorities and GPs before someone is considered suitable for the home. Prospective residents’ needs would be assessed prior to them moving in, and this would involve meeting with the resident, their representatives and family where appropriate, to make sure that their needs and wishes are identified and can be met by staff. Then prospective residents and their representatives would be offered the chance to visit the home to meet staff Gravers Care Home Ltd DS0000065690.V318061.R01.S.doc Version 5.2 Page 9 and the other residents and to look around the home before making any decisions about moving there. Each resident has a placement agreement explaining the terms and conditions of their residency at the home and this document is signed by the resident. Gravers Care Home Ltd DS0000065690.V318061.R01.S.doc Version 5.2 Page 10 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. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7 and 9. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents are encouraged to live as independently as possible taking into account any risks that need to be considered. EVIDENCE: The care records of three residents show that there is a range of information about each person and this includes details of their personal, health and social care needs. Information from assessments is reflected in the care plan for each resident and states how needs are to be met. Residents are encouraged to make their own decisions and choices and information within the individual care records supports this. Resident preferences about how they prefer to receive support is detailed within their care plans and good staffing levels ensure that one to one support can be given. There is other information in the care plan about the resident’s involvement in the daily running of the home. One resident helps out with Gravers Care Home Ltd DS0000065690.V318061.R01.S.doc Version 5.2 Page 11 setting the tables and doing other chores around the house and receives financial reward for this. Care plans are regularly reviewed and updated to reflect any changing needs. Comments from the health professional surveys that have been returned indicate that they feel the staff team work hard to maintain and develop residents skills in order to promote their independence. A number of risk assessments are carried out on each resident and the actions that need to be taken to minimise risk are identified and recorded. The risk assessment information focuses on promoting the resident’s skills and independence. Risk assessments also show how decisions have been made about possible restrictions to the resident such as a resident who may wish to administer their own medication but is not safe to do so. Some care plans have risk and relapse management plans in place explaining what needs to be done if there are signs that a resident’s mental health is deteriorating. There is up to date information about any treatments and interventions from external care professionals including input from mental health services. Records are regularly kept up to date on each resident and a member of staff is responsible for summarising the weekly events for each resident in individual records. Some information within the daily records needs to be worded more appropriately so that it accurately reflects the what has been happening and this was discussed with the proprietors of the home. Gravers Care Home Ltd DS0000065690.V318061.R01.S.doc Version 5.2 Page 12 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 15, 16 and 17. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents enjoy a varied lifestyle and have opportunities to take part in social and occupational activities in the local community. EVIDENCE: The resident care plans detail their individual preferences of activities. Residents feel that they are not pressurised into joining in with activities and some like to spend their time relaxing around the home. During discussions the residents made positive comments about their life at the home and the activities and opportunities which are available to them. Some of them work locally and others attend day centres and social clubs. There are also educational opportunities for the residents and one of them is attending local literacy classes. The planning of activities is discussed in regular meetings between residents and staff. Some residents went on a cruise Gravers Care Home Ltd DS0000065690.V318061.R01.S.doc Version 5.2 Page 13 earlier this year and described the experience as “fantastic” and a holiday to Centre Parks has also been arranged. Some residents have regular contact with their family and can receive visits or go and see them at any time. The home also has a telephone to enable residents to speak to relatives and friends at any time if they wish to do so. Residents said that the quality of meals is “good” and there is always sufficient choice. Shopping is planned on a weekly basis with residents and fresh produce is bought. Special diets are catered for and one resident who is vegetarian made comments that there are always non-meat options on the menu to suit her personal tastes. Residents have access to snacks and teamaking facilities at all times. Gravers Care Home Ltd DS0000065690.V318061.R01.S.doc Version 5.2 Page 14 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. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19 and 20. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents receive personal support to suit their wishes and have access to specialist services when required in order to make sure that their healthcare needs are met. EVIDENCE: Each resident living at the home needs differing levels of support with their personal and healthcare and this is detailed within their care records. Residents feel that they receive “very good” care and one resident described the staff team as “brilliant”. Those residents needing assistance feel that this is provided in a sensitive manner that promotes their privacy and dignity and residents feel that the staff team are always polite when talking to them. A health care professional survey has comments that the home always acts in the best interests of the residents and there is a strong emphasis on protecting their rights. Others made comments that the home is good at communicating with healthcare agencies in making sure resident’s health needs are met. Gravers Care Home Ltd DS0000065690.V318061.R01.S.doc Version 5.2 Page 15 Each resident has a GP and access to other healthcare services. Some residents have input from mental health services and receive support where appropriate in attending hospital appointments. In one health care professional survey there are comments that the skills and interventions of the staff team in supporting a resident with mental health problems has helped in preventing the resident from needing to be admitted into hospital. The resident agreed with these comments and feels that the staff team are “fantastic” in managing any relapses in her mental health within the home. Relative surveys indicate that they feel residents in the home are well looked after. The home’s medication system and facilities are satisfactory. Medication records are up to date and accurate and all medication is safely stored. Staff responsible for administering medication in the home have all attended the appropriate training. Gravers Care Home Ltd DS0000065690.V318061.R01.S.doc Version 5.2 Page 16 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. JUDGEMENT – we looked at outcomes for the following standard(s): 22 and 23. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Proper arrangements are in place to make sure that resident’s concerns are listened to and acted upon and residents are safeguarded from harm. EVIDENCE: The home has a complaints procedure that clearly details how complaints are to be dealt. A summary of the complaints procedure is available within the service user guide that is given to all the residents and their representatives. Residents said that they would raise concerns with the management if they have any concerns and feel confident that any concerns would be dealt with properly. The home has policies and procedures in place to safeguard their residents from harm. These reflect the local multi-agency policies and procedures that detail clearly what actions are to be taken in response to suspected or incidents of abuse. All the staff receive abuse awareness training and a recently employed member of staff said that abuse is included as part of the induction programme. Gravers Care Home Ltd DS0000065690.V318061.R01.S.doc Version 5.2 Page 17 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. JUDGEMENT – we looked at outcomes for the following standard(s): 24 and 30. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The residents live in a homely, comfortable and safe living environment, with both private and communal space being suitable for their needs. EVIDENCE: The home is decorated and furnished to a high standard and there is an ongoing programme for the redecoration, refurbishment and maintenance of the home. Bedroom accommodation is over three floors in the main part of the home. Four bedrooms are situated within two cottages at the rear of the building and there is a self-contained maisonette in an adjoining property. There is also a single bedded sitting room with a kitchenette and bathroom and this is located on the ground floor and a two bedroom self contained flat on the first floor. These types of accommodation aim to help residents to develop their daily Gravers Care Home Ltd DS0000065690.V318061.R01.S.doc Version 5.2 Page 18 living skills and live more independently. The home has ramped access on the ground floor to accommodate people with mobility problems. The home has two communal lounges and a conservatory and these are all accessible to residents. There is a paved outside area at the rear of the building where some residents like to sit and smoke and there is a summerhouse in the front which is a designated smoking area. Resident bedrooms are personalised and residents spoke favourably about the standard of their accommodation. One resident enjoys and is very skilled in artwork and painting and there are exhibits of his work on display throughout the home. All the bedrooms are lockable and each resident has their own key. Each resident also has an individual lockable cabinet in another part of the home where they are able to store valuables and monies safely and the care records give indication as to when residents have chosen for staff to be responsible for the safekeeping of these. The premises are clean and well maintained. Proper arrangements are in place to promote good food hygiene and infection control practices. The home is meeting the requirements of the fire safety department and has a fire risk assessment in place and the local fire authority is consulted about any fire safety matters. There are monitoring systems in place for the hot water temperatures and findings from these are recorded. Gravers Care Home Ltd DS0000065690.V318061.R01.S.doc Version 5.2 Page 19 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. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 34 and 35. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents receive a good standard of care from a committed and well-equipped staff team. EVIDENCE: The home has good staffing levels and has recently recruited extra members of care staff. Both residents and staff said that the staffing levels are good. Residents said they are always able to access staff easily and one resident describes the staff team as “brilliant”. The home has good recruitment procedures in place and by looking at the staff records it is evident that all the proper checks are in place before new staff start working at the home. All the staff receive a range of training to equip them in meeting the needs of the resident group and this includes health and safety training, medication management and abuse awareness. Staff also receive training in the use of deescalation techniques which support staff in managing difficult situations from Gravers Care Home Ltd DS0000065690.V318061.R01.S.doc Version 5.2 Page 20 residents who have challenging behaviours. Staff do have a good understanding of the residents’ needs, however would benefit from some specific learning on the needs of people with a mental health and/or learning disability. Gravers Care Home Ltd DS0000065690.V318061.R01.S.doc Version 5.2 Page 21 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. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39 and 42 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is well run in the best interests of the residents, and proper attention is given to promoting their health and safety. EVIDENCE: The registered manager is also a joint proprietor of the home and is well experienced in management and care. Residents and staff feel that the home’s management is both “approachable and supportive”. Arrangements are in place to seek the views of the residents and staff about the care and services at the home. Meetings are held with residents on a regular basis and the home sends out questionnaires to the residents to encourage their opinions about how the home could improve. Staff meetings Gravers Care Home Ltd DS0000065690.V318061.R01.S.doc Version 5.2 Page 22 take place regularly and this encourages the staff team to give their opinions. Supervision arrangements are in place to support staff in their work and to enable management to be aware of any staffing issues. Relatives attend care plan reviews and have contact with the staff team through visiting and telephoning the home. Arrangements are in place for the promotion of a safe and secure environment for residents, visitors and staff. The home has a health and safety policy and procedure and all staff attend health and safety training. A number of satisfactory certificates and reports were seen relating to the premises and there are a number of individual and general risk assessments in place to promote a safe working environment. Gravers Care Home Ltd DS0000065690.V318061.R01.S.doc Version 5.2 Page 23 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 Standard No Score 1 X 2 3 3 X 4 X 5 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 3 25 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 X 34 3 35 3 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 X 3 X LIFESTYLES Standard No Score 11 X 12 3 13 4 14 X 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 3 X 3 X X 3 X Gravers Care Home Ltd DS0000065690.V318061.R01.S.doc Version 5.2 Page 24 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 Refer to Standard YA35 Good Practice Recommendations The registered person should make arrangements through training or other means to help staff develop their understanding of the needs of people with mental health problems. Gravers Care Home Ltd DS0000065690.V318061.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection York Area Office Unit 4 Triune Court Monks Cross York YO32 9GZ 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 Gravers Care Home Ltd DS0000065690.V318061.R01.S.doc Version 5.2 Page 26 - 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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