Inspection on 06/12/06 for Gregory House

This inspection was carried out on 6th December 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

Gregory House 03/03/09

Gregory House 15/02/06

Gregory House 20/09/05

Gregory House 30/03/05

Gregory House 26/05/04

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

CARE HOMES FOR OLDER PEOPLE Gregory House Welby Gardens Grantham Lincs NG31 8BN Lead Inspector Mr David Bacon Key Unannounced Inspection 6th December 2006 08:00 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 Gregory House DS0000002367.V322309.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. Gregory House DS0000002367.V322309.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Gregory House Address Welby Gardens Grantham Lincs NG31 8BN 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) 01476 562192 www.oxfordshire.gov.uk The Orders Of St John Care Trust Mrs M Cooke Care Home 37 Category(ies) of Old age, not falling within any other category registration, with number (37) of places Gregory House DS0000002367.V322309.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. The home is registered to provide personal care for service users of both sexes whose primary needs fall within the following category:Old age, not falling within any other category (OP) - 37 The maximum number of service users to be accommodated is 37. Date of last inspection 15th February 2006 Brief Description of the Service: Gregory House is a purpose built care home situated in a quiet residential area within Grantham and is set in its own grounds having landscaped gardens with several seating areas and a summer house. It was built in the 1960’s for the Local Authority and since then has been registered by the Orders of St Johns Care Trust. Grantham town centre is within close proximity. The home is registered to provide residential care for 37 service users over the age of 65 years, category OP. There are 23 single bedrooms and 7 shared bedrooms and several lounge and dining areas. The home is one of a group of homes run by the Order’s of St John Trust and its stated aim is to provide a homely, relaxed and caring environment that takes into account the individual needs of the residents. The range of fees is from £336 to £449 per week. Gregory House DS0000002367.V322309.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The site visit took place over 4 hours; it was unannounced and was carried out by one inspector. A tour of the premises was conducted, service users care records and staff records were inspected along with some policies, food provision, activities and maintenance of the home. The inspector spoke with the registered manager, four service users and three staff members. As part of this unannounced inspection the quality of information given to people about the care home was looked at. People who use services were also spoken to, to see if they could understand this information and how it helped them to make choices. The information included the service user’s guide (sometimes called a brochure or prospectus), statement of terms and conditions (also known as contracts of care) and the complaints procedure. These findings will be used as part of a wider study that CSCI are carrying out about the information that people get about care homes for older people. This report will be published in May 2007. Further information on this can be found on our website www.csci.org.uk. What the service does well: The service users spoken with expressed high overall levels of satisfaction about the standards of care provided and said that they were treated respectfully and that their care needs were appropriately met. Service users also spoke positively about the standard of meals and the physical environment. High levels of satisfaction were also expressed within fourteen questionnaires completed by service users as part of the homes own recently undertaken quality assurance programme. Service users comments included: “I can say with absolute assurance that the care is wonderful, the food incredible and the staff are the best”. “I would rather be at home of course but they could not have tried any harder or be a home any better than here”. “The manager and staff have been a wonder to be, marvellous, really marvellous”. The home is clean, tidy and very well maintained. Extensive recruitment procedures are in place and the staff receive a good standard of induction and training for the work they perform to meet the care needs of service users. Gregory House DS0000002367.V322309.R01.S.doc Version 5.2 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. The summary of this inspection report can be made available in other formats on request. Gregory House DS0000002367.V322309.R01.S.doc Version 5.2 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 Gregory House DS0000002367.V322309.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 2, 3, Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. There are satisfactory procedures in place overall for the introduction of residents to the home. EVIDENCE: The service users care records viewed identified that a basic assessment of each service users care needs had taken place, which included basic information about nutrition, moving and handling, psychological needs, continence, social needs an assessment of risk. The manager said that care assessments were currently being reviewed and updated to improve this system. The assessment information seen provided only a basic insight as to the personal history of each service user and any likes and dislikes. The care plans seen were updated regularly and evidenced where service users, or their representatives had been consulted with regarding their care plan. The service users spoken with said they could not recall being admitted Gregory House DS0000002367.V322309.R01.S.doc Version 5.2 Page 9 to the home but all confirmed that staff had always been kind and helpful. Comments included: “They welcomed me here and from then on they have been tremendous”. “I’m not above to recall much but the staff have always been tops, always”. “Oh, they are very good and always have been, super”. The home does not provide intermediate care services. Gregory House DS0000002367.V322309.R01.S.doc Version 5.2 Page 10 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, 10 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The service users spoken with feel they are treated with respect and they are satisfied with the care and health care provided although some care records provide staff with basic information regarding service users. Procedures for the administration of medication are appropriate. EVIDENCE: The service users spoke highly about the care provided and confirmed that they received consistently good standards of care and that staff respected their privacy and dignity. Comments included: “Faultless, a great team”. “Very good, you could not moan really, they are all nice and helpful”. “They do what they can and you could not wish for better”. “We are spoilt really, they are there when you need them”. “I don’t want to be here but they could not do better”. Staff members during the visit were observed being courteous and respectful to the service users. Gregory House DS0000002367.V322309.R01.S.doc Version 5.2 Page 11 The care records viewed instructed staff how service users care needs were to be met although some records were basic, providing only a brief indication as to an individuals needs. The manager confirmed that this system is in the process of being improved to more fully document service users needs and to provide staff with more detailed information. Care records are updated daily and where service users care needs change and they are reviewed each month. The staff spoken with were aware of service users care needs and how these were met and staff were observed interacting appropriately with service users throughout the visit. The care plans viewed identified service users health care needs and how these were being met and included any given instruction or advice from health professionals. The homes medication system was well maintained and documented medicines as receipted into the building, where administered and as disposed. Medicines are securely stored and staff whom administer medication receive training regarding this subject matter. Gregory House DS0000002367.V322309.R01.S.doc Version 5.2 Page 12 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, 15 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The services users enjoy the food provided by the home, they can choose how they spend their time and their visitors are made welcome. Recently there have been an insufficient amount of activities provided overall. EVIDENCE: The service users spoken with confirmed that they were able spend their time as they liked and that their visitors were made welcome. The homes activity co-ordinator had recently left and a carer was temporarily filling this position and the post is being advertised. The manager confirmed that records of recent activities were intermittent as a result of this, but that a programme of activities was being arranged for the Christmas period. Service users said they enjoyed life within the home and the relaxed atmosphere but they were not fully aware of the homes programme of activities. Comments included: “It’s a nice place, friendly and informal”. “I’m not sure what they have to do but I’m satisfied with things”. “They have Gregory House DS0000002367.V322309.R01.S.doc Version 5.2 Page 13 things on I’m sure but I couldn’t tell you what”. “They treat you very well, they have a few things on but not so much recently because of staffing”. A three-week menu is in place and much of the food is home produced. A record of all meals provided is maintained along with meal and equipment temperature records. The home cook was observed talking with service users to ascertain individual choices for the forthcoming meal. The service users spoken with expressed high levels of satisfaction regarding the homes meal provisions. Comments included: “Well, I’m difficult to please, I enjoyed cooking but the food is surprisingly good”. “The meals are tasty, there’s enough, well more than enough to eat for me”, “If you don’t like something then you can have an alternative”. “You only have to say if you don’t like anything”. “They really do provide a good selection and it’s good stuff”. The home has recently been awarded four stars for its food hygiene provision following an environmental health inspection. Gregory House DS0000002367.V322309.R01.S.doc Version 5.2 Page 14 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, 18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. There are procedures in place overall to ensure that service users are protected and service user feel that they can raise concerns should they wish to. Staff are aware of the homes whistle blowing and safeguarding adults policies and procedures. EVIDENCE: There have been no complaints or safeguarding adult referrals made since the last inspection visit. The homes complaints procedure is displayed in the home and included within the service users guide. The service users spoken with said they felt able to complain and service user comments included: “I’ve not needed to test it but am sure they would listen”. “The staff are all approachable and the manager makes herself well known, you would only have to say”. I can’t remember receiving any information about this but my family would deal with it”. Risk assessments are undertaken for each service user. The staff members recently recruited have not yet attended formal training but the staff spoken with were aware of abuse and whistle blowing policies and procedures. Training regarding this subject matter is booked and a rolling programme of training is in place. Gregory House DS0000002367.V322309.R01.S.doc Version 5.2 Page 15 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, 26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The environment is very well maintained and comfortable and it meets the individual needs of service users whose health and safety is protected. EVIDENCE: The home was very clean, tidy and well maintained throughout. The service users spoken with said that the environment was homely and comfortable and that they are supported to personalise their own accommodation, which was further evidenced during a tour of the building. Domestic staff keep the home clean and odour free. Health and safety policies and procedures are in place for staff, who receive awareness training regarding this. A risk assessment has been undertaken of the premises and of individual service users. Gregory House DS0000002367.V322309.R01.S.doc Version 5.2 Page 16 Fire safety systems were being tested as per fire safety regulations. For example, records of emergency lighting and fire system tests. Hot water temperatures within the home are monitored each month and regulating valves are fitted to water outlets. Systems are in place to prevent risks from legionella. Protective covers are fitted to radiators. Gregory House DS0000002367.V322309.R01.S.doc Version 5.2 Page 17 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, 30 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. There are sufficient numbers of staff who are appropriately recruited to safeguard and meet the needs of the service users, and staff have the skills, experience and support necessary to carry out their roles. EVIDENCE: The service users spoken with said that their care needs were consistently met by sufficient numbers of staff, which was further evidenced through viewing the homes staffing rota. Service users comments included: “You could not wish for more, I have no gripes with the place”. “They attend to your every need”. “They respond promptly, you may wait a little while but not too long”. “It seems well run, you only have to ask for help”. “They seem to know what you need, excellent staff”. The staff members spoken with expressed high levels of satisfaction regarding the homes induction and training programmes. The staff files inspected evidenced that comprehensive recruitment policies and procedures are in place. These include equal opportunities monitoring, application and interviewing systems and records. Newly recruited staff attend a high level of induction training upon commencing work at the home and a comprehensive training plan is in place where staff training needs are identified and provided for, which link to the individual needs of service users. Gregory House DS0000002367.V322309.R01.S.doc Version 5.2 Page 18 Gregory House DS0000002367.V322309.R01.S.doc Version 5.2 Page 19 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, 33, 35, 38 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Service users are well supported to express their views regarding life within the home and the care provided. Service users and staff are satisfied with the management of the home. The premises are well maintained and procedures are in place to protect service users finances. EVIDENCE: The staff members spoken with made reference to the value of the individual support and supervision they received and said that they were satisfied with the manager’s approach to the role, which was further confirmed by the service users spoken with. Service users comments included: “You can talk with any of them and the office is close by”. “If you have any questions then Gregory House DS0000002367.V322309.R01.S.doc Version 5.2 Page 20 you just simply ask, the staff are trained and friendly”. “You don’t want for anything and they are all so helpful”. “I would prefer to be at home but I’m here and they are truly faultless”. Quality satisfaction questionnaires are sent to service users and service users meetings are held of which records are maintained. Action is taken by the home following these to respond to service users views. External senior staff within the organisation also undertake regular quality audits of which action is taken as necessary and records are maintained. The fourteen completed satisfaction questionnaires seen identified that service users overall were very satisfied with the care provided by the home. A risk assessment of the premises had been undertaken, which is reviewed as necessary and the staff members spoken with were satisfied with the homes management of health and safety. The homes health and safety and policy and procedures are updated regularly and are made available to staff. Individual risk assessments are also undertaken. Records show that fire safety precautions such as tests, drills and equipment checks are carried out as per fire safety regulations. Systems are in place to safeguard service users finances where the home has any involvement in these. Gregory House DS0000002367.V322309.R01.S.doc Version 5.2 Page 21 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 2 X X X 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 2 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X X X X X 3 STAFFING Standard No Score 27 4 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 4 X 3 X X 3 Gregory House DS0000002367.V322309.R01.S.doc Version 5.2 Page 22 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 OP12 Regulation 15 and 16 (2) (n) Requirement The homes provision of activities must be revised to more appropriately meet service users recreational needs. Timescale for action 31/01/07 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 Gregory House DS0000002367.V322309.R01.S.doc Version 5.2 Page 23 Commission for Social Care Inspection Lincoln Area Office Unity House, The Point Weaver Road Off Whisby Road Lincoln LN6 3QN 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 Gregory House DS0000002367.V322309.R01.S.doc Version 5.2 Page 24 - 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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