Inspection on 08/06/05 for Grenham Bay Court

This inspection was carried out on 8th June 2005.

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

The inspector found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Grenham Bay Court 13/11/08

Grenham Bay Court 13/11/07

Grenham Bay Court 22/08/06

Grenham Bay Court 17/11/05

Grenham Bay Court 20/04/05

Grenham Bay Court 07/03/05

Grenham Bay Court 06/07/04

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

CARE HOMES FOR OLDER PEOPLE Grenham Bay Court Cliff Road Birchington Kent CT7 9JX Lead Inspector Tina Taylor 8 June 05 10:30 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Grenham Bay Court v231971 h56-h05 s34959 grenham bay court v231971 080605 stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Grenham Bay Court Address Cliff Road Birchington Kent CT7 9JX Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) 01843 841008 Grenham Bay Care Ltd Registered Care Home 34 Category(ies) of Older Persons registration, with number of places Grenham Bay Court v231971 h56-h05 s34959 grenham bay court v231971 080605 stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 20th April 2005 Brief Description of the Service: Grenham Bay Court provides accommodation and care for older people. It is situated facing the sea in the residential area of Birchington, which is near to the seaside town of Margate. The Home is within walking distance of most local amenities. The Home has its own transport, that can assist residents to access local shops and other places of interest in the area. There is unrestricted on road parking to the front of the property. The Home is owned by a private company. The day-to-day management of the Home is the responsibility of the manager. Staff are on duty 24 hours a day which includes a senior member of staff on all shifts during the day and two staff on wakeful duty at night, senior staff are available on-call at night. Grenham Bay Court v231971 h56-h05 s34959 grenham bay court v231971 080605 stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced inspection carried out to follow up on the requirements made at the last inspection of 20th April 2005. The visit started at 10.30am and lasted for six hours. A senior business services administrator accompanied the inspector. The company has employed a new manager and she has been working at the home for approximately two weeks. Discussion was held with the manager on her initial findings of the home and the work that she had prioritised. The inspector was reassured that the new manager had already made positive changes and had implemented improved practice. A brief tour of the home was made, and observations were made during the lunchtime period of care practice. Initial responses from residents on the new regime were positive. Medication storage and administration records were checked; care files were sampled. What the service does well: What has improved since the last inspection? The update of the care planning system to the new format is nearly completed. Care plans sampled contained good information on residents’ backgrounds, and their work and social history. The staff have obviously been working very hard to complete these documents. Nutritional monitoring charts are in place and being kept up to date. Staff were observing good hygiene practice. Grenham Bay Court v231971 h56-h05 s34959 grenham bay court v231971 080605 stage 4.doc Version 1.30 Page 6 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. Grenham Bay Court v231971 h56-h05 s34959 grenham bay court v231971 080605 stage 4.doc Version 1.30 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Standards Statutory Requirements Identified During the Inspection Grenham Bay Court v231971 h56-h05 s34959 grenham bay court v231971 080605 stage 4.doc Version 1.30 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) Not assessed at this visit EVIDENCE: Grenham Bay Court v231971 h56-h05 s34959 grenham bay court v231971 080605 stage 4.doc Version 1.30 Page 9 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 7, 8, 9 There is now a clear care planning system in place. The system provides staff with the information they need to satisfactorily meet resident’s needs. The medication recording system is poor and potentially places residents at risk EVIDENCE: The new format for care planning and risk assessment has nearly been completed. Those plans sampled contained good information about the resident’s life history and interests. Improvements have been made to the information contained in identified needs and risk assessments. The manager said that the final care plans and risk assessments would be completed within two weeks. Health care needs for some residents with particular needs were checked and it was seen that nutritional assessments have been completed and food and fluid intake records were being kept. The recording of medication has not been improved to a satisfactory standard. Staff have received formal medication training and the inspector has previously Grenham Bay Court v231971 h56-h05 s34959 grenham bay court v231971 080605 stage 4.doc Version 1.30 Page 10 asked for competence assessments to be carried out, but this has not, as yet, been completed. The manager had already identified that medication practice was not up to standard and had asked staff to go through all the stocks of medication and to return excess stocks and out of date medications. She is arranging for the supplying pharmacist to visit the home to discuss on-going problems. In discussion with the manager it was agreed that due to the high temperature and limited space a new storage facility would need to be found for medication. The manager had arranged for a new medication fridge to be purchased, and this had been more appropriately sited. Grenham Bay Court v231971 h56-h05 s34959 grenham bay court v231971 080605 stage 4.doc Version 1.30 Page 11 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 13, 15 The home works well to ensure the residents are able to maintain contact with family and friends. The home provides meals in pleasing surroundings. EVIDENCE: During the course of the visit, there were many visitors to the home. A resident said that family and friends were able to visit the home whenever they wished. A visitor said she felt very welcome at the home. The home has two separate dining areas for the residents. The dining area to the front of the property has large picture windows and overlooks the sea. A resident said the food was always lovely. Residents are provided with soup before their main meal. Bowls of fruit and cold drinks were seen available for residents in communal areas. Residents said they were provided with wine and sherry. The manager said that an alternative was always available and that the cook is now spending time with the residents establishing their preferences. The manager as part of her initial assessment of care and practice is going to spend time observing meal times. Grenham Bay Court v231971 h56-h05 s34959 grenham bay court v231971 080605 stage 4.doc Version 1.30 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 standard(s) 18 The arrangements for the training of staff in adult protection needs further improvement and are not yet satisfactory. EVIDENCE: The manager said she has been talking to staff about working practices that could constitute abuse. Some staff had received training in non- aversive intervention but further training needs to be provided for staff in the management of behaviours that challenge. The manager has been unable to locate a policy for staff on behaviour management and said she will ensure one is put in place. The manager is also going to access more in depth training for senior staff in dementia. Grenham Bay Court v231971 h56-h05 s34959 grenham bay court v231971 080605 stage 4.doc Version 1.30 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 standard(s) 20, 24, 26 The decoration and furnishings of the environment provide the residents with an attractive and homely place in which to live. There are issues with regard to hot water temperatures and the storage of hazardous products that have the potential to place residents at risk. EVIDENCE: The communal areas are pleasantly decorated and furnished and provide a warm and homely environment. There are a number of different lounges where residents can sit and choose their company. Resident’s bedrooms are individual and they may bring items of their own furniture to personalise their rooms as they wish. Some bedrooms are becoming in need of redecoration and the manager has already identified what needs to be done. Hot water was checked to some baths and whilst one bedroom took so long for the hot water to come through that the task was abandoned, two other baths had hot water coming from the taps that was well in excess of the safety Grenham Bay Court v231971 h56-h05 s34959 grenham bay court v231971 080605 stage 4.doc Version 1.30 Page 14 range. The manager agreed to warn all staff the same day to take extra care and to arrange for the system to be checked the next day. Hazardous products were found stored in an unlocked facility. Hygiene practices were improved from the last inspection and the home was clean and odour free. The manager is going to arrange for the fire escape stairs to be checked, and to speak with the Fire Safety Officer with regard to a suitable alarm for the door leading to the fire escape, and if a fire escape door in a bedroom needs to remain so. The manager has arranged for existing environmental risk assessments to be reviewed and updated, and for additional ones to be completed. Grenham Bay Court v231971 h56-h05 s34959 grenham bay court v231971 080605 stage 4.doc Version 1.30 Page 15 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27 The deployment and numbers of staff met the needs of the residents EVIDENCE: During the inspection sufficient staff were observed catering for the needs of the residents. Staff were deployed effectively around the home. There are additional staff to carry out meal preparation, domestic and administrative duties. Grenham Bay Court v231971 h56-h05 s34959 grenham bay court v231971 080605 stage 4.doc Version 1.30 Page 16 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 32 The manager has a good understanding of the areas in which the home needs to improve. EVIDENCE: The manager has already made some changes to staff practice and has a good understanding of the training that will need to be undertaken by staff. She has ideas for improvements to induction and competence assessments. Residents were complimentary about the manager’s style and presence. Grenham Bay Court v231971 h56-h05 s34959 grenham bay court v231971 080605 stage 4.doc Version 1.30 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score x x x x x x HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 1 10 x 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 x 13 3 14 x 15 3 COMPLAINTS AND PROTECTION x 3 x x x 3 x 1 STAFFING Standard No Score 27 3 28 x 29 x 30 x MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score x x 2 x 3 x x x x x x Grenham Bay Court v231971 h56-h05 s34959 grenham bay court v231971 080605 stage 4.doc Version 1.30 Page 18 yes Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard 7 Regulation 15 Requirement Review and update of all care plans (previous timescale of 30 April 2005 was extended to 30 June 2005) Review and update of all risk assessments (previous timescale of 30 April 2005 was extended to 30 June 2005) All medications to be correctly recorded (previous timescales of 18 March 2005 and 20 April 2005 not met) Staff to receive appropriate training on behaviour management (previous timescale of 31 March not met and extension to 30 June 2005 will not be met) Training to be booked by Hazardous products must be kept locked (previous timescale of 20 April 2005 not met) Hot water to baths must be maintained at a safe temperature Arrangements to be made for checks on the fire escape, fire safety equipment and fire doors by Area in garden to be cleared and risk assessed v231971 h56-h05 s34959 grenham bay court v231971 080605 stage 4.doc Timescale for action 30 June 2005 30 June 2005 13 June 2005 17 June 2005 2. 7 13 3. 9 13 4. 18 18 5. 6. 7. 26 26 26 13 13 13 8 June 2005 9 June 2005 17 June 2005 17 June 2005 Page 19 8. 26 13 Grenham Bay Court Version 1.30 9. 9 13 Assessment to be carried out on the resiting of medication 17 June 2005 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 18 Good Practice Recommendations Policies and procedures to be sourced regarding behaviour management Grenham Bay Court v231971 h56-h05 s34959 grenham bay court v231971 080605 stage 4.doc Version 1.30 Page 20 Commission for Social Care Inspection 11th Floor, International House Dover Place Ashford Kent TN23 1HU 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 Grenham Bay Court v231971 h56-h05 s34959 grenham bay court v231971 080605 stage 4.doc Version 1.30 Page 21 - 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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