Inspection on 12/02/07 for Gresley House Care Home

This inspection was carried out on 12th February 2007.

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

Gresley House Care Home 23/06/08

Gresley House Care Home 15/10/07

Gresley House Care Home 16/08/06

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

CARE HOMES FOR OLDER PEOPLE Gresley House Care Home Market Street Church Gresley Swadlincote Derby DE11 9PN Lead Inspector Vanessa Davies Key Unannounced Inspection 12th February 2007 09:30 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Gresley House Care Home DS0000067515.V329107.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. Gresley House Care Home DS0000067515.V329107.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Gresley House Care Home Address Market Street Church Gresley Swadlincote Derby DE11 9PN 01283 212094 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) Mrs Judith Dena Griffin Stewart Westley Barker Vacant Care Home 27 Category(ies) of Dementia - over 65 years of age (11), Old age, registration, with number not falling within any other category (14), of places Physical disability (2) Gresley House Care Home DS0000067515.V329107.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. 4. 2 places within the total of 27 can be used for (PD) either sex aged 50 - 65 yrs. Plus one (1) day care placement not regulated by Commission for Social Care Inspection. An additional PD place for CW - This person is named in the noticed of proposal (CW) this agreed place will cease on the termination of this person. For the home to accommodate one named person in the notice of proposal (PS) this agreed place will cease on the termination of this persons care at the home. 16th August 2006 Date of last inspection Brief Description of the Service: Gresley House care home provides personal care and accommodation for up to 27 people aged 65 years and over, including 2 places for persons 50 - 65 years and 1 day care place. Gresley House is situated in Church Gresley town centre, close to shops and local amenities; the home does not have a car park, however there is roadside parking outside the home. Residents have access to a well set out garden area. The home is situated on 2 floors and has 25 single rooms and 1 double room. Access to the first floor is by stairs and a passenger lift. The home has 4 lounge and dining areas. Gresley House Care Home DS0000067515.V329107.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection visit was unannounced. The Acting Manager was available throughout the visit. Information to formulate this report was gathered before and during the visit by reading documentation, speaking with residents, speaking with staff and speaking with the Acting Manager. What the service does well: The Provider has made a large number of positive changes within the home. A new care planning system has been implemented since the last visit. Residents spoken with stated that the staff respected their privacy and dignity and this was observed during the inspection. The home assists residents and relatives to maintain contact, there are no unnecessary restrictions on visiting. Staff have built good positive relationships with residents and those spoken with stated that the staff, the Acting Manager and the provider are lovely. Activities are varied and meet the needs of the residents. Residents stated that the food was lovely and that they had a choice, if they did not want what was on the menu an alternative would be provided. The home keeps a record of food offered. The menu appeared to offer a varied and healthy diet. Residents spoken with considered that staff were approachable and that concerns were listened to and acted upon. The home has a detailed complaints procedure. The majority of the staff team have achieved NVQ 2 or above in Care. There is a low staff turnover, the staff team is established and appear to work well together and since the Acting Manager has commenced at the home fulltime there is now continuity and staff are well supported. The new provider is implementing a detailed quality audit document, this will ensure that all care provided is audited regularly and changed accordingly. Gresley House Care Home DS0000067515.V329107.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. Gresley House Care Home DS0000067515.V329107.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 Gresley House Care Home DS0000067515.V329107.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): 3,6 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Detailed information gathered prior to any move to the home and updating this information on a regular basis ensures that the changing needs of the residents are met and a good standard of care provided. EVIDENCE: Three residents files were examined during the visit. Each of the files had an assessment of need in place, there was evidence of these being completed prior to admission and kept up to date by the Acting Manager since admission. The new Acting Manager and staff team have clearly worked hard to ensure that the assessments of need highlight the needs to be addressed, are completed prior to admission to ensure that needs can be met and are kept up to date to ensure that changing needs are met. The Provider stated at the previous inspection visit that she was in the process of implementing new assessments and care plans and this has been completed for many of the Gresley House Care Home DS0000067515.V329107.R01.S.doc Version 5.2 Page 9 residents and will continue until all residents have a new assessment and care plan in place. Although the assessments are much improved the Acting Manager should ensure that the resident an/or relatives have input with their assessment and care plan and that this is evidenced within their file. The home does not provide intermediate care. Gresley House Care Home DS0000067515.V329107.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 adequate This judgement has been made using available evidence including a visit to this service. Clear assessments of need and care plans ensure that highlighted needs are met, however limited information relating to social needs and medication being administered by staff not trained to do so potentially prevents staff from meeting the holistic needs and puts them at risk. EVIDENCE: Residents spoken with stated that the staff respected their privacy and dignity and this was observed during the inspection. The care plans and assessments of need have improved greatly since the previous inspection. Care plans contain necessary detail to assist the staff with meeting resident’s medical needs, however the social information contained within the files examined was very limited, one file examined stated within the ‘social life/community links’ ‘daughter and grand-daughter live in ……….’ Gresley House Care Home DS0000067515.V329107.R01.S.doc Version 5.2 Page 11 Residents spoken with felt that their health needs were being met. Within the files examined there was evidence of risk assessments for tissue viability, nutritional needs and manual handling. The new Provider assured the inspector at the previous inspection visit that she intended to implement new paperwork, and this was clearly evidenced during this visit. Arrangements were in place to enable residents to be seen by an optician and chiropodist on a regular basis, and a dentist as required. All contact/visits from G.P.s, optician and chiropodist were documented. It was evident on the day of inspection that one member of staff had administered medication without having received training to do so. The home keeps a clear record of medication received and administered at the home. The Acting Manager has changed the medication file to include photographs and room numbers of the residents, evidence of good practice. Gresley House Care Home DS0000067515.V329107.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 good. This judgement has been made using available evidence including a visit to this service. Contact with family and friends is encouraged, ensuring residents maintain contact with their community, assisting in the promotion of choice and independence. EVIDENCE: Residents and staff confirmed that contact with family and friends is supported. Residents said that family and friends can visit at any reasonable time and are made to feel welcome in the home. The Acting Manager makes herself available to relatives and appears approachable. Residents said that the staff were lovely. Discussions with residents and observations showed that residents are helped to exercise choice and control over their lives, where possible. Residents said that the daily routines are flexible. Residents spoken with said that they were satisfied with the level of activities provided in the home, and said that there personal interests were supported. A number of residents were playing dominoes during the visit. A couple of Gresley House Care Home DS0000067515.V329107.R01.S.doc Version 5.2 Page 13 residents attended local centres, and one resident spoken with was involved in an advocacy group in the community and stated that this was supported by the staff and gave her a great deal of independence. Residents stated that the food was lovely and that they had a choice, if they did not want what was on the menu an alternative would be provided. The home keeps a record of food offered. The menu appeared to offer a varied and healthy diet. Gresley House Care Home DS0000067515.V329107.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 adequate. This judgement has been made using available evidence including a visit to this service. Detailed complaints and Safeguarding Adults procedures and an Acting Manager who is aware of what to do in the event of an allegation of abuse ensures that residents are safe, however lack of staff training in Safeguarding Adults potentially puts residents at risk. EVIDENCE: Residents spoken with considered that staff were approachable and that concerns were listened to and acted upon. Since the change of Provider and the new Acting Manager has been at the home complaints are recorded and addressed. The home has a detailed complaints procedure and residents spoken with were aware of it and confident that complaints would be addressed. Detailed policies and procedures were in place to safeguard resident’s. The Acting Manager was aware of her role in the event of an allegation of abuse. Although a number of staff have received training in the Safeguarding of Adults, there was evidence that some staff still needed to complete the training. The Acting Manager stated that she ensures that staff are aware of the procedure in the event of an allegation of abuse and are made aware of what abuse is. Gresley House Care Home DS0000067515.V329107.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 poor. This judgement has been made using available evidence including a visit to this service. The poorly maintained carpets, lack of window restrictors and hot radiators potentially put residents at risk of harm. EVIDENCE: Residents consider that the environment is homely and comfortable and is maintained to a good standard, however there were areas on the day of the visit, which raised concerns. The carpet in the dining room had a number of ‘bubbles’ in which could potentially be a trip hazard; the carpet leading from the hall into the lounge was frayed, again potentially causing a trip hazard. When a number of windows were checked on the first floor there were no restrictors. The radiators in the hall were too hot to touch and had no covers or risk assessments in place. Gresley House Care Home DS0000067515.V329107.R01.S.doc Version 5.2 Page 16 The home was clean and free from odours at the time of the inspection. The duty rota evidenced that domestic cover was provided 7 days a week and laundry cover is provided 5 days a week. Gresley House Care Home DS0000067515.V329107.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 adequate. This judgement has been made using available evidence including a visit to this service. A high percentage of staff have received training in NVQ2 Care, however there are a number of training shortfalls and this potentially puts residents at risk. EVIDENCE: Training records confirmed that over 50 of care staff had achieved or were in the process of achieving a national approved qualification (N.V.Q Level 2 or 3), to ensure they are trained and competent to do their job, however there were a number of short falls in the training. A number of staff appeared to need fire safety training, although the Acting Manager stated that the training has been completed and certificates were awaited. Safeguarding Adults training was needed for a number of staff as was First Aid. Staff and residents considered that the staffing levels were sufficient to meet residents’ needs. The home has an established staff team, with a very supportive Acting Manager and Provider. The home continues to have a low turnover of staff. The Provider ensures that the home follows a rigorous recruitment procedure and this was evident when examining staff files. Gresley House Care Home DS0000067515.V329107.R01.S.doc Version 5.2 Page 18 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): 31,33,38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. A qualified and competent manager in post provides the staff and residents with necessary stability ensuring that changing needs are met and the service progresses as necessary. EVIDENCE: The Acting Manager reported that although a number of staff still need to undertake mandatory training, she and the provider were in the process of arranging further training. The Acting Manager has many years experience working with older people and has managed another of the providers homes. The Provider is in the process of implementing a detailed quality audit document, this will ensure that all care provided is audited regularly and Gresley House Care Home DS0000067515.V329107.R01.S.doc Version 5.2 Page 19 changed accordingly. The Acting Manager has started to review the care plans and assessments of need, which is a great improvement on the last visit. The Acting Manager informed the inspector that the fire alarm system could now be heard from the laundry room, Fire systems are checked regularly and residents spoken with were aware of what to do in the event of a fire, as were the staff. As stated previously within this report there are areas within the home, which need to be made safe to ensure that residents are not put at risk. Gresley House Care Home DS0000067515.V329107.R01.S.doc Version 5.2 Page 20 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 X X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 1 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 2 1 X X X X X X 3 STAFFING Standard No Score 27 3 28 2 29 3 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X X X X 2 Gresley House Care Home DS0000067515.V329107.R01.S.doc Version 5.2 Page 21 Are there any outstanding requirements from the last inspection? YES 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 OP18 Regulation 13.6 Requirement Timescale for action 30/06/07 2. 3. 4. 5. OP9 OP19 OP19 OP28 All staff and the Registered Manager must receive training in Adult Protection. (Previous timescale 30/09/06) 13.2 18.1 Medication must be administered ci by staff trained to do so. 13.4 a, c Unnecessary risks to health and safety must be identified and eliminated. 23.2(b) All parts of the home must be 13.4(a) free from hazards. 18.1 (c)(i) Staff must receive training appropriate to the work they undertake. 12/02/07 12/02/07 12/02/07 30/06/07 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. 2. Refer to Standard OP3 OP7 Good Practice Recommendations The Acting Manager should ensure that new assessments of need and care plans are implemented for all residents. Detailed social histories should be sought for all residents to assist staff with meeting needs. Gresley House Care Home DS0000067515.V329107.R01.S.doc Version 5.2 Page 22 Commission for Social Care Inspection Derbyshire Area Office Cardinal Square Nottingham Road Derby DE1 3QT 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 Gresley House Care Home DS0000067515.V329107.R01.S.doc Version 5.2 Page 23 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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