This inspection was carried out on 25th October 2005.
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.
CARE HOMES FOR OLDER PEOPLE
Grimsargh House Residential Home Preston Road Grimsargh Preston Lancashire PR2 5JE Lead Inspector
Ms Susan Dale Unannounced Inspection 25th October 2005 11:00 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 Grimsargh House Residential Home DS0000009820.V252461.R01.S.doc Version 5.0 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. Grimsargh House Residential Home DS0000009820.V252461.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION
Name of service Grimsargh House Residential Home Address Preston Road Grimsargh Preston Lancashire PR2 5JE 01772 651031 01772 653994 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) Stanner Manufacturing Limited Mrs Shirley Ithurralde Care Home 28 Category(ies) of Old age, not falling within any other category registration, with number (28) of places Grimsargh House Residential Home DS0000009820.V252461.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION
Conditions of registration: 1. The Registered Person shall at all times employ a suitably qualified and experienced Manager who is registered with the Commission for Social Care Inspection. The home shall accommodate no more than 28 (twenty eight) service users within the category of Old Age not falling within any other category. 24th May 2005 2. Date of last inspection Brief Description of the Service: Grimsargh House is situated within extensive grounds in the village of Grimsargh. The home is registered for 28 service users and provides personal care to older people over the age of sixty-five years both male and female. The home is not purpose built and has three floors accessible by a lift. There is ample communal space with two conservatories as well as a large dining room and lounge. Service users are only allowed to bring in pets after prior consultation with the manager; there are two cats belonging to the home. The service provided is intended for service users who are fairly independent and do not require nursing care. Grimsargh House Residential Home DS0000009820.V252461.R01.S.doc Version 5.0 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. The inspection was unannounced and the focused mainly on the standards not assessed at the last inspection. The inspector was able to speak to service users and staff and examine various records. A tour of the premises took place. What the service does well: What has improved since the last inspection?
The manager is constantly striving to improve all aspects of the home and currently is considering new paperwork for the recording of care plans etc; how successful this has been will be assessed at the next inspection. One of the bedrooms has been decorated and the corridor has been decorated and re-carpeted. An additional shower is to be installed in one of the bathrooms, as most service users prefer a shower. Grimsargh House Residential Home DS0000009820.V252461.R01.S.doc Version 5.0 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. Grimsargh House Residential Home DS0000009820.V252461.R01.S.doc Version 5.0 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 Grimsargh House Residential Home DS0000009820.V252461.R01.S.doc Version 5.0 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 the following standard(s): 2 All service users are provided with a contract/terms and conditions of residency. EVIDENCE: There was evidence that each service user is provided with their own signed copy of a contract/terms and conditions of residency. The contracts seen cover all areas and are in fairly large print and user friendly. The contract is signed and dated by both the service user and the manager and both parties hold a copy. Grimsargh House Residential Home DS0000009820.V252461.R01.S.doc Version 5.0 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 the following standard(s): 9 & 11 There is a suitable policy and procedure for the provision of medication and suitable procedures are in place with regard to the death of a service user. EVIDENCE: At the initial assessment service users are assessed as to whether there are any risks associated with them self-medicating or whether they need assistance from staff. The details are recorded and any risks associated with self-medication are recorded; lockable storage for medication is provided in the service users bedrooms. Other medication is stored in an appropriate purpose built trolley that can be secured to the wall. A record is kept of the medication provided and oversight to ensure the details are correctly recorded is provided by the manager. Currently there are eight staff trained to provide medication; the local chemist and also the registered manager have provided training; staff have also attended one day medication awareness training. Controlled drugs are suitably stored in a separate area and a record is maintained by two staff each time the medication is provided. Grimsargh House Residential Home DS0000009820.V252461.R01.S.doc Version 5.0 Page 10 A policy is available regarding the procedures to follow in the event of a death of a service user; the procedures are kept in an accessible place on the wall of the office. At the initial assessment details are recorded about the wishes of each service user with regard to their death or an emergency of any kind; a relative generally completes the form. Grimsargh House Residential Home DS0000009820.V252461.R01.S.doc Version 5.0 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 the following standard(s): There were no standards assessed at this inspection EVIDENCE: Grimsargh House Residential Home DS0000009820.V252461.R01.S.doc Version 5.0 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 the following standard(s): 17 There are suitable procedures operating in the home that ensure the legal rights of service users are protected. EVIDENCE: Service Users are able to vote by either a visit or by post. Information about the advocacy service in order to protect the legal rights of service users is available within the home. The advocacy service has been contacted in the past over the interests of individual service users. Grimsargh House Residential Home DS0000009820.V252461.R01.S.doc Version 5.0 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 the following standard(s): 20, 21, 22, 23, 24, & 25 The home is clean and well maintained. There are sufficient toilet and bathing facilities and service users’ personal accommodation is safe clean and comfortable. EVIDENCE: The home has extensive communal space that includes a large lounge and a smaller sun lounge; there is also a patio that provides safe outdoor space. Lighting is domestic in character and the furnishings within the home are of good quality and suitable for the range of interests preferred by the service users. The home has accessible toilets close to the lounge and dining areas. The home has four bathrooms and one shower all providing assisted bathing. The majority of rooms (15) have en-suite facilities; there are plans to change one of the bathrooms and add an additional shower, as this is the choice of the majority of service users. Specialist equipment is provided according to the needs of the service users and there is a call system located within each room.
Grimsargh House Residential Home DS0000009820.V252461.R01.S.doc Version 5.0 Page 14 All the bedrooms are beautifully decorated and provide a neutral backdrop for any furnishings preferred by the service user. The carpets, curtains and fittings are of good quality and the majority of rooms have plenty of space for service users’ own possessions. All the rooms can be locked and there is the facility to store medication, money and valuables safely. The bedrooms are centrally heated and the temperature can be controlled individually. Radiators are guarded to provide safe surface temperatures. Water is stored at a safe temperature and evidence was provided to show individual water temperatures are checked each week and they have met the required temperature of 43 degrees. Emergency lighting is provided throughout the home. Grimsargh House Residential Home DS0000009820.V252461.R01.S.doc Version 5.0 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 consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 28 & 29 Training is a high priority and the number of staff with an appropriate qualification is high. The recruitment policy and procedure for staff ensures the care and safety of service users. EVIDENCE: All staff are encouraged to attend training and out of the total of 15 care staff, 10 staff already have an NVQ qualification. In addition, a further four staff have commenced NVQ training, three staff are in the process of obtaining a qualification at NVQ level 4. There is a suitable policy and procedure for the recruitment of staff and three new staff have commenced since the last inspection. The documentation was examined and all necessary checks had been undertaken prior to the staff commencing at the home; all of them had been provided with an inductiontraining programme that covered all areas. Grimsargh House Residential Home DS0000009820.V252461.R01.S.doc Version 5.0 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 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 33 & 37 The care and happiness of the service users is central in the procedures operating within the home. Service users are able to contribute and have access to their individual records. EVIDENCE: All the records seen were up to date and in good order; service users are provided with information about their ability to have access to their personal records at any time. The home is registered and complies with the requirements of the Data Protection Act. Quality assurance monitoring systems have been put into place with questionnaires devised and provided to service users, relatives and district nurses and provided approximately four times a year. The results are analysed and the results shared with the service users and staff. Grimsargh House Residential Home DS0000009820.V252461.R01.S.doc Version 5.0 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 Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X 3 X X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 X 8 X 9 3 10 X 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 X 13 X 14 X 15 x COMPLAINTS AND PROTECTION Standard No Score 16 X 17 3 18 x X 3 3 3 3 3 3 x STAFFING Standard No Score 27 X 28 3 29 3 30 x MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score X X 3 X X X 3 x Grimsargh House Residential Home DS0000009820.V252461.R01.S.doc Version 5.0 Page 18 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. Refer to Standard Good Practice Recommendations Grimsargh House Residential Home DS0000009820.V252461.R01.S.doc Version 5.0 Page 19 Commission for Social Care Inspection North Lancashire Area Office 2nd Floor, Unit 1, Tustin Court Port Way Preston PR2 2YQ National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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