Inspection on 07/05/09 for Grindley House Care Home

This inspection was carried out on 7th May 2009.

CQC found this care home to be providing an Adequate service.

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

Grindley House Care Home 13/06/08

Similar services:

Polesworth Group Friary Road

Polesworth Group Pooley Heights

Polesworth Group 32 Station Road

Polesworth Group 70 Long Street

Breme

Polesworth Group 64 Long Street

Polesworth Group 68 Long Street

10 Whitfield Avenue

Extracts from inspection reports are licensed from CQC, this page was updated on 06/08/2009.

Key inspection report CARE HOMES FOR OLDER PEOPLE Grindley House Care Home Aynsleys Drive Blythe Bridge Stoke on Trent Staffordshire ST11 9HJ Lead Inspector Dawn Evans Unannounced Inspection 7th May 2009 09:00 DS0000067071.V375204.R01.S.do c Version 5.2 Page 1 This report is a review of the quality of outcomes that people experience in this care home. We believe high quality care should: • • • • • Be safe Have the right outcomes, including clinical outcomes Be a good experience for the people that use it Help prevent illness, and promote healthy, independent living Be available to those who need it when they need it. We review the quality of the service against outcomes from the National Minimum Standards (NMS). Those standards are written by the Department of Health for each type of care service. Copies of the National Minimum Standards – Care homes for older people can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop. The mission of the Care Quality Commission is to make care better for people by: • Regulating health and adult social care services to ensure quality and safety standards, drive improvement and stamp out bad practice • Protecting the rights of people who use services, particularly the most vulnerable and those detained under the Mental Health Act 1983 • Providing accessible, trustworthy information on the quality of care and services so people can make better decisions about their care and so that commissioners and providers of services can improve services. • Providing independent public accountability on how commissioners and providers of services are improving the quality of care and providing value for money. Grindley House Care Home DS0000067071.V375204.R01.S.doc Version 5.2 Page 2 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report Care Quality Commission General Public 0870 240 7535 (telephone order line) Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Grindley House Care Home DS0000067071.V375204.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Grindley House Care Home Address Aynsleys Drive Blythe Bridge Stoke on Trent Staffordshire ST11 9HJ 01782 398919 01782 395221 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) Sudera Care Associates Limited Marie Elizabeth Bryan Care Home 22 Category(ies) of Past or present drug dependence over 65 years registration, with number of age (2), Learning disability over 65 years of of places age (6), Mental Disorder, excluding learning disability or dementia - over 65 years of age (4), Old age, not falling within any other category (22) Grindley House Care Home DS0000067071.V375204.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: None Date of last inspection 13th June 2008 Brief Description of the Service: Grindley House is located in Stoke On Trent, Staffordshire and provides a residential service for older people. The detached property is set within it’s own grounds in a quiet residential area. The home is in walking distance to local amenities, such as pubs, shops and local bus route. The property offers 18 single and two shared bedrooms located on both the ground and first floor. En suite facilities are not provided but all bedrooms have a washbasin. Bathing facilities and toilets are located near to bedrooms and communal areas. The home also provides three lounges, a dining room, kitchen and laundry. All areas of the home are equipped with essential furnishings and fitments to ensure people’s comfort. Equipment and adaptations are provided to promote people’s independence, such as, ramp access to the property, grab rails, assisted baths and a stair lift. People have access to a well-maintained garden at the front and rear of the property. Staffing is provided on a 24 hour basis to ensure people have the necessary support when required. People also have access to relevant healthcare services. Information about the fees charged for the service provided at the home was not made available. The reader is advice to contact the service directly for this information. Grindley House Care Home DS0000067071.V375204.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 1 Star. This means the people who use this service experience adequate quality outcomes. This inspection was carried out over one day; the home did not know we were going to visit. The focus of inspections we, the Care Quality Commission, undertake is upon outcomes for people who use the service and their views of the service provided. This process considers the care homes capacity to meet regulatory requirements, standards of practice and focuses on aspects of service provision that need further development. Prior to the visit taking place we looked at all the information that we have received, or asked for, since the last key inspection. This included an Annual Quality Assurance Assessment (AQAA). This is a document that provides information about the home and how they think that it meets the needs of people living there. Three people living in the home were ‘case tracked.’ This involves establishing individual’s experiences of living in the care home by meeting them, observing the care they receive, discussing their care with staff, looking at care files, and focusing on outcomes. Tracking people’s care helps us to understand the experiences of people who use the service. We looked around some areas of the home. A sample of care, staff and health and safety records were looked at. What the service does well: People have access to relevant healthcare services to ensure their healthcare needs are met. Grindley House Care Home DS0000067071.V375204.R01.S.doc Version 5.2 Page 6 Staffs approach ensures people’s right to privacy is respected. People are offered meals that meet their nutritional needs and promote their health. Bedrooms are personalised to reflect the individual’s style and interests. What has improved since the last inspection? What they could do better: People do not have access to relevant information to enable them to make an informed choice about the suitability of the service to meet their assessed needs. Care plans do not provide staff with the information needed to enable them to support people to meet their health and social needs. Assessment and care planning does not include information about people’s race, culture, gender or sexuality to ensure the service meets their individual needs. Inappropriate management of medicines do not promote people’s health and could place them at risk of harm. Grindley House Care Home DS0000067071.V375204.R01.S.doc Version 5.2 Page 7 Evidence of thorough pre employment safety checks was not available. So we were not assured staff members were suitable to work with vulnerable people. If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line – 0870 240 7535. Grindley House Care Home DS0000067071.V375204.R01.S.doc Version 5.2 Page 8 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 Grindley House Care Home DS0000067071.V375204.R01.S.doc Version 5.2 Page 9 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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 1 and 3 People using the service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People and their representatives do not have access to information needed to enable them to make an informed decision about the home’s suitability to meet their assessed care needs and ensure their best interest. EVIDENCE: Grindley House Care Home DS0000067071.V375204.R01.S.doc Version 5.2 Page 10 The AQAA shows people wishing use the service are provided with information about the Statement of Purpose and Service User Guide. These documents should provide people with the information needed to enable them to establish the home’s suitability to meet their assessed care and social needs. These documents were not accessible to people. Discussions with people who use the service and a visiting relative confirmed they had not received a copy of the Statement of Purpose before accessing the service. We did not see the Statement of Purpose displayed in the home. Since the inspection of this service the manager has now provided a copy of the Statement of Purpose to us. She said this document is provided to people on request. This means people may not have the information needed to make an informed choice or to determine whether the service will meet their needs. The AQAA shows a needs assessment is undertaken before people are admitted to the home. A needs assessment enables the home to find out what people’s care needs are and to ensure staff have all the information they need to meet these needs. We looked at three care records, which confirmed the undertaking of this assessment. People spoken to also confirmed this. This should ensure the service people receive reflects their choice, individuality and promotes their health and social needs. Grindley House does not provide an intermediate care service. Grindley House Care Home DS0000067071.V375204.R01.S.doc Version 5.2 Page 11 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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 and 10 People using the service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are not assured staff will have all the information they need about their health and personal care needs, which may compromise their health and wellbeing. EVIDENCE: The AQAA stated, “We provide on going, in depth care plans to ensure best care and support for individuals.” This information was not entirely correct. We case tracked three people looking at their experiences of living in the home. We looked at their care plan. A care plan should provide information about the person’s assessed care Grindley House Care Home DS0000067071.V375204.R01.S.doc Version 5.2 Page 12 and social needs and tell staff how to meet these needs to promote their health and independence. One care plan showed the person was allergic to Penicillin, other care records relating to this person, stated they had no allergies. The manager confirmed the person was not allergic to Penicillin and she was unsure where this information had come from. Incorrect information of this nature could comprise the care provided by other healthcare professionals and put this person at risk. Care records told us the person was diagnosed with dementia. This information was not contained in the care plan. The manager and staff spoken to also acknowledged this. Staff described the person as “confused” and told us about behaviours that challenged the service. The manager confirmed these behaviours and said this information was not written in the care plan. This person’s care could be compromised because the care plan did not tell staff how to meet their mental health needs and ensure their wellbeing. Another care plan showed the person had a health condition. The care plan did not tell staff how to assist the person to manage their health. The manager said this person’s health was managed by medication. We spoke to two care staff who were not aware of the person’s health diagnoses. This means the person cannot be confident staff will have the knowledge to promote their health. We looked at another care plan, which told us the person had a diagnosis of epilepsy. The care plan did not tell staff how to manage this health condition. The manager said the epilepsy was controlled by prescribed medicines and confirmed this information was not in the care plan. The care plan did not contain a record of seizures or tell staff when it would be necessary to obtain advice or support from other healthcare professionals. Staff said they were aware of the person’s health condition, they told us the seizures were infrequent. Staff said, although information about people’s healthcare needs were not written in the care plan, they were aware of their needs. One staff member said the care plans don’t tell you much, they can be quite repetitive. This could result with people being placed at risk because staff are not provided with relevant written information about their health needs or how to support them. Grindley House Care Home DS0000067071.V375204.R01.S.doc Version 5.2 Page 13 One person had signed their care plan showing they were actively involved in their care planning. We looked at a further two care plans which, did not show people’s involvement. Three people spoken to confirmed they were not involved in planning their care. We explained to them what a care plan was and they said they had never seen one. Staff also confirmed people were not involved in planning their care. This could result with people not receiving a service that reflects their choice or care needs. We saw some care plans had not been reviewed for over a month. This may compromise the care provided to people. For example, staff told us about one person’s recent behaviours that challenged the service. This information was not contained in their care plan because it had not been reviewed for more than a month. This does not ensure that information contained in these plans will reflect the persons current care needs and could compromise the level of support and care provided to them. We looked at risk assessments; these should tell staff about potential risks and what support people require to ensure their independence and safety. One risk assessment showed the person required the use of a walking frame but sometimes forgot to use it. The assessment did not tell staff how to ensure this person’s safety whilst walking. For example, it did not tell us if the person required assistance from a carer to mobilise or transfer safely. The lack of written information provided to staff could place people at risk of not receiving the appropriate level of support. The AQAA told us people have access to relevant healthcare services. Care records and discussions with people also confirmed this. We saw an Optician at the home on the day of our visit. Access to these services should promote people’s physical and mental health. We looked at the service’s medication practices and systems. Discussions with staff confirmed they had received a days training in the safe handling of medicines. This should ensure staff have the skills to assist people to take their medicines safely. Discussions with the manager confirmed they had controlled medicines in storage. These are prescribed medicines that need to be stored and recorded separately. These medicines were not stored or recorded appropriately to ensure safety standards. For instance, the home did not have a controlled medication cupboard to ensure the safe storage of these medicines. Since this inspection visit the manager has now confirmed that an appropriate control drug cabinet has been purchased. This should ensure that medicines are security maintained. Grindley House Care Home DS0000067071.V375204.R01.S.doc Version 5.2 Page 14 Records maintained for one medicine stored and recorded as a controlled medicine had not been signed but the balance of tablets remaining suggested the person had received their medicine. The manager also confirmed this. This practice could place people at risk of receiving the incorrect dose of medicine. We looked at medication administration records. This told us what people’s prescribed medicines were and when they need to be given. These records had been signed by staff members in most cases showing when medicines had been administered. This practice should ensure people receive their prescribed medicines regularly, safely and provide an audit trail. The AQAA stated, “Privacy and respect are core values at this home; staff knock on service user’s door before entering.” We observed staff members knocking on doors before entering private rooms. Privacy screening was provided in shared bedrooms. People also confirmed staff respected their privacy. One person said, “Staff always knock my bedroom door before they enter.” These practices should promote people’s rights to privacy. Grindley House Care Home DS0000067071.V375204.R01.S.doc Version 5.2 Page 15 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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 and 15 People using the service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are encouraged to maintain relationships with people important to them but may not receive the support required to enable them to access their local community to pursue their social interests. Access to well balanced nutritional meals promotes people’s health. However, the lack of choice may not reflect their likes and dislikes. EVIDENCE: The AQAA stated, “We have frequent activities which meet the individual needs of service users.” “Outside interests are encouraged and accessed.” Grindley House Care Home DS0000067071.V375204.R01.S.doc Version 5.2 Page 16 The service was unable to evidence this information. We looked at three care records which did not tell us about people’s specific social, cultural or recreational interests. Discussions with the manager confirmed the service had not considered people’s cultural and social needs. The assessment of people needs did not provide comprehensive information relating to their specific needs. Therefore, people cannot be confident the service would enable them to live a lifestyle of their choice or to reflect the importance of their culture, sexuality, gender, race or religious faith. Staff members said social activities within the home consisted of card making, flower arrangements, board games, manicures and reminiscence. We saw these activities displayed on the notice board within the office. One person confirmed access to these activities and said it was their choice not to participate. We saw one person in the garden feeding the birds; others were watching the television and some chose to be within the privacy of their bedroom. People and staff members said social activities within the local community were very infrequent. One staff member said they had been employed with the service for a number of years and had never been on an outing/trip with people because they did not take place very often. People said they don’t go out much unless their relatives take them out. The manager said people do have access to the local community but this was limited and relatives were encouraged to assist with taking people out. The manager said people are somewhat reluctant to participate in social activities within the community. It is recommended that people’s social interests and their involvement in social activities are recorded. Care records told us about people’s religious faith. Staff said a Christian service was held every Wednesday within the home. People we spoke to also confirmed this. One person said they use to attend church every Sunday before moving into the home and they were no longer able to do this. As this person did not have access to the service’s Statement of Purpose or Service User Guide, they may not be ware that the service would support them to practice their faith where they choose. The Statement of Purpose states, “Service users may attend religious services either within or outside the home if they so desire.” “If services are outside the home, the service user should, if necessary and where possible arrange for transport and accompaniment with friends or relatives.” “In the event of this Grindley House Care Home DS0000067071.V375204.R01.S.doc Version 5.2 Page 17 not being possible, care staff may accompany service users on specific occasions if staffing levels permit.” Staff said people would be supported to attend the church of their choice but no one at present had made a request for assistance. The manager confirmed this had not been discussed with people. Hence, they may not be aware they can continue to worship at a place of their choice. The Statement of purpose showed people were able to maintain contact with family and friends. People we spoke to also confirmed this and we also saw visitors on the day of our visit. One visiting relative told us they were able to visit at anytime and staff always made them welcome. People are therefore, assured they will be able to maintain contact with people important to them. Discussions with staff and our observations confirmed people were able to personalise their bedroom to reflect their style and interests. One person showed us their family photographs and ornaments which decorated their room. They told us they enjoyed spending time in their room. The home provided a four week menu to reflect people’s nutritional needs. A menu board was displayed in the dining room showing meals on offer that day. An alternative choice was not shown. We looked at minutes of a meeting undertaken with people who use the service. One person had requested to know the alternative choice when sausage was on the menu. This would ensure people’s preference to meals are reflected. The manager and cook said the alternative choice of meal was not written on the menu board but confirmed people could request this. Due to some people’s memory loss they may not have the skills to do so. One person said, “The food is OK, the meal today was nice.” Another person told us, “The food is very good.” We observed meals were well presented and appeared appetising. Discussions with staff confirmed no one required a special diet due health, religious or cultural needs but were confident they would be able to provide a service for any future dietary requirements. Grindley House Care Home DS0000067071.V375204.R01.S.doc Version 5.2 Page 18 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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18 People using the service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People do not have access to a complaints procedure to share their concerns and ensure their rights are respected. However, they can be confident staff will have the skills to protect them from harm ensuring their best interests. EVIDENCE: The AQAA stated, “Grindley House has a clear and accessible complaint procedure.” The complaints procedure was not available on the day of our visit. Since the inspection of this service the manager has provided evidence of the home’s complaint procedure. One visiting relative told us they had received a copy of this procedure. Three people said they had never seen the complaints procedure but confirmed they would share any concerns with staff or the manager. They said they did not have any reason to complain. The lack of access to a written complaints procedure does not ensure everyone would know how to share their concerns. Grindley House Care Home DS0000067071.V375204.R01.S.doc Version 5.2 Page 19 Staff training records were not made available to us and the AQAA did not tell us if staff had received safeguarding training. However, staff told us they had received this training and they would report any allegations of abuse to the manager or us. This should protect people from potential abuse. The AQAA also told us the service had not received any complaints or safeguarding referrals since the last inspection visit. The manager also confirmed this. We have not received any concerns, complaints or safeguarding referrals. Safeguarding is where there maybe an allegation of abuse or where care practices may compromise people’s health and safety. Grindley House Care Home DS0000067071.V375204.R01.S.doc Version 5.2 Page 20 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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 19 and 26 People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home is clean and suitable to meet people’s needs to ensure their comfort. EVIDENCE: Grindley House is situated in a quiet residential area, the detached property is set within its own grounds. The property provides 18 single and two shared bedrooms located on the ground and first floor. En suite facilities are not provided, although rooms are equipped with a washbasin. The home also offered three lounges, dining Grindley House Care Home DS0000067071.V375204.R01.S.doc Version 5.2 Page 21 room, laundry and kitchen located on the ground floor. The accommodation enables people to choose whether they wish to be alone or socialise with other people who use the service. One person said, “I have a lovely room, I spend all my time here.” Bathing facilities and toilets were situated near bedrooms and communal areas. Equipment and adaptations provided to promote people’s independence and safety consisted of assisted baths, grab rails, ramp access and a stair lift. People had access to well maintain gardens at the front and rear of the property. People said they were happy with the facilities provided and their rooms were comfortable. Discussions with a visiting relative, healthcare professional and people who use the service confirmed the home was always clean and tidy. We also observed all areas of the home were clean and well presented. This should promote people’s health and comfort. Grindley House Care Home DS0000067071.V375204.R01.S.doc Version 5.2 Page 22 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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 and 30 People using the service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Staff members provided in sufficient numbers ensures people’s assessed needs are met but the lack of evidence of recruitment practices does not guarantee the suitability of staff working in the home and this may place people at risk. EVIDENCE: Discussions with the manager and staff members confirmed sufficient staffing levels were provided to meet people’s needs. Staffs working rotas showed a minimum of three staff members were available during the day and two at night. One person said, “There is always someone around, the staff are good and very helpful.” This should ensure people receive the support needed to meet their assessed needs. The AQAA told us 13 out of 21 staff members had completed the National Vocational Qualification (NVQ) level 2 in Care. The manager confirmed these figures. Staff also confirmed receiving this training. NVQ training should ensure staff have the skills to promote good outcomes for people. Grindley House Care Home DS0000067071.V375204.R01.S.doc Version 5.2 Page 23 The AQAA shows staff recruitment practices ensure people have the appropriate safety checks, including Criminal Record Bureau clearance (CRB), Protection of Vulnerable Adults register check (PoVA 1st) and two written references. These safety checks should ensure staff are suitable to work in the home and ensure people are protected from harm. Staff personnel files were not made available to us to confirm these checks were undertaken. The manager said records were being put onto a new Information Technology (IT) system and she did have access to staff files. These files were also not made available at the last inspection visit. However, staff confirmed they had received these safety checks. The AQAA did not provide clear information about staff training and these records were not made available. Staff told us they had received the following training: fire awareness, food hygiene, health and safety, moving and handling, dementia and safeguarding. This training should ensure staff have the skills to maintain quality standards. Grindley House Care Home DS0000067071.V375204.R01.S.doc Version 5.2 Page 24 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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35 and 38 People using the service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People cannot be assured the home will be run in a way that will promote their best interests. EVIDENCE: Grindley House Care Home DS0000067071.V375204.R01.S.doc Version 5.2 Page 25 The AQAA shows the manager is experienced in social care and has obtained the National Vocational Qualification Managers Award. It also told us she continues to undertake further training. This training should influence practices that promote people’s interest, health and welfare. It was apparent the manager had not put this learning into practice. For example, care plans did not tell staff about people’s assessed care needs or how to support them to promote their health and social needs. Poor risk assessments may also place people at risk. People were not provided with relevant information, such as a Statement of Purpose, Service User Guide or Complaints procedure. This means people rights and choice may also be compromised. The AQAA told us the service distributes quality assurance questionnaires. These questionnaires should give people the opportunity to express their views and opinions about quality standards within the home. People we spoke to could not remember receiving these questionnaires. However, we did see some completed questionnaires. The manager said information gathered from these surveys was put into an annual report. This report was not made available to us to show what action would be taken to improve standards within the home and enhance people’s quality of life. We requested to see systems in use to promote quality standards. For example, quality audits regarding care practices and health and health safety. This information was not made available. The manager said she did not have access to these documents. People cannot be confident that standards within the home will ensure they have good outcomes or promote their health, independence and rights. The AQAA was sent to us within the required timescale. The AQAA did not demonstrate the manager understood the shortfalls within the service and how this would be improved so people’s welfare can be assured. Record management was poor. Staff personnel and training records were not made available to show if staff were suitable to work in the home to ensure people’s safety. The manager said the home held a small amount of cash in safekeeping for some people, records of transactions and balances were maintained. Receipts were also maintained. This should ensure people’s finances are managed to protect them from financial abuse. The home had a current fire risk assessment in place. This should enhance fire safety standards and ensure staff know what to do in the event of a fire. Grindley House Care Home DS0000067071.V375204.R01.S.doc Version 5.2 Page 26 We looked at safety records, which showed lifting appliances, were routinely serviced twice a year ensuring people’s safety. Discussions with the manager and staff members confirmed they had received health and safety training ensuring safe working practices. Grindley House Care Home DS0000067071.V375204.R01.S.doc Version 5.2 Page 27 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 2 X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 1 8 3 9 2 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 2 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 2 17 X 18 3 3 X X X X X X 3 STAFFING Standard No Score 27 3 28 3 29 2 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 X 1 X 3 X X 3 Grindley House Care Home DS0000067071.V375204.R01.S.doc Version 5.2 Page 28 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. 1. Standard OP7 Regulation 15(1)(2)( a)(b)(c)(d ) Requirement Care plans do not provide information about people’s assessed care or social needs and don’t tell staff how to support the individual to ensure their needs are met. Measures must be taken so staff are provided with the appropriate written information enabling them to meet people’s assessed needs. Risk assessments told staff about potential risks but did not tell them how to promote people’s independence whilst ensuring their safety. Action must be taken so staff are provided with relevant written information to ensure people’s health and safety. 3. OP9 13(2) The controlled drugs record was not signed to show the person had received their medicine. This could place the person at risk of receiving the wrong dose of medicine. DS0000067071.V375204.R01.S.doc Timescale for action 30/07/09 2. OP8 13(4)(a)( b)(c) 30/07/09 30/06/09 Grindley House Care Home Version 5.2 Page 29 The appropriate measures must be taken to ensure clear concise records are maintained of medicines given. This will promote safety standards. 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 OP1 Good Practice Recommendations To ensure the Statement of Purpose and Service User Guide is made available to people before they move into the home. This will enable them to establish the service’s suitability to meet their assessed needs. To ensure care plans are reviewed on a monthly basis to reflect people’s current health and social needs. Assessments and care planning need to include people’s race, gender, culture and sexuality ensuring their needs are met. To ensure people are involved in their care planning to reflect their choice and individuality. To ensure people’s social interests and their involvement in social activities are recorded. Menus should provide an alternative choice to reflect people’s nutritional needs, likes and dislikes. To ensure people have access to a complaints procedure in a format they understand. This should enable people to share their concerns and promote their rights. To ensure staff training records are made accessible for inspection. This will show if staff are suitably skilled to meet people’s needs. 2. 3. 4. 5. 6. 7. 8. OP7 OP7 OP7 OP12 OP15 OP16 OP30 Grindley House Care Home DS0000067071.V375204.R01.S.doc Version 5.2 Page 30 Care Quality Commission West Midlands West Midlands Regional Contact Team 3rd Floor 77 Paradise Circus Queensway, Birmingham B1 2DT National Enquiry Line: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. 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