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Inspection on 22/08/05 for Grisedale Croft

Also see our care home review for Grisedale Croft for more information

This inspection was carried out on 22nd August 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.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

The home carries out in-depth assessments of people before admission, to ensure their individual needs can be met and the correct level of care given. The care staff have all the information required, through the corporate care planning system, to provide a high level of care. All healthcare needs are met, with a record of all professional healthcare visits and external appointments noted on the supervisor`s record sheets. Residents said they were able to see the doctor or nurse when they wanted to. There is a limited programme of activities for those wishing to join in. Efforts are made to ensure that a nutritious and varied menu is provided with a choice at each meal.

What has improved since the last inspection?

Changes in the allocation of staff hours to take into account the extra given to the home have ensured a higher level of care and given the staff the opportunity of spending more time with the resident on a one to one basis.

What the care home could do better:

There were no requirements or recommendations made during the inspection and this home continues to provide a good standard of care.

CARE HOMES FOR OLDER PEOPLE Grisedale Croft Church Road Alston Cumbria CA9 3QS Lead Inspector Margaret Drury Unannounced 22 August 2005 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. Grisedale Croft F58 F10 s36586 grisedale croft v242224 220805 ui stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Grisedale Croft Address Church Road Alston Cumbria CA9 3QS 01434 381221 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) Cumbria Care Sandra Shepherd Care Home 19 Category(ies) of 19 OP - Old Age registration, with number 2 DE(E) - Dementia, over 65 of places Grisedale Croft F58 F10 s36586 grisedale croft v242224 220805 ui stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: 1. The service must at all times employ a suitably qualified and experienced manager who is registered with the Commission for Social Care Inspection 2. The home is registered for a maximum of nineteen service users to include: - up to 19 service users in the category of OP (Older people not falling within any other category) - up to 2 service users in the category of DE(E) (Dementia over 65 years of age) 3. The staffing levels for the home must meet the Residential Forum Care Staffing Formula for Older Adults. 4. When single rooms of less than 12sqm usable floor space become available they must not be used to accommodate wheelchair users, and where existing wheelchair users are in bedrooms of less than 12sqm they must be given the opportunity to move to a larger room when one becomes available. 5. This registration includes a total of 6 residents accommodated as follows: Flat 1 - 1 Resident Flat 2 - 1 Resident Flat 3 - 1 Resident Flat 4 - 1 Resident Flat 6 - 2 Residents 6. The manager has no responsibilities, other than in an emergency for any other flats or accommodation attached to the home.. Date of last inspection 16 March 2005 Grisedale Croft F58 F10 s36586 grisedale croft v242224 220805 ui stage 4.doc Version 1.40 Page 5 Brief Description of the Service: Grisedale Croft is a care home offering accomodationan and care for up to 19 older people, two of whom may have varying forms of dementia. The home is operated by Cumbria Care, an internal business unit of Cumbria County Council. Grisedale Court is situated on two floors, the upper being served by a passenger lift and a stair lift. All the rooms are for single occupation, six of them having a small kitchen and toilet. There are bedrooms on the ground floor, together with a lounge/diner, smoking lounge, a bathroom and toilets. On the first floor there are bedrooms, a lounge/diner, bathroom and toilets. The six rooms with the kitchen and toilet are situated on the mezzanine floor that is accessed by a short flight of stairs and the stair lift. There are well kept gardens and car parking at the front of the building. Grisedale Croft F58 F10 s36586 grisedale croft v242224 220805 ui stage 4.doc Version 1.40 Page 6 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced inspection of the home, and took place over one morning. During the inspection, time was spent talking with the supervisor, care staff on duty and the cook. Records to do with the day-to-day running of the home and the care of residents were examined. Time was spent with the residents individually and most of the home was inspected during the visit. What the service does well: What has improved since the last inspection? Changes in the allocation of staff hours to take into account the extra given to the home have ensured a higher level of care and given the staff the opportunity of spending more time with the resident on a one to one basis. Grisedale Croft F58 F10 s36586 grisedale croft v242224 220805 ui stage 4.doc Version 1.40 Page 7 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. Grisedale Croft F58 F10 s36586 grisedale croft v242224 220805 ui stage 4.doc Version 1.40 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 Standards Statutory Requirements Identified During the Inspection Grisedale Croft F58 F10 s36586 grisedale croft v242224 220805 ui stage 4.doc Version 1.40 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 2, 3, 4 & 5 Residents benefit from an admission process that ensures a full assessment of need is completed prior to admission. EVIDENCE: The home has a full admission procedure, which means all residents have an in-depth assessment prior to admission, to ensure all the needs can be met and the correct level of care delivered. Family members and/or friends are encouraged to visit the home to meet the staff and look around before any resident is admitted. Grisedale Croft F58 F10 s36586 grisedale croft v242224 220805 ui stage 4.doc Version 1.40 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 7, 8, 10 & 11 The home has a clear and consistent care planning system, which ensures residents’ health, and social care needs are met in a way that promotes their privacy and dignity. EVIDENCE: The home uses the corporate care planning system and this was examined during the inspection. The care plans contained information about residents care needs, including moving and handling assessments. They are regularly reviewed and updated by the supervisor and key worker. The plans provide the care staff with the information needed to deliver the level of care required to meet the assessed needs. Details of healthcare needs and professional visits are recorded on daily record sheets and residents said that they only have to request a G.P. visit and the appointment is made. The care staff speak to the residents in a courteous and polite manner and always knock before entering bedrooms. Residents said that the staff give personal care in a way that preserves their privacy and dignity, whilst encouraging independence. Details of the residents’ wishes after death are recorded on the care plans. Grisedale Croft F58 F10 s36586 grisedale croft v242224 220805 ui stage 4.doc Version 1.40 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) 12, 13 & 15 Limited social activities are organised and provide entertainment and stimulation for people living in the home. Links with the local community are good and meals are nutritious and balanced, offering a healthy and varied diet. EVIDENCE: There is a limited programme of activities organised and discussions with the supervisor evidenced that most of the residents enjoyed what is organised for them. A group of residents organise their own nightly game of dominoes. A monthly church service takes place and Communion is provided for those who wish to partake. There are visiting entertainers and a weekly exercise class. Staff take residents out to the library, the shops and for coffee. Visitors are welcome any time and there is a varied, five-week menu providing nutritious meals with a choice given at all times. Grisedale Croft F58 F10 s36586 grisedale croft v242224 220805 ui stage 4.doc Version 1.40 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) 16, 17 & 18 Staff have a good knowledge and understanding of adult protection issues, which safeguards the residents from harm or abuse. Residents benefit from the complaints procedure, a copy of which is included in the Statement of Purpose. EVIDENCE: Residents are given information about how to complain when moving into the home, and said that if they had any issues to raise they were sure they would be dealt with promptly. Information about making a complaint is included in the Statement of Purpose, copies of which are on display throughout the home. There is a full abuse policy in place and staff have completed training in this subject. There are also adult protection training videos available for staff to use. Discussions with staff evidenced their knowledge of adult protection and of what action to take should this be required. All the residents are given the opportunity to take part in the local and national elections. Grisedale Croft F58 F10 s36586 grisedale croft v242224 220805 ui stage 4.doc Version 1.40 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) 19, 20, 21, 22, 23, 24 & 26 Residents benefit from a warm, safe and pleasant environment in which to live. EVIDENCE: Although there is an annual maintenance programme authorised by staff at Head Office the home is now looking “a little tired” in parts and some internal re-decoration would benefit the residents. Access for residents is good, with a passenger lift servicing all floors. The bathing and toilet facilities on both floors are suitable for residents with a physical disability. There is sufficient communal space for activities and for residents to have private visits if they wish. All the bedrooms are for single occupancy and although some are a little on the small side, the residents said they were quite happy with them. They are all personal to the residents and contain pictures, photographs and ornaments. Domestic arrangements in the home ensure it is clean, pleasant and hygienic. Grisedale Croft F58 F10 s36586 grisedale croft v242224 220805 ui stage 4.doc Version 1.40 Page 14 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, 29 & 30 A staff group, who are appointed following a robust and thorough recruitment procedure, cares for the residents. This ensures maximum protection for those living in the home. EVIDENCE: The manager uses her allocation of staff hours well and for the benefit of the residents. A recent increase of 18 hours means that care staff should be able to spend more time with the residents on a one to one basis. Cumbria Care has a full recruitment and selection policy with all the necessary checks being completed prior to the start of employment. Staff training is up to date with a number of care staff already qualified to NVQ level 2 and others currently working towards the award. Staff supervision contributes to the competency of the staff. Grisedale Croft F58 F10 s36586 grisedale croft v242224 220805 ui stage 4.doc Version 1.40 Page 15 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, 33, 34, 35, 36 & 37 Although the manager was not on duty on the day of the inspection there was an indication of leadership, guidance and direction to staff to ensure residents receive consistent good quality care. EVIDENCE: The manager was not available on the day of the inspection but the supervisor on duty was able to assist the inspector. Those staff interviewed said they found the manager supportive and approachable, which motivated them to improve their knowledge and skills and so continue providing good care to the residents. There was a system that was followed when looking after money on behalf of residents, which safeguarded their financial affairs. The viability of the home is in the hands of the accountants at the organisation’s head office. There are policies and procedures in place and these, together with the home’s record keeping, safeguard the residents and contribute to their welfare. Grisedale Croft F58 F10 s36586 grisedale croft v242224 220805 ui stage 4.doc Version 1.40 Page 16 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 3 3 3 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 x 10 3 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 x 15 3 COMPLAINTS AND PROTECTION 3 3 3 3 3 3 x 3 STAFFING Standard No Score 27 3 28 x 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 3 3 x 3 3 3 3 3 3 x Grisedale Croft F58 F10 s36586 grisedale croft v242224 220805 ui stage 4.doc Version 1.40 Page 17 NO 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 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. 1. Refer to Standard Good Practice Recommendations Grisedale Croft F58 F10 s36586 grisedale croft v242224 220805 ui stage 4.doc Version 1.40 Page 18 Commission for Social Care Inspection Eamont House Penrith 40 Business Park Gillan Way Penrith, Cumbria CA11 9BP 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 Grisedale Croft F58 F10 s36586 grisedale croft v242224 220805 ui stage 4.doc Version 1.40 Page 19 - 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. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!