Inspection on 07/11/06 for Grisedale Croft

This inspection was carried out on 7th November 2006.

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.

Other inspections for this house

Grisedale Croft 12/11/08

Grisedale Croft 08/03/06

Grisedale Croft 22/08/05

Grisedale Croft 16/03/05

Grisedale Croft 28/07/04

Grisedale Croft 15/03/04

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

CARE HOMES FOR OLDER PEOPLE Grisedale Croft Church Road Alston Cumbria CA9 3QS Lead Inspector Mrs Margaret Drury Unannounced Inspection 7th November 2006 10:45 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 Grisedale Croft DS0000036586.V311919.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. Grisedale Croft DS0000036586.V311919.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Grisedale Croft Address Church Road Alston Cumbria CA9 3QS 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) 01434 381221 www.cumbriacare.org.uk Cumbria Care Ms Sandra Shepherd Care Home 19 Category(ies) of Dementia - over 65 years of age (2), Old age, registration, with number not falling within any other category (19) of places Grisedale Croft DS0000036586.V311919.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. The service must at all times employ a suitably qualified and experienced manager who is registered with the Commission for Social Care Inspection. 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) 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 The manager has no responsibilities, other than in an emergency for any other flats or accommodation attached to the home. 8th March 2006 3 4 Date of last inspection Brief Description of the Service: Grisedale Croft is a care home offering accommodation and care for up to 19 older people, two of whom may have varying forms of dementia. Cumbria Care, an internal business unit of Cumbria County Council, operates the home, which is run on a day-to-day basis by Ms Sandra Shepherd. Grisedale Croft 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 DS0000036586.V311919.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced visit that forms part of the key inspection took place over one day in November. The manager had completed a pre-inspection questionnaire prior to the visit, which contained information about residents, fees staffing and facilities on offer at the home. No completed questionnaires from residents and/or relatives had been received prior to the visit. As the manager was on sick leave following surgery the supervisor in charge was able to assist the inspector during the visit. The inspector was able spend time with the supervisor on duty discussing the operation of the home and looking at the administrative procedures, care plans and records. A tour of the building looking at the environment was undertaken. The inspector spoke with residents, visitors and members of the staff team as well as observing lunch being taken in the two dining areas. The fees charged at this home range from £363.00 to £422.00, as at the date of the visit, with extra charges for hairdressing, newspapers, magazines, personal toiletries hairdressing, private chiropody and some outings. This home does not provide intermediate care. What the service does well: Residents and visitors spoke very highly of the staff and praised the level of care and support provided. The inspector observed warm interaction between staff and residents and visitors said they were “always made welcome and offered tea and biscuits”. The home provides a warm and homely atmosphere with staff supporting residents in their daily life and ensuring the routines within the home are applicable to the assessed needs. Care plans are well kept with all the monthly reviews up to date. Information on them was, in the main relevant and provided sufficient detail for the support workers to meet the assessed needs. Details of professional healthcare visits are noted on the daily records as well as the supervisors’ notes. Medication records were examined and found to be up to date and correctly completed. Grisedale Croft DS0000036586.V311919.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. Grisedale Croft DS0000036586.V311919.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 Grisedale Croft DS0000036586.V311919.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): 2, 3 & 5 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The manager ensures that care needs assessments are completed prior to admission, which helps to ensure the care given is appropriate to meet the needs of the residents. EVIDENCE: Admissions to Grisedale Croft do not take place until a full assessment of needs has been completed. The dependency levels of those already living in the home are also taken into consideration when assessing prospective residents. Family members are often present during the assessment, which ensures they know that the home can meet the assessed needs. Grisedale Croft DS0000036586.V311919.R01.S.doc Version 5.2 Page 9 All prospective residents and their families are invited and encouraged to visit the home prior to their admission. This gives opportunity for them to meet the staff and talk to other people living in the home. Some residents have previously had periods of respite care or attended the home for day care and were familiar with the home and the facilities on offer prior to being admitted. All residents are given a contract and terms and conditions of residency and there is a copy held on each resident’s file. Grisedale Croft DS0000036586.V311919.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): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. An effective and efficient care planning system is in place showing the personal, social and healthcare needs are being met effectively. EVIDENCE: Each resident has a care plan that is used as a working tool and is understood by all staff. It is written in clear language with resident and/or family member involvement wherever possible, and is used to ensure the correct level of care is provided. Each care plan includes a comprehensive risk assessment. Management of risk takes into account the needs of residents and demonstrates a balanced view in maintaining safety while also offering choice. The care plans are updated each month by the supervisors working closely with the key workers. Discussions with the supervisor confirmed that the procedure for reviewing the care plans and the recording of the reviews may Grisedale Croft DS0000036586.V311919.R01.S.doc Version 5.2 Page 11 be changed in the near future. There is a possibility that the system of “tick boxes” for the reviews is to be replaced. All professional healthcare visits are recorded in detail and the supervisor who assisted with the visit confirmed that the home has a very good working relationship with doctors and, in particular, the district nurses who visit the home on a daily basis. Optical, chiropody and dental services are arranged when necessary. The medication is received in a monitored dosage system and all the supervisors responsible for giving out the medication have completed training in “safe handling of medication”. Records were checked and found to be in order. The home follows the corporate policy of having a second member of staff acting as a “checker” when the medication is being given to residents. Residents who spoke with the inspector said that the staff always treated them with respect and kindness and that any personal care required is given in the privacy of their own rooms. They are always asked how they wish to be addressed. Doctor’s visits are arranged on request and those who spoke with the inspector confirmed that they always receive their medication on time. Grisedale Croft DS0000036586.V311919.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. The routines of the home are planned around the residents’ needs and wishes and are flexible enough to meet the changing needs of the individual. EVIDENCE: Routines in the home are flexible and suit the needs of the residents. Those who spoke to the inspector were pleased that they could spend their days as they wish. Some residents choose to take their meals in their rooms Cultural/religious needs are met by regular visits by the clergy and Roman Catholic Communion is provided for those residents who wish to take it. There is Anglican Communion every month. The local Methodist Church also visits the home every three weeks to conduct a service. There are some activities organised but the supervisor and members of staff told the inspector it was not always possible to persuade the residents to take part. Grisedale Croft DS0000036586.V311919.R01.S.doc Version 5.2 Page 13 Visitors to the home are welcome at any time and are invited to stay for a meal if their visit coincides with lunch or tea. Two visitors who spoke with the inspector said what “a lovely welcome they received and they were always given refreshments when they arrived. Copies of the menu were examined and discussions with residents confirmed that they enjoy their meals. One resident was pleased to tell the inspector that “we always have a choice” and the “meals are always hot when they are served”. Special diets are catered for as there are some diet-controlled diabetics living in the home. The inspector was able to observe lunch being served in both dining rooms and noted that the atmosphere was warm and relaxed. Grisedale Croft DS0000036586.V311919.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 good. This judgement has been made using available evidence including a visit to this service. The home has a complaints procedure that is easy to understand and residents feel confident that any issue they raise will be dealt with promptly. Residents are safeguarded by the home’s adult protection policies. EVIDENCE: The home has a complaints book in place but there have been none to record for over a year. The home encourages open dialogue and many of the residents are well able to express their opinions. Details of the complaints procedure forms part of the terms and conditions given to each resident and there is a copy on display. Residents, meeting are organised, which gives the residents the opportunity to air their views. There are policies and procedures in place that outline the rights of those living in the home and these also form part of the terms and conditions of residency. Adult protection issues are discussed during staff induction and this area is also covered in the NVQ training course. Staff interviewed showed a good awareness of abuse issues and the process to follow should this be necessary. Grisedale Croft DS0000036586.V311919.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, 20, 22, 23, 24 & 26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents live in a home that is clean, hygienic and maintained to a good standard. This helps to ensure their safety and comfort. EVIDENCE: There has been some redecoration of bedrooms, one of the lounges, a bathroom and two toilets since the last inspection but there is still some refurbishment required. However the home is quite well maintained and suitable for its purpose although all planned maintenance of buildings has been put on hold by the organisation due to financial constraints. There is a range of equipment available in the home to assist people in their day-to-day life. This includes a passenger lift, a stair lift to the mezzanine Grisedale Croft DS0000036586.V311919.R01.S.doc Version 5.2 Page 16 floor, hand and grab rails, assisted baths, toilets and hoists. There are rails on all the corridors to assist with movement around the building. There are sufficient bathrooms and toilets for the residents, all of which are suitable for people with a disability. The bedrooms that were inspected during the visit were all personal to the individual, with ornaments, pictures and photographs from the residents’ own homes. Although some of the bedrooms are a little small all those residents who spoke to the inspector were pleased with their accommodation. There are lounge and dining facilities on both floors The outside space is well maintained and there are seats available for the residents to use during the warm weather. Grisedale Croft DS0000036586.V311919.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 good. This judgement has been made using available evidence including a visit to this service. There is a trained and experienced staff team to care for the residents that has been recruited using the organisation’s robust policies and procedures. EVIDENCE: Grisedale Croft has a very low staff turnover providing a staff team that works together for the benefit of the residents. There is sufficient care staff on duty during the day to meet the assessed needs of the residents and provide a good standard of care although sometimes, during busy times of the day, an extra member of staff would be an advantage. The home has 2 members of staff on waking night duty. There are, currently, staff vacancies but these posts have been filled, subject to the required health and legal checks being completed. Extra, allocated, staff hours have been utilised for a member of staff to work with the supervisors as a “checker” when giving out the medication. The home uses the organisation’s recruitment policy and procedure, which ensures all the required checks are completed prior to employment starting. The residents spoke very highly of the staff with one saying” the staff are wonderful” and “they can’t do enough for you”. Another told the inspector that Grisedale Croft DS0000036586.V311919.R01.S.doc Version 5.2 Page 18 the “ staff could not be kinder even though they are always so busy” and “they are all so polite”. There is a good training programme with each member of staff being responsible for keeping their own continuous professional development files up to date. Eight members of staff are qualified to NVQ level 2 with a further one working towards the award. Training recently completed includes, medication, manual handling, equality and diversity, dementia, care planning and emergency action. Supervisors have completed training in improving attendance, recruitment and selection and mistreatment of vulnerable adults. Grisedale Croft DS0000036586.V311919.R01.S.doc Version 5.2 Page 19 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, 35, 36, 37 & 38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is currently run by a competent and experienced manager who ensures it is run in the best interest of the residents. EVIDENCE: The manager was on sick leave, following surgery, on the day of the inspection but the supervisor on duty was available to assist the inspector during the visit. The manager called into the home for a short time during the inspection and confirmed that she has recently completed the Registered Managers Award and has almost finished her NVQ level 4 in care. Grisedale Croft DS0000036586.V311919.R01.S.doc Version 5.2 Page 20 There is a strong senior team at the home, this being evidenced by comments such as, “if I had a problem I would talk to Sandra (the manager) or one of the supervisors”. The atmosphere in the home was warm and friendly and the inspector was able to speak with visitors to the home who all confirmed that the home is run for the benefit of the residents and that the manager is always available for help and advice. Staff are appropriately supervised every two months with written records on file and available for inspection. Where the home is responsible for looking after residents’ personal monies individual written records are kept and all receipts held on file. The home’s operations manager audits the records on a regular basis. Regular residents’ meetings are held and annual quality assurance questionnaires are given to residents, visitors and health and social care professionals to complete and return to the home. These are looked ay by the senior team and any suggestions are acted upon if possible. All policies and procedures are in place with annual updates provided by the organisation. Monthly audits of the policies are completed with care staff during supervision. The home has a corporate health and safety policy and manual in place. The organisation’s health and safety officer completes annual audits after which a report is prepared and given to the manager with an action plan if required. All risk assessments are in place and equipment is maintained via annual maintenance contracts. Grisedale Croft DS0000036586.V311919.R01.S.doc Version 5.2 Page 21 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 3 X 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 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 3 3 3 X 3 3 3 X 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 3 3 3 Grisedale Croft DS0000036586.V311919.R01.S.doc Version 5.2 Page 22 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. 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 Grisedale Croft DS0000036586.V311919.R01.S.doc Version 5.2 Page 23 Commission for Social Care Inspection Eamont House Penrith 40 Business Park Gillan Way Penrith Cumbria CA11 9BP 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 Grisedale Croft DS0000036586.V311919.R01.S.doc Version 5.2 Page 24 - 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!