Inspection on 23/10/08 for Grosvenor House

This inspection was carried out on 23rd October 2008.

CSCI found this care home to be providing an Good 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

Grosvenor House 26/10/06

Grosvenor House 16/02/06

Extracts from inspection reports are licensed from CQC, this page was updated on 05/12/2008.

Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: Grosvenor House 11 Grosvenor Place Ashton Preston Lancashire PR2 1ED     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Lesley Plant     Date: 2 3 1 0 2 0 0 8 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. the things that people have said are important to them: They reflect This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Adults (18-65 years) 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 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 Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Adults (18-65 years) Page 2 of 27 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2008) Commission for Social Care Inspection (CSCI). 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 CSCI copyright, with the title and date of publication of the document specified. www.csci.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 27 Information about the care home Name of care home: Address: Grosvenor House 11 Grosvenor Place Ashton Preston Lancashire PR2 1ED 01772721938 01733552132 clairfrancis@aol.com Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Mrs Indrannee Pumbien,Mr Meghadeven Pumbien Type of registration: Number of places registered: care home 3 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 mental disorder, excluding learning disability or dementia Additional conditions: The registered person may provide the following category of service only: Care home only - Code PC to service users of the following gender: Either whose primary care needs on admission to the home are within the following categories: Mental disorder Code MD The maximum number of service users who can be accommodated is: 3 Date of last inspection Brief description of the care home Grosvenor House is a detached property situated in a residential area of Ashton, Preston. The home is registered to provide care to three adults of both sexes, who have a mental health disorder. The home is located close to local shops, a bus route and other amenities. The accommodation comprises of three single bedrooms each with a wash hand basin. There is a bathroom and separate toilet. Communal space consists of a large lounge with dining space and a designated smoking room. The lounge includes a facility of a sink unit, cupboards, kettle etc, to allow individuals to Care Homes for Adults (18-65 years) Page 4 of 27 Over 65 0 3 Brief description of the care home prepare their own refreshments. These facilities are situated on the ground floor and there is also an accessible garden area. Both Mr and Mrs Pumbien are the registered providers of Grosvenor House, however it is Mr Pumbien who delivers the service and manages the day- to- day running of the home. No staff are employed. Care Homes for Adults (18-65 years) Page 5 of 27 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Individual needs and choices Lifestyle Personal and healthcare support Concerns, complaints and protection Environment Staffing Conduct and management of the home peterchart Poor Adequate Good Excellent How we did our inspection: This key inspection focused on the outcomes for the people living at the home and involved gathering information about the service from a wide range of sources over a period of time. The visit to the home was unannounced and looked at all the key national minimal standards, apart from those relating to staffing, as there are no staff employed at the home. The registered provider, Mr Pumbien and the two people resident at the home were spoken to during the visit and records were viewed. Information was also gained from the annual quality assurance assessment completed by Mr Pumbien. This is a self Care Homes for Adults (18-65 years) Page 6 of 27 assessment that focuses on how well outcomes are being met for people using the service. CSCI surveys had also been completed by both the people living at the home, giving their views of life at Grosvenor House. Since the last key inspection in October 2006, a review of the service took place in January 2008. What the care home does well: What has improved since the last inspection? What they could do better: 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 set out on page 4. The report of this inspection is available from our website www.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 240 7535. Care Homes for Adults (18-65 years) Page 8 of 27 Details of our findings Contents Choice of home (standards 1 - 5) Individual needs and choices (standards 6-10) Lifestyle (standards 11 - 17) Personal and healthcare support (standards 18 - 21) Concerns, complaints and protection (standards 22 - 23) Environment (standards 24 - 30) Staffing (standards 31 - 36) Conduct and management of the home (standards 37 - 43) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Adults (18-65 years) Page 9 of 27 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them, what they hope for and want to achieve, and the support they need. People can decide whether the care home can meet their support and accommodation needs. This is because they, and people close to them, can visit the home and get full, clear, accurate and up to date information. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between the person and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Prior to coming into the home a full assessment takes place. This ensures that the persons needs can be met. Evidence: At the time of this visit there were two people resident at the home. One person having lived at the home for 18 years and the other for 8 years. Original assessment information is still kept on files and this was viewed. Both the files viewed contain information which show that a thorough assessment took place prior to admission to the home. Mr Pumbien explained that he had received an enquiry regarding the vacancy at Grosvenor House. After consideration this referral did not go ahead as it was felt that the person, in relation to their needs and personality, would not be compatible with the two people already living at the home. Mr Pumbien is qualified and experienced in carrying out assessments and clearly understands the importance of compatibility, Care Homes for Adults (18-65 years) Page 10 of 27 Evidence: particularly in such a small home. Information within the annual quality assurance document completed by Mr Pumbien states that a trial period would be offered to anyone admitted to the home and that an information pack is available. The two people living at the home were spoken to individually and both confirmed that they were happy living at Grosvenor House and satisfied with the support they receive.One person has had a recent social work review, the outcome being that the placement was still meeting his needs. Care Homes for Adults (18-65 years) Page 11 of 27 Individual needs and choices These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s needs and goals are met. The home has a plan of care that the person, or someone close to them, has been involved in making. People are able to make decisions about their life, including their finances, with support if they need it. This is because the staff promote their rights and choices. People are supported to take risks to enable them to stay independent. This is because the staff have appropriate information on which to base decisions. People are asked about, and are involved in, all aspects of life in the home. This is because the manager and staff offer them opportunities to participate in the day to day running of the home and enable them to influence key decisions. People are confident that the home handles information about them appropriately. This is because the home has clear policies and procedures that staff follow. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Care plans are in place and people are able to make decisions about their lives. Evidence: Each file contains a personal profile and history and a list of the individuals strengths. Care plans are in place and have been signed by the individual concerned. Mr Pumbien keeps a diary type record of any important events and writes a monthly update for each person. For one person, this is carried out more formally, with a more detailed monthly review taking place and records of these were seen. The need for this came about due to the person resisting prompts and reminders regarding personal care, such as bathing and changing his clothes. This person signs his monthly reviews and occasionally adds his own written comments. Motivation in respect of personal care and attending day services remains low and he is resistive to any encouragement in these areas. During discussion this person stated that he was happy with his lifestyle and did not want to attend any structured day services. Care Homes for Adults (18-65 years) Page 12 of 27 Evidence: The other person has a Care Programme Approach care plan, with the last review being in January 2008. Part of this care plan is supported by staff at the day service he attends, who monitor his mood and general mental health. Both people are able to make decisions about their day to day lives, regarding where they go and how they spend their time. Both people had recently completed feedback questionnaires supplied by Mr Pumbien and had responded that they do not want to be more involved with decision making at the home.Advocacy information is available and both people have regular contact with relatives who would advocate on their behalf if necessary. There are restrictions in place for one person, who has a set amount of money given to him each day. This has been arranged by his close relative who is the court of protection appointed person. The individual concerned understands the reasoning behind this arrangement and agrees that it is in his best interests. A copy of the written agreement has been lodged with the social worker. Clear records were viewed, with the individual signing to confirm receipt of his money. Mr Pumbien provides guidance regarding personal safety and risks as part of day to day activity at the home. One person likes to use public transport for days out and has recently been to London for the day. He explained that he takes the phone number of the home with him, in case of any emergency. Care Homes for Adults (18-65 years) Page 13 of 27 Lifestyle These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They can take part in activities that are appropriate to their age and culture and are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives and the home supports them to have appropriate personal, family and sexual relationships. People are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. Their dignity and rights are respected in their daily life. People have healthy, well-presented meals and snacks, at a time and place to suit them. People have opportunities to develop their social, emotional, communication and independent living skills. This is because the staff support their personal development. People choose and participate in suitable leisure activities. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People choose how to spend their time and family links are supported. People enjoy the meals provided at the home. Evidence: Time was spent talking to both the people living at the home. Both are able to plan their days and arrange their own social activities. One person attends day services for two days each week. He explained that he liked the social aspect of these days, doing activities such as bowling and quizzes. This person enjoys using public transport and visits his relatives in Blackpool. During the summer he enjoyed a holiday with them in America. Other activities include going to church on Sundays, shopping, collecting his pension and spending time on his computer, which has a video link used for keeping in touch with friends abroad. This individual also keeps in touch with an ex resident of the home. Mr Pumbien has arranged for a Sky television box to be installed in this persons Care Homes for Adults (18-65 years) Page 14 of 27 Evidence: bedroom as he enjoys watching sport on TV. The other person spends his time locally in a café, betting shop and pub, having resisted encouragement to attend day services. Grosvenor House is close to local shops and facilities. Individuals have a key to the home and a key to their bedroom and can come and go as they please. Relatives had recently completed feedback questionnaires supplied by Mr Pumbien. The responses showed that people are made welcome when they visit, feel comfortable asking questions and that their relative appears well cared for. The people currently living at the home confirmed that they do not want to be more involved in household activities such as cooking. Mr Pumbien makes the meals and these tend to be at set times, which give a structure to the day. There is a small kitchenette in the living room at the home, meaning that people can make their own drinks and snacks as seen during the visit. Mr Pumbien is aware of likes and dislikes regarding food and takes these into account when cooking the meals. Both people said that they liked the food provided. Care Homes for Adults (18-65 years) Page 15 of 27 Personal and healthcare support These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People receive personal support from staff in the way they prefer and want. Their physical and emotional health needs are met because the home has procedures in place that staff follow. If people take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it in a safe way. If people are approaching the end of their life, the care home will respect their choices and help them to feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Health care needs and medication are well managed, meaning that individuals are supported to keep well and maintain good health. Evidence: The two people living at the home do not require practical support regarding personal care. One person is resistant to any prompting regarding bathing or changing clothes and his care plan reflects this. Clear records of health care appointments were viewed. These allow for any health issues or interventions to be monitored. Both people are able to arrange their own health care appointments. Mr Pumbien will provide support if this is needed and during the last year has accompanied one of the individuals at the home, to attend a number of hospital appointments. The other person is often accompanied to appointments by one of his relatives. Records are kept of any prescribed medication and when it is administered. Records were viewed, which show that medication is being well managed at the home. Mr Care Homes for Adults (18-65 years) Page 16 of 27 Evidence: Pumbien takes responsibility for the safe storage and administration of medication. A previous resident did use to manage her own medication, showing that this would be supported if appropriate. A risk assessment was seen regarding self administration for one person, which concluded that the potential risks were too high. This person was spoken to and agreed that he may not manage his medication very well and was happy for Mr Pumbien to take control of this. The other resident agreed that he was happy not to be involved in looking after his medication, but that he had managed to administer his own eye drops, which were prescribed for a short time. This flexibility is good and recognises that someone may be able to manage part of their medication but not all. Care Homes for Adults (18-65 years) Page 17 of 27 Concerns, complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them, know how to complain. Their concern is looked into and action taken to put things right. The care home safeguards people from abuse, neglect and self-harm and takes action to follow up any allegations. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People feel safe at the home and are able to raise any concerns. Evidence: The home has a written complaints procedure and a copy of this is displayed on the noticeboard in the lounge. In reality any issues are dealt with as they arise, such as during discussion at meal times. No complaints have been received by the home or by the Commission. The two people who live at the home completed CSCI surveys and both confirmed that they know who to speak to if unhappy and how to make a complaint if necessary. Both the people living at the home are able to voice their opinions and have regular contact with Mr Pumbien through natural day to day activities. Relatives are in regular contact and would advocate on the individuals behalf if needed. Details of advocacy services are also available. Mr Pumbien has a copy of the locally agreed No Secrets guidance and would refer to this if any issue regarding protection arose. In questionnaires recently supplied by Mr Pumbien, both residents stated that they feel safe at the home. One person living at the home has money held on their behalf, with set amounts given to him each day. Clear records of these transactions were viewed. Care Homes for Adults (18-65 years) Page 18 of 27 Care Homes for Adults (18-65 years) Page 19 of 27 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, comfortable, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. People have enough privacy when using toilets and bathrooms. This is what people staying in this care home experience: Judgement: People using this 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 individuals living at Grosvenor House are happy with their accommodation. Evidence: Grosvenor House is close to local amenities and facilities. All the accommodation is on the ground floor, with the registered providers Mr and Mrs Pumbien living on the floors above. The home is maintained to a reasonable standard. Each person has their own bedroom. There is a large lounge, with kitchenette area and a separate small lounge for smoking. The lounge has patio doors opening onto an enclosed and private garden area. Each bedroom is furnished to suit individual tastes and people have got their own TVs in their rooms. Since the last key inspection some parts of the home have been decorated and some new carpeting fitted. External work to the roof has also taken place and the outside of the house has been painted. Information within the annual quality assurance document completed by Mr Pumbien states that new flooring is to be fitted to the bathroom and toilet. This will improve this part of the home. Mr Pumbien takes responsibility for the cleaning and laundry. The current residents are Care Homes for Adults (18-65 years) Page 20 of 27 Evidence: happy with this arrangement. The home appeared clean. Care Homes for Adults (18-65 years) Page 21 of 27 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent, qualified staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable. People’s needs are met and they are supported because staff get the right training, supervision and support they need from their managers. People are supported by an effective staff team who understand and do what is expected of them. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. No staff are employed at the home. The support provided by Mr and Mrs Pumbien meets the needs of those currently living at the home. Evidence: There are no staff employed at the home. The registered providers Mr and Mrs Pumbien live on the premises, with Mr Pumbien carrying out the day to day running of the home, with occasional input from Mrs Pumbien. Both residents are very independent and have a key to the house and a key to their bedroom. The adult son of the registered providers is sometimes in residence above the home, during university holidays and occasionally helps in the home. A Criminal Records Bureau disclosure was seen for this person. Care Homes for Adults (18-65 years) Page 22 of 27 Conduct and management of the home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is run and managed appropriately. People’s opinions are central to how the home develops and reviews their practice, as the home has appropriate ways of making sure they continue to get things right. The environment is safe for people and staff because health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately, with an open approach that makes them feel valued and respected. They are safeguarded because the home follows clear financial and accounting procedures, keeps records appropriately and makes sure staff understand the way things should be done. This is what people staying in this care home experience: Judgement: People using this 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 well managed with some quality monitoring systems in place. The health and safety of those living at the home is promoted. Evidence: The registered providers are both qualified mental health nurses. Mr Pumbien carries out the day to day running of the home and has completed the Registered Manager Award, which is the recommended qualification for managers of care homes. Mr Pumbien has also completed a number of relevant short training courses The people living at the home are able to give their opinions about the support they receive, as part of their daily contact with Mr Pumbien. Questionnaires have recently been given to both the people living at the home and their relatives. These responses were seen and showed that all are happy with the standard of care and support being provided. Following recommendations given by the fire and rescue service, the fire alarm system Care Homes for Adults (18-65 years) Page 23 of 27 Evidence: has been altered and some new emergency lighting has been installed. Mr Pumbien was able to confirm that he had complied with all the recommendations made by the fire and rescue service in January 2007. The people living at the home are aware of certain safety issue such as only smoking in the designated lounge and understand the importance of keeping their front door key safe. Mr Pumbien has undertaken various health and safety training courses and is aware of his responsibilities in this area. Care Homes for Adults (18-65 years) Page 24 of 27 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards No. Standard Regulation Requirement Timescale for action Care Homes for Adults (18-65 years) Page 25 of 27 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations Care Homes for Adults (18-65 years) Page 26 of 27 Helpline: 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 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 © (2008) Commission for Social Care Inspection (CSCI). 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 CSCI copyright, with the title and date of publication of the document specified. Care Homes for Adults (18-65 years) Page 27 of 27 - 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. 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