Inspection on 26/10/06 for Grosvenor House

This inspection was carried out on 26th October 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is (sorry - unknown). 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

Grosvenor House 23/10/08

Grosvenor House 16/02/06

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

CARE HOME ADULTS 18-65 Grosvenor House 11 Grosvenor Place Ashton Preston Lancashire PR2 1ED Lead Inspector Lesley Plant Unannounced Inspection 26th October 2006 11:45 Grosvenor House DS0000062889.V309771.R01.S.doc Version 5.2 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 Grosvenor House DS0000062889.V309771.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 Adults 18-65. 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. Grosvenor House DS0000062889.V309771.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Grosvenor House Address 11 Grosvenor Place Ashton Preston Lancashire PR2 1ED 01772 721938 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) Mr Meghadeven Pumbien Mrs Indrannee Pumbien Care Home 3 Category(ies) of Mental disorder, excluding learning disability or registration, with number dementia (3) of places Grosvenor House DS0000062889.V309771.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The service may accommodate up to 3 service users in category MD (Mental Disorder), excluding learning disability or dementia categories 16th February 2006 Date of last inspection Brief Description of the Service: 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 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. Grosvenor House DS0000062889.V309771.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was unannounced and looked at all of the key national minimum standards. At the time of the inspection there were three service users living at the home. The inspector spoke to Mr Pumbien, the registered provider in day-to-day management of the home, viewed care and medication records and looked at the accommodation provided. Time was spent talking to the three people living at the home, who are all able to express their views about the service provided. Each service user had also completed a comment card giving feedback about the home. Information was also gained from a pre inspection questionnaire completed by the registered manager. The current scale of fees is £260 to £293 weekly. What the service does well: What has improved since the last inspection? The specific agreements regarding personal care arrangements for one person continue to be upheld and have reduced any perceived conflict. This individual meets with Mr Pumbien each month and signs his review sheet to confirm that he is still happy with the agreement regarding personal care. The current agreement appears to be working well and the person concerned said that he Grosvenor House DS0000062889.V309771.R01.S.doc Version 5.2 Page 6 was still happy with this arrangement. This monthly exchange should continue as it a good opportunity for views to be aired. An individual’s request for social work contact has been responded to, with continued social work support being available via the day service if required. Since the last inspection the problem with the leaking roof has been remedied. A number of policies have been reviewed 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. Grosvenor House DS0000062889.V309771.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR 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) Scoring of Outcomes Statutory Requirements Identified During the Inspection Grosvenor House DS0000062889.V309771.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 2 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service. Prior to moving into the home, a full assessment takes place, ensuring that needs can be met. EVIDENCE: There have been no recent admissions to the home, the current service users having been resident for many years. All three case files were viewed and contained documentation, which shows that full assessments had taken place before they moved into the home. A detailed assessment form was completed and then a profile of each person was compiled. Social work assessments had also been carried out. Full Care Programme Approach joint assessments took place at a later date; as for two individuals this type of joint assessment was not part of mental health practice when they moved into the home. Grosvenor House DS0000062889.V309771.R01.S.doc Version 5.2 Page 9 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7 and 9 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service. Changing needs are responded to and people are supported to make decisions about their lives. EVIDENCE: Each person has a written care plan, which reflects areas highlighted during the assessment process. Service users have signed their own care plan. Mr Pumbien keeps good records using a diary log sheet for each person. Significant events are recorded and then a monthly update is completed in respect of each service user. For one person, this is carried out more formally with the service user, with a more detailed review taking place. This was advised at a previous inspection. The particular issues regarding lack of motivation in respect of personal care and attending day services remain, however the individual stated that he is still happy with the agreements contained in his care plan. These monthly meetings should continue, even though the service user shows little interest at the time. Two people still have Care Programme Approach (CPA) reviews undertaken by their mental health care coordinator. For one person a more structured week Grosvenor House DS0000062889.V309771.R01.S.doc Version 5.2 Page 10 was recommended, and this was put in place. The individual does not always attend his day placements as agreed and records of this are kept. Mr Pumbien is aware that encouragement to attend is not welcomed by the individual and therefore limits his intervention to maintaining a supportive safety net and keeping records of changes. Each person has some social work contact via day service attendance or CPA meetings. Since the last inspection, renewed social work contact has been achieved for one service user who had been considering future life changes. The three people living at the home are all able to express their views and enjoy some level of independence. Each of the service users has contact with a relative. Individuals are encouraged to make decisions about how they live their lives. Any restrictions are in the persons’ best interests. For one person there is an agreement regarding daily amounts of spending money, which has been agreed with the individual, a relative and court of protection appointee. The social worker was also sent a copy of this written agreement. Mr Pumbien keeps good records of these transactions, which are signed by the service user. Advice was given regarding monitoring the amount of money held and contacting the appointee should this amount become excessive. People choose how they spend their time and the friendships they maintain. Information regarding advocacy, with a contact telephone number is available on the notice board. Service users are able to come and go as they please and each person has a front door key. Mr Pumbien provides advice and guidance regarding personal safety. Service users stated that they understood the need for certain house rules such as not smoking in their bedroom. A written risk assessment is in place for one person who manages her own medication. Grosvenor House DS0000062889.V309771.R01.S.doc Version 5.2 Page 11 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 15, 16 and 17 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service. Attendance at day placements is encouraged, helping people to maintain community contacts. Family links are supported. The meals meet the needs and preferences of the people currently living at the home. EVIDENCE: The current service users all have some contact with day services for people with mental health problems. One person attends a day placement three days each week and enjoys having time to visit town and carry out personal errands on the other days. Another service user talked about how she enjoys going to a day service on certain days of the week, seeing this as an important opportunity to see friends and associates. Activities for this person include drama, maths classes and music sessions. This individual enjoys the female company at her day service. The third service user had a CPA meeting at the beginning of the year, which advised that a more structured week and attendance at day services would be beneficial. The person concerned has difficulties motivating himself and prefers to spend his time out and about Grosvenor House DS0000062889.V309771.R01.S.doc Version 5.2 Page 12 locally. It is acknowledged that this service user resents too much perceived interference in his life and difficulties arose when a firmer approach was taken. Discussions with this person confirmed that he feels good about his life at the moment and is enjoying stable mental health. Grosvenor House is situated close to a range of community facilities and is within easy reach of the city centre. The current service users are all able to go out and about independently. Service users spoke about going to the pub, the betting shop, local café, visiting a relative and shopping in town. Two people have concessionary bus passes. The people living at Grosvenor House all have contact with family members and confirmed that they are supported to keep in contact or will make their own arrangements. One person regularly travels by bus to see his relative. Another individual has a relative who is closely involved in his wellbeing, providing support to attend certain health appointments and taking the necessary responsibility for his finances. Day activities/work placements provide further opportunity for socialising and making friends. Although people are able to go to bed and get up when they wish, getting up to attend agreed day placements is encouraged. Meals are generally at set times, although the small kitchenette means that snacks and drinks can be made at any time. People have a key to the front door as well as a key for their bedroom. Mr Pumbien carries out the main household tasks of cooking and cleaning, with each person spoken to confirming that they are happy with this arrangement. One person said she was happy to dust her bedroom but did not want to have any more responsibility regarding cleaning. The home has a pet cat, with one service user in particular enjoying stroking and looking after it. The people spoken to were satisfied with the food provided and said that the provider knew their likes and dislikes. The current people at the home do not wish to be involved in the main cooking, which was recorded in their files, but the small kitchenette in the lounge means that they are able to make drinks and snacks for themselves. Individuals are out on most days, taking part in planned day services and the main meal is at teatime. Comments from service users included, “He knows what I like or will ask what I want” and “I enjoy the meals, but am not a fussy person.” The provider is advised to keep the current arrangements regarding household tasks under review as in the future, as people spend more time at home, they may wish to be more involved. Grosvenor House DS0000062889.V309771.R01.S.doc Version 5.2 Page 13 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19 and 20 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service. Health care needs are met. Medication is appropriately managed and selfadministration supported. EVIDENCE: The service users currently living at the home do not need practical help with their personal care. Mr Pumbien provides general oversight and takes care of all laundry tasks. One person does have difficulty motivating himself and this aspect of care has been discussed with Mr Pumbien at past inspections. The individual concerned resents any prompting or guidance in this area, a cause of conflict in the past. This person has requested that Mr Pumbien does not remind or prompt him regarding bathing and his care plan contains agreements, which appear to be reducing this conflict and the service user stated that he is happy with this arrangement. The situation appears to be being managed more sensitively. Grosvenor House DS0000062889.V309771.R01.S.doc Version 5.2 Page 14 Good records of healthcare appointments are kept. For one person, a relative provides support to attend certain health care appointments. Service users are able to access appointments independently or Mr Pumbien will accompany them. One person stated that she is happy to go to see her GP alone but had appreciated Mr Pumbien taking her to certain hospital appointments. Mr Pumbien confirmed that sometimes the key worker from the day centre accompanies one individual to appointments with a psychiatrist but that he is kept informed of the outcome. Mr Pumbien looks after and administers medication for two service users at the home. Both service users confirmed that they are still happy with this arrangement. This medication is kept in a locked cupboard in the kitchen. Administration records are accurate and well maintained. The third service user manages her own medication and confirmed that she is happy with this arrangement. Mr Pumbien provides some oversight and a risk assessment has been carried out. Grosvenor House DS0000062889.V309771.R01.S.doc Version 5.2 Page 15 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 22 and 23 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service. Service users feel that their views are listened to. There are systems in place, which promote the protection of those living at the home. EVIDENCE: There is a complaints procedure in place and this is displayed in the lounge, along with details of advocacy services. No complaints have been received since the last inspection. The people spoken to confirmed that they could raise any concerns and each has contact with relatives who may advocate on their behalf if necessary. Meal times provide a natural opportunity for open discussion, as does the monthly meeting with one service user. Mr Pumbien has a copy of the locally agreed abuse procedures, “No Secrets in Lancashire” and would follow this guidance if any such situation arose. Mr Pumbien has undergone training regarding handling aggression and although no staff are employed, has developed appropriate policies. Since the last inspection Mr Pumbien has undertaken some training regarding abuse. Mr Pumbien supports one individual with their finances, providing an agreed amount of money each day. Appropriate records of these arrangements are maintained and these were viewed. Grosvenor House DS0000062889.V309771.R01.S.doc Version 5.2 Page 16 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 24 and 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service. Individuals living at Grosvenor House are happy with the accommodation provided. EVIDENCE: The premises are maintained to a reasonable standard and there is good access to local facilities and services. All service user accommodation is on the ground floor of the home. The small kitchenette area in the main lounge/dining room allows individuals to make their own drinks and snacks, so promoting independence. At the time of the last inspection there was a problem with part of the roof leaking and repair work has since been carried out. The three people living at the home all stated that they are happy with their individual bedrooms and the accommodation provided. Each person has a TV/entertainment system in his or her bedroom and individuals enjoy spending time in their room as well as in the lounge area. The environmental health agency visited the home earlier in the year, with no issues being raised. Grosvenor House DS0000062889.V309771.R01.S.doc Version 5.2 Page 17 Although service users are encouraged to keep their rooms clean and tidy, Mr Pumbien takes responsibility for the majority of the cleaning and all laundry tasks. The individuals spoken to stated that they are happy with these arrangements and do not want to be more involved in household tasks. Grosvenor House DS0000062889.V309771.R01.S.doc Version 5.2 Page 18 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): These standards are not applicable to Grosvenor House as no staff are employed at the home. EVIDENCE: Grosvenor House DS0000062889.V309771.R01.S.doc Version 5.2 Page 19 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. 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 are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39 and 42 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service. Informal quality monitoring systems are in place and service users feel that their views are listened to. The home is well run and the health and safety of people living at the home is promoted. EVIDENCE: Mr Pumbien is a qualified Mental Health Nurse and has many years experience in this area of work. Mr Pumbien carries out the day-to-day running of the home and no staff are employed. The inspector viewed confirmation of successful completion of NVQ 4 Registered Managers Award. Mr Pumbien continues to update his skills and knowledge and is currently awaiting assessment regarding the NVQ assessor’s award. Grosvenor House DS0000062889.V309771.R01.S.doc Version 5.2 Page 20 Quality monitoring takes place informally as part of day-to-day life at the home. Individual and group discussions take place, such as at meal times. Records show that one person has monthly meetings with Mr Pumbien to confirm satisfaction with agreements regarding personal care. Although this person shows little interest during these meetings, it does provide an opportunity for views to be aired. Discussions with this service user confirmed that he is aware that he can raise any issues at these meetings. The three people living at the home all have contact with relatives, who would advocate on their behalf if necessary. Individuals also have link workers at the day centres/sheltered employment settings they attend, providing another outlet for people to express their views. Service users confirmed that their views are listened to. Mr Pumbien has undertaken certain health and safety training, including; first aid, food hygiene, fire safety and medication. The people living at the home stated that they are aware of safety issues such as only smoking in the small lounge and not in their bedrooms and understood the importance of keeping their front door key safe. A risk assessment is in place regarding the service user who manages her own medication. Grosvenor House DS0000062889.V309771.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 Adults 18-65 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 X 2 3 3 X 4 X 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 3 25 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 N/A 32 N/A 33 N/A 34 N/A 35 N/A 36 N/A CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 X 3 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 X 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 3 X 3 X X 3 X Grosvenor House DS0000062889.V309771.R01.S.doc Version 5.2 Page 22 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. 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 Grosvenor House DS0000062889.V309771.R01.S.doc Version 5.2 Page 23 Commission for Social Care Inspection North Lancashire Area Office 2nd Floor, Unit 1, Tustin Court Port Way Preston PR2 2YQ 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 Grosvenor House DS0000062889.V309771.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. 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