Inspection on 19/10/05 for Grosvenor House Nursing Home

This inspection was carried out on 19th October 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.

Other inspections for this house

Grosvenor House Nursing Home 17/11/08

Grosvenor House Nursing Home 12/12/06

Grosvenor House Nursing Home 21/03/06

Grosvenor House Nursing Home 24/01/05

Grosvenor House Nursing Home 21/07/04

Grosvenor House Nursing Home 12/02/04

Grosvenor House Nursing Home 13/10/03

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

CARE HOMES FOR OLDER PEOPLE Grosvenor House Nursing Home 39 Duchy Road Harrogate North Yorkshire HG1 2HA Lead Inspector David White Unannounced Inspection 19th October 2005 09:30 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 Grosvenor House Nursing Home DS0000027932.V257046.R01.S.doc Version 5.0 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. Grosvenor House Nursing Home DS0000027932.V257046.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Grosvenor House Nursing Home Address 39 Duchy Road Harrogate North Yorkshire HG1 2HA 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) 01423 523447 01423 527672 grosvenor.house@ashbourne_homes.co.uk APTA Healthcare (Birmingham) Limited Mrs Glenda Maharani Ibbotson Care Home 50 Category(ies) of Old age, not falling within any other category registration, with number (46), Terminally ill (4) of places Grosvenor House Nursing Home DS0000027932.V257046.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. Age range 60 years plus - OP Age 45 years plus - TI 5 day care places 60 years upwards Date of last inspection 24th January 2005 Brief Description of the Service: Grosvenor House is a large converted and extended detached house. It is situated on Duchy Road in a quiet residential area within a short drive of Harrogate town centre. The home offers nursing care for up to 50 service users. Grosvenor House Nursing Home DS0000027932.V257046.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place over 6 hours. The premises were looked at and four residents, one relative, five members of staff and the registered manager were spoken to. The care records of four residents were inspected along with a number of other records. What the service does well: Residents are encouraged to be independent. Residents said staff were “helpful and caring”. A wide range of training is provided to enable staff to have the knowledge and skills to meet resident needs. Resident views are listened to and acted upon. Care planning documentation is good so staff are clear about the needs of the residents and how these are to be met. A wide range of modern aids, adaptations and equipment are available to promote the independence and safety of the residents. Residents enjoy a range of activities. The home is well managed with residents, relatives and staff describing the manager as “supportive and approachable”. Residents said that the quality of the food was good. Grosvenor House Nursing Home DS0000027932.V257046.R01.S.doc Version 5.0 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. Grosvenor House Nursing Home DS0000027932.V257046.R01.S.doc Version 5.0 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 Grosvenor House Nursing Home DS0000027932.V257046.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 3 and 6 Information published by the home together with a detailed pre-admission assessment was very good providing residents and prospective residents of the service with clear information about the care, services and facilities on offer in the home and assuring them that their needs would be met. EVIDENCE: Prospective residents and their relatives are given a brochure detailing information about the home prior to admission. The residents spoken to said they were offered the chance to visit the home with their relatives prior to making a decision about moving into the home. The admission procedure, which is carried out, by the registered manager or her deputy is very thorough and this makes sure that residents are properly assessed and that staff are fully aware of their needs. Information is gathered from residents’ relatives and other care professionals such as care managers and doctors as part of the assessment process. Any risks are identified as part of the pre-admission process. Grosvenor House Nursing Home DS0000027932.V257046.R01.S.doc Version 5.0 Page 9 Staff have a good understanding of the needs of the residents and receive a wide range of training specific to the needs of the residents in their care. The home does not provide any form of intermediate care. Grosvenor House Nursing Home DS0000027932.V257046.R01.S.doc Version 5.0 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 the following standard(s): Standards 7, 8, 9 and 10 There is a good care planning system in place to provide staff with the information needed to care for the residents. Residents are involved in making decisions about the home with the aim of promoting their independence. In general medication policies and procedures were followed EVIDENCE: The residents looked clean and tidy and well cared for. The care records of four residents were inspected and all had detailed care plans in place. The care plans contained clear and detailed information about the likes and dislikes of each resident and their preferred daily living routines. The care plans included the social and spiritual needs as well as the healthcare needs of each resident. A number of risk assessments were in place to cover a number of aspects of daily living to promote independence and safety. It was noted in the daily records that a member of night staff had concerns that a resident’s bedrails were not secure. The entry had been made the night prior to the inspection and the nurse in charge was aware of the matter and was dealing with it. The resident concerned had been admitted into the home five Grosvenor House Nursing Home DS0000027932.V257046.R01.S.doc Version 5.0 Page 11 days earlier and had required bedrails as part of her care but no risk assessment had been carried out to reduce the risks from the use of bedrails. Referrals to outside health agencies were detailed and GPs visits are made to the home on request. A dentist also visits the home upon request and a chiropodist routinely calls to attend to foot cares. A number of residents were admitted to the home with pressure sores and care plans were very good and specific about promoting healing. Assessments of mental health were carried out and this included a geriatric depression rating-screening tool. Daily documentation within the care records reflected the care that was being given. Care plans including risk assessments were regularly reviewed and a relative confirmed that he was invited to the care plan review of his relative. All the residents and relatives spoken to said that the care was “very good” with one resident saying “if I had to live in a care home then this is as good as any”. A relative said that he was “pleased with care offered to his wife” and that he was always kept updated about his wife’s progress. Staff could be seen treating residents in a respectful manner and addressed the residents by their preferred names. Staff knocked on doors before entering a resident’s bedroom. Residents spoken to said the staff team were very respectful and polite. The medication systems were inspected and proper arrangements are in place for the storage and disposal of medication. The Medication Administration Records inspected were accurate and up to date. The controlled drugs register was inspected and it was noted that in some instances controlled drugs medication had been administered without the presence of a witness. The home must ensure that medication practices are in line with the home’s medication policies. Grosvenor House Nursing Home DS0000027932.V257046.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 12, 13, 14 and 15 Residents enjoy activities in the home. The meals provided are of good quality and to suit different tastes. EVIDENCE: The home has an activities co-ordinator who has developed a structured weekly activity programme. Residents said that they enjoyed the bingo, scrabble, knitting circle and outings. One resident said that she particularly enjoyed the physical exercise sessions. Church services are held at the home and are well attended. One resident said “the activities help to keep me busy and my mind active” whilst another resident said she was pleased that there was no pressure put on people to take part in the activities. Visiting times are flexible and a relative said he was always made to feel welcome and kept updated about his wife’s progress. Residents can have a telephone in their bedroom if they wish. Grosvenor House Nursing Home DS0000027932.V257046.R01.S.doc Version 5.0 Page 13 Residents are able to carry out their daily routines as they wish. One resident said she was able to get up in a morning and go to bed at night whenever she wanted. All residents spoken to were positive about the quality and variety of the meals provided, saying there was choice of the main meal at lunchtime and also at teatime. Menus are rotated on a regular basis and feedback is sought using a comment book about the quality of the meals provided. An agency chef was working at the time of inspection and she had written instructions of the special dietary needs of each resident to help guide her. Grosvenor House Nursing Home DS0000027932.V257046.R01.S.doc Version 5.0 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 inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 16 and 18 Residents concerns are dealt with and their interests are safeguarded. EVIDENCE: The home has a complaints policy and procedure in place to deal with complaints. Inspection of the complaints records confirmed that complaints are being dealt with properly within given timescales. Residents knew what to do if they wished to raise any concerns and felt confident that any concerns would be dealt with immediately. The home has an adult protection policy and procedure in place. The home has recently had two incidents, which required referral to adult protection agencies, and correct procedures had been followed. Staff spoken to confirmed that they had received training about abuse and adult protection as part of their induction to the home and a number of staff have attended some recent additional POVA (Protection of Vulnerable Adults) training which they will share with colleagues. Grosvenor House Nursing Home DS0000027932.V257046.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 19, 22 and 26 The standard of the environment is good and provides residents with a clean and homely place in which to live. EVIDENCE: Three residents rooms were looked at and these were clean, tidy and comfortable as was the home in general. The home has two floors that can be accessed via a shaft lift so that residents have access to all parts of the home. There are a number of lounges in the home including a designated smoking lounge and the fabrics and fittings throughout the home were in good condition. The first floor of the home is to be decorated shortly as part of the planned maintenance programme. The home has nice gardens and there is ramped access to the gardens to accommodate people with mobility problems. Aids, adaptations and equipment were modern and staff commented that one of the best things about working at the home was “having a good supply of all the necessary equipment to be able to look after the residents properly”. Grosvenor House Nursing Home DS0000027932.V257046.R01.S.doc Version 5.0 Page 16 Residents said that the home is always kept clean. Appropriate arrangements had been made for the laundering of bedding, linen and personal clothing. There were plentiful supplies of aprons, hand paper towels, soap dispensers and disposable gloves throughout the home. Call bell systems are located in bedrooms, toilets and all communal areas of the home. A random check of a hot water temperature in one of the bathrooms was found to be within safe limits. Any recommendations made from visits by the fire officer and environmental health officer had been acted upon. Grosvenor House Nursing Home DS0000027932.V257046.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 27, 28, 29 and 30 Residents receive a good standard of care from a well-motivated and enthusiastic staff team. The home’s recruitment procedures protect residents from harm. EVIDENCE: On the day of inspection there were two qualified nurses and six carers on duty. For an afternoon shift there are usually two nurses and five carers and on a night there are two nurses and two carers. There was a good atmosphere in the home and staff morale was good. All the residents spoken to were complimentary about the staff team. One resident said that the “care was very good” and another said that the staff were “always helpful and friendly”. Residents and a relative spoken to felt there were always enough staff on duty and that call bells were responded to promptly. The home employs catering and domestic staff to maintain standards of hygiene and cleanliness throughout the home. Agency chefs were being used to cover periods of sickness in the kitchen. All staff undergo a range of training. An induction programme is in place for all new staff and records of induction training undertaken were available within individual staff files. Staff receive a range of training to develop their skills and knowledge and this included training specifically related to the needs of the Grosvenor House Nursing Home DS0000027932.V257046.R01.S.doc Version 5.0 Page 18 resident group and the majority of the care staff were trained to NVQ level 2 or above. Each member of staff has a well-organised training file containing records of training undertaken and supervision sessions. Staff spoken to said “we are offered a good variety of training opportunities. Three staff files inspected were those of recently appointed members of staff and these contained evidence that the necessary pre-employment checks had been carried out. Grosvenor House Nursing Home DS0000027932.V257046.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 31, 33, 35 and 38 The home is well managed and residents are involved in decision-making about how the home is run. Proper attention is given to health and safety in promoting a safe environment for residents, staff and visitors to the home. EVIDENCE: The registered manager is very experienced and is well supported by the care manager in providing leadership in the home. Residents, a relative and the staff spoken to were complimentary about the registered manager commenting that they had “full confidence” in her abilities and benefited from her “handson approach”. Staff said that they felt management were very supportive towards them. A number of satisfaction surveys have been carried out in the past to seek the views of residents and relatives about the home. Resident and staff meetings Grosvenor House Nursing Home DS0000027932.V257046.R01.S.doc Version 5.0 Page 20 are held regularly and are recorded and a relatives meeting is held on a sixmonthly basis. Each month an audit is carried out by the registered manager on one aspect of care in the home and an external person audits the home every six months. Care plan reviews take place on a regular basis and encourage the involvement of the resident and their family. Relatives and solicitors have responsibility for the monies of residents who do not wish to or lack capacity to look after their own monies. Formal supervision arrangements are in place for the staff and these are recorded. Arrangements were in place were in place for the promotion and maintenance of a safe and secure environment for residents, visitors and staff. A number of satisfactory safety reports and certificates were seen relating to the premises. The fire alarm system is tested on a weekly basis and fire equipment is regularly serviced. Health and safety training is included in the induction programme and this is updated regularly. Accidents are clearly recorded within the daily records and in the home’s accident book. Individual and general risk assessments are in place to promote independence and safeguard residents from harm. Grosvenor House Nursing Home DS0000027932.V257046.R01.S.doc Version 5.0 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 X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 2 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 X X 3 X X X 3 STAFFING Standard No Score 27 3 28 3 29 3 30 4 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X X 3 Grosvenor House Nursing Home DS0000027932.V257046.R01.S.doc Version 5.0 Page 22 Are there any outstanding requirements from the last inspection? N/A 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. 1 2 Refer to Standard OP7 OP9 Good Practice Recommendations A risk assessment must be carried out on all residents who have bedrails. The home must administer controlled drugs in line with the medication policy. Grosvenor House Nursing Home DS0000027932.V257046.R01.S.doc Version 5.0 Page 23 Commission for Social Care Inspection York Area Office Unit 4 Triune Court Monks Cross York YO32 9GZ 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 Grosvenor House Nursing Home DS0000027932.V257046.R01.S.doc Version 5.0 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. 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