Inspection on 28/09/07 for Grosvenor Lodge

This inspection was carried out on 28th September 2007.

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 Lodge 30/05/06

Grosvenor Lodge 18/10/05

Grosvenor Lodge 23/05/05

Grosvenor Lodge 03/02/05

Grosvenor Lodge 28/09/04

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

CARE HOMES FOR OLDER PEOPLE Grosvenor Lodge 40 Old Shoreham Road Hove East Sussex BN3 6GA Lead Inspector Jane Jewell Key Unannounced Inspection 11:00 28 September 2007 th 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 Lodge DS0000014201.V345421.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. Grosvenor Lodge DS0000014201.V345421.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Grosvenor Lodge Address 40 Old Shoreham Road Hove East Sussex BN3 6GA 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) 01273 739739 01273 739450 grosvenor.lodge@btconnect.com Mrs M Holliday-Welch Mrs Kim Long Care Home 31 Category(ies) of Dementia (31) registration, with number of places Grosvenor Lodge DS0000014201.V345421.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. The maximum number of service users to be accommodated is thirtyone (31). Service users must be older people aged sixty-five (65) years or over on admission. Service users with a dementia type illness only to be accommodated. Date of last inspection 30th May 2006 Brief Description of the Service: Grosvenor Lodge is a privately owned residential home for up to thirty-one older people who have dementia. The home’s provider also owns a further three registered homes for older people within the Sussex area with each home being a standalone business. The home is a large detached property situated in Hove on the main A270. It is located near to local amenities such as shops, cafes and bus routes into Brighton and Hove. The home is presented across four levels, basement, ground, first and second floor with access to the first floor and second floors via stairs or shaft lifts. Resident’s accommodation consists of twenty-seven single and two shared bedrooms, with all rooms providing en-suite facilities. Shared facilities include two lounges, dining room, hairdressing room, conservatory and rear garden. The front garden is mainly paved to provide off road parking. The homes literature states that the home is committed to offer a highly professional care service for the elderly with a personal touch. The fees vary from £441 to £480 a week depending on the room occupied. These fees include all services and facilities apart from hairdressing, chiropody and newspapers/magazines and toiletries, which are itemised separately on the monthly invoices or paid from residents monies held by the home. Grosvenor Lodge DS0000014201.V345421.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The information contained in this report has been comprised from an unannounced inspection undertaken over six hours and information gathered about the home before and after the inspection. This includes: residents and relatives survey questionnaires, discussion with relatives and health care professionals. The manager had completed an Annual Quality Assurance Assessment form prior to the inspection and the information contained in this document has been used to inform the inspection of the home. The inspection was facilitated in the main by Kim long (Registered Manager). The inspection involved a tour of the premises, observation, examination of records and discussion with residents and staff. There were thirty residents living at the home at the time of the inspection. The focus of the inspection was to look at the experiences of life at the home for people living there. Signs of residents well-being/ill-being (terminology used for observing behaviour for people with dementia) were observed. In order that a balanced and thorough view of the home is obtained, this inspection report should be read in conjunction with the previous inspection reports. The Inspector would like to thank the residents, staff and management for their assistance and hospitality during the visit. What the service does well: Residents continue to live in a pleasant environment that is accessible and homely, which meets their individual and collective needs in a comfortable and informal style. Comments about the environment included “keep the grounds well”; “my bedroom is always kept clean” and “I visited many other homes but this one was clean , staff helpful the room was big and lovely, you couldn’t fault it”. There is regular input from a variety of health care professionals to ensure that residents receive a range of medical support and assistance. The system for the administration of medication remains consistently good ensuring residents medication needs are met. Flexibility in the daily routines, helps to promote resident’s choices. There is evidence that residents are treated as individuals with their individual preferences respected. Resident’s lives are enriched by the home providing various opportunities for occupation and leisure. Residents spoke positively about the home and their comments included: “Look after me so well” and the best bit about living at the home is “all the Grosvenor Lodge DS0000014201.V345421.R01.S.doc Version 5.2 Page 6 entertainment we get”. A health care practitioner said “I hold the home in high regard, it wasn’t always like that they have really improved over the last few years in terms of their understanding of people who have dementia. Links with families continued to be valued and supported by the home. With relatives commenting: “always made to feel very welcome” and “friendly atmosphere”. The meals are good offering both choice and variety. Comments received regarding the food included: “well catered for you get an alternative meal if you don’t like what they give you” and “very nice food”. Residents benefit from a core group of staff who have worked at the home for a number of years. Comments regarding staff included: “great anything you want they get it”; “in general very friendly and kind”; “Staff very nice” and “staff always seem to be making sure they are comfortable”. What has improved since the last inspection? What they could do better: Further work is needed to ensure a consistent approach to preserving resident’s privacy and dignity. Records of meals eaten by residents need to be maintained in order to demonstrate that residents receive a balanced and varied diet. It remains necessary that persons left in charge in the absence of the manager are suitable qualified in order to ensure that residents are safe at all times and Grosvenor Lodge DS0000014201.V345421.R01.S.doc Version 5.2 Page 7 that there is a full quality assurance system in place which is used to self assess the home and inform any areas for service development. 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 Lodge DS0000014201.V345421.R01.S.doc Version 5.2 Page 8 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Grosvenor Lodge DS0000014201.V345421.R01.S.doc Version 5.2 Page 9 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 1 2 3 4 and 5 People who use the service experience good, quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. The home provides both prospective and existing residents, with a good level of information about what services are provided and what to expect when living at the home. Residents are only accommodated if the home is satisfied that they can meet their needs. EVIDENCE: There is a range of information about the home and the services it provides, this includes a statement of purpose and service user guide which are displayed at the home and given to prospective residents, representatives and other interested parties. The manager spoke of their plans to further develop this information into a format more accessible to people who have dementia by using pictures. Grosvenor Lodge DS0000014201.V345421.R01.S.doc Version 5.2 Page 10 Residents are provided with a written contract of terms and conditions of residency with the home. This is used with residents and their families to make explicit the placement arrangements and clarify mutual expectations around rights and responsibilities. Documents seen for recent admissions showed that residents are accommodated following an assessment of their needs. Information about their needs is gathered from a variety of sources including the resident, their representative and health care professionals. The manager had a clear understanding of the level of resident’s needs the home can safely meet and ensures that the homes admission criteria is adhered to. The majority of residents are assessed as low to medium needs with a few who have more complex needs. There was a range of evidence that the home is able to meet the needs of residents. Staff were able to demonstrate a clear knowledge and understanding of the needs of each resident and also how those needs are consistently met. The home was also found to have supported residents to move on when their needs had been assessed to significantly change and could no longer be met by the home. A health care practitioner said that staff always tried to meet resident’s needs before they asked for assistance for an alternative placement to be found. Several staff commented that now that residents are being admitted with low to medium needs they have more time to focus on individual needs of residents. Residents spoke positively about the home and their comments included: “Look after me so well” and the best bit about living at the home is “all the entertainment we get”. For some residents not able to verbalise their experiences of the home the inspector observed many wellbeing indicators in their behaviour throughout the course of the inspection. Comments made by relatives included: “very confident with the home being able to look after my mother well”: “always feels good and welcoming”; “friendly atmosphere” and “cant fault the home very impressed so far”. A health care practitioner said “I hold the home in high regard, it wasn’t always like that they have really improved over the last few years in terms of their understanding of people who have dementia. Relatives consulted with spoke of being provided with the opportunity to visit the home in advance to assess the quality, facilities and suitability of the home. Most residents consulted with said that it was their families that looked around the home on their behalf. A relative said “that they visited many other homes but this one was clean , staff helpful the room was big and lovely, you couldn’t fault it”. Intermediate care is not offered at the home therefore this standard is not assessed. Grosvenor Lodge DS0000014201.V345421.R01.S.doc Version 5.2 Page 11 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): 7 8 9 10 and 11 People who use the service experience good, quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. There is a good care planning system in place, which provides staff with the information they need to be able to meet resident’s needs. The health needs of residents are being met with evidence of regular input from health care professionals. Residents are protected by consistently good systems of medication management. Further work is needed to ensure a consistent approach to preserving resident’s privacy and dignity. EVIDENCE: Five individual plans of care were inspected. These comprised of several documents including risk and needs assessments, basic information, daily notes and a plan of care. These were found to be up to date, and contained information to support staff to meet most needs of residents. Care plans showed evidence of being reviewed on a regular basis. Staff demonstrated a Grosvenor Lodge DS0000014201.V345421.R01.S.doc Version 5.2 Page 12 good understanding of the needs and preferences of residents and how they were to be met in a consistent manner. A health care practitioner felt that the key worker system operated by the home ensured that the staff take responsibility for a small group of residents and this meant that the day staff they knew the residents really well. The home maintains a daily record for each resident on events and occurrences. Examples were noted whereby the tone and language used was not always respectful. This was discussed with the manager who acknowledged that some comments lacked relevant, objectiveness or factual content and agreed to address this with the individuals. Records of medical intervention showed that the home works closely with health care professionals including GP’s, Occupational therapists, District and specialist nurses, to ensure residents receive the necessary health care intervention. A health care practitioner said that: “have a very good working relationship with the home” and felt that staff were very good at following any treatment instructions and were always very proactive at getting medical support. Residents and their representatives confirmed that when they have asked to see a Doctor then this has been sought promptly. The system for the administration of medication remains consistently well managed with clear and comprehensive arrangements being in place to ensure resident’s medication needs are safely met. Good practices were noted in the conduct of a member of staff who was observed providing relaxed and discrete assistance during the administration of medication. Some of the homes practices helped to preserve resident’s privacy and dignity. Observation of such practices included staff using residents preferred names, knocking on bedroom doors prior to entry and staff demonstrating knowledge of good practices, which promote resident’s privacy and dignity. However some personal care information was displayed in the kitchen. The displaying of personal care information has previously been raised with the home. Not all bedroom doors had locks fitted as they had recently been removed and an example was noted whereby there was a gap large enough to see into the bedroom around the doorframe. The Manager has been required to ensure that resident’s privacy and dignity is maintained at all times by addressing these issues. The home works together with health care professionals in caring for terminally ill residents as well as ensuring that the needs and wishes of residents and their relatives are met. A health care professional commented on the good standard of palliative care the home has provided in the past. Grosvenor Lodge DS0000014201.V345421.R01.S.doc Version 5.2 Page 13 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 and 15 People who use the service experience good, quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. Flexibility in the daily routines, helps to promote resident’s choices. There is evidence that residents are treated as individuals. Resident’s lives are enriched by the home providing various opportunities for occupation and leisure. The meal at inspection was good offering both choice and variety, however records need to be maintained in order to demonstrate that residents receive a balanced and varied diet. Links with families continued to be valued and supported by the home. EVIDENCE: Observation of the daily routines and discussion with residents and staff continue to confirm that staff accommodate resident’s personal wishes with regard to meal times, going to bed, rising and bathing. A staff member commented that “routine is very important to some residents but we try to be as flexible as possible where we can”. During the inspection residents were observed to move around the home choosing which room to be in and what Grosvenor Lodge DS0000014201.V345421.R01.S.doc Version 5.2 Page 14 level of company they wanted to enjoy with a resident saying “I decide when I want to go to bed”. Considerable feedback was received from staff and relatives that the opportunities for occupation and stimulation have significantly improved. There is a activities plan which included such activities as: cards, board games, bingo, skittles, reminiscence games, music, quizzes, film afternoons, daily newspapers and magazines. Art therapy sessions are also now being held. On the day of the inspection musical entertainers were visiting. This was clearly popular with residents who were observed actively engaging in the performance. A staff member said: “now not having to do so much physical tasks for residents have more time to spend with residents” another staff member said: “we try to ensure that residents are not sitting around doing nothing”. Visitors consistently commented upon how welcomed they are made to feel during their stay, this included being offered beverages and staff being friendly and approachable. Their comments included: “always made to feel very welcome” and “friendly atmosphere”. One resident commented: “I don’t have visitors so the staff get all my shopping for me”. Relatives commented upon how well kept informed they are of any changes to their relatives needs and are regularly updated on their wellbeing. Staff were observed involving residents in as much choice in planning their day to day support and activities as possible. For a few residents exercising their choice was more difficult. The staff were seen to use their acquired knowledge of a resident to help them in these circumstances to make decisions on a residents behalf. Staff spoke knowledgeable about the individual needs and preferences of residents and of any cultural or religious beliefs. The meal served at inspection was presented well with resident’s individual preferences being catered for. Staff were observed providing discrete assistance to those who needed additional support to eat. Comments about the food included: “well catered for you get an alternative meal if you don’t like what they give you” and “very nice food”. It was previous recommended that records are maintained to identify what is actually eaten by each resident. This had not been actioned and this has now been required. This is necessary in order to comply with food safety guidance and to be able to identify that residents are receiving a balanced diet. In addition to the main meals hot drinks and snacks are provided throughout the day. Grosvenor Lodge DS0000014201.V345421.R01.S.doc Version 5.2 Page 15 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 and 18 People who use the service experience good, quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. A complaints procedure and appropriate adult protection policies and training for staff in safeguarding adults helps to enable resident’s rights and interests are promoted and protected. EVIDENCE: Details of how to make a formal complaint are displayed within the home. All residents and relatives consulted with felt confident to approach staff with any concerns. A relative commended: “if I had any worries would go to the manager” The Manager stated in information submitted both before and during the inspection, that the home has not received any complaints about the service in the last twelve months. There are written policies covering safeguarding adults and whistle blowing. These make clear the vulnerability of people in residential care, and the duty of staff to report any concerns they may have to a responsible authority for investigation. The staff consulted with said that they had recently attended safeguarding adults training and showed a good level of understanding of their roles and responsibilities under safeguarding adult’s guidelines. Grosvenor Lodge DS0000014201.V345421.R01.S.doc Version 5.2 Page 16 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 21 22 24 25 and 26 People who use the service experience good, quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. The home provides a pleasant environment that is accessible and satisfactorily maintained, meeting residents’ individual and collective needs in a comfortable and homely style. EVIDENCE: The home is located in a residential area in Hove with access to transport links into Brighton and Hove. Accommodation is presented across three floors with a shaft lift providing level access to some parts of the first and second floors. The standard of décor remains overall good with an ongoing programme of minor redecoration having been developed. Grosvenor Lodge DS0000014201.V345421.R01.S.doc Version 5.2 Page 17 The ground floor has two lounges, dining area, panelled hallway, hairdressing room and large conservatory. The conservatory overlooks a small, attractive, secure garden. There is a good provision of communal space enabling for a range of different social activities to take place and for residents to be able to walk around freely. There is a rear secure garden, which has recently been further renovated to provided level access. The garden is well maintained and provided a number of seating areas. A covered smoking area has been developed to enable residents to smoke outside under dry cover. Residents consulted with said that they liked their bedroom and that they provided everything they needed. Individual rooms were found to be personalised and clean. Comments about the environment include: “very nice” “when friends have visited they have said what a nice place it is always clean and it does not smell”; “keep the grounds well” and “my bedroom is always kept clean”. A health care practitioner commented that the lino flooring in residents bedrooms looks clinical but it did help to manage odours. The home is not registered to admit residents with physical disabilities and the stairs and other access arrangements would make it unsuitable for people with significantly restricted mobility. There was a range of individual aids and adaptations to assist resident’s mobility and independence, including raised toilet seats, walking aids, hoist, ramps and grab rails. The home was found to be warm and comfortable, with good levels of light and ventilation. Parts of the home visited were observed to be clean with any melodious odours confined to a few areas. Laundry facilities are clean and hygienic. Systems are in place for the control of infection and all staff have been trained in this area and were observed to be working in ways that minimised the risk of infection, by wearing gloves and aprons when required. Grosvenor Lodge DS0000014201.V345421.R01.S.doc Version 5.2 Page 18 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 and 30 People who use the service experience good, quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. Staffing levels are suitable to ensure the needs of the residents living in the home can be met. Resident’s benefit from a trained staff team with many weekday staff having worked at the home some time providing continuity in their daytime care. Further work is however needed to ensure that there is a balance of staff skills and experience working at all times. Residents are being protected by the home’s recruitment policy and practices. EVIDENCE: From the practices observed and through discussion with staff and residents, there were sufficient staff on duty to meet the assessed needs of residents. All staff were observed to have a good rapport with residents and visitors which promoted a relaxed and comfortable atmosphere. Residents clearly enjoyed the company of staff with humour often being used to communicate with residents. Feedback was received that staff in the past have often all gone for a break together. A staff member confirmed that this had happened in the past but has now been stopped and breaks are staggered to ensure that there is always appropriate numbers of staff on duty. Grosvenor Lodge DS0000014201.V345421.R01.S.doc Version 5.2 Page 19 Residents comments regarding staff included: “great anything you want they get it”; “all the staff I get on well with”; “nice people here” - “Manager hand picks the staff all very nice”. Relative’s comments regarding staff included: “Staff all very friendly and nice people”; “staff very friendly”; “generally they are ok”; “in general very friendly and kind”; “Staff very nice” and “staff always seem to be making sure they are comfortable”. A health care practitioner commented “generally very good willing to help know the residents well, polite and helpful always seem to have the clients best interest at heart”. There is a core group of staff who have worked at the home for a number of years and who work in the main each weekday morning. There is a further staff team that works evenings and weekends. The inspector received some comments about the different standards in staffing qualities from the weekdays to weekends, there was no evidence however that indicated any poor standards of care. The manager was aware of the need to ensure that there is a mixture of skills and experience of the staff on duty at all times in order to ensure consistent standards and agreed to further review the situation to establish whether any action was needed. Comments received included: “weekend staff are not so knowledgeable”; “weekend staff are good too”; “many of the weekend staff do not speak English” and “A completely different staff team at the weekends”. Staffing records showed that staff who work weekends received the necessary training, in the main work part time at the home and have not worked at the home for as long. It has been required for some time that persons in charge in the absence of the manager are suitably qualified. This relates to weekend supervisors and ensuring that they are competent and hold all of the necessary training and skills to oversee the home in the manager’s absence. The manager reported that they do undertake spot checks at the weekend. Notwithstanding this further steps must now be taken as a matter of priority to fully meet this requirement in order to ensure that residents are being safeguarded at all times. In information submitted to the Commission as part of the inspection process, the manager stated that currently over half of the staff team have completed National Vocational Qualifications to at least NVQ Level 2. The personal files of newly appointed staff were inspected and these showed that a recruitment process is followed which includes the use of an application form, interviews, Criminal Records Bureau (CRB) checks and written references prior to employment commencing. The manager reported that the homes recruitment documentation had recently been viewed by immigration official as part of random visits to care homes in Brighton and reported that they were following all the necessary practice guidelines in the employment of overseas staff. Grosvenor Lodge DS0000014201.V345421.R01.S.doc Version 5.2 Page 20 The home has been proactive in ensuring that staff receive a National Vocational Qualification (NVQ ) in Care. Eleven members of staff were reported to have completed an NVQ Level 2 or above with several staff also working towards this qualification. Staff have the opportunity to undertake a variety of training courses, which includes core topics such as manual handling, fire safety, safeguarding adults and food safety as well as specialist training in dementia and bereavement. The manager confirmed that new staff undertaken “skills for care” induction, which is the industry recommended minimum inductions standards, along with the homes own induction check list. Significant improvements have been made in staffs understanding of people who have dementia, this is evident in the good practices observed by the inspector and in their discussion with staff. Staff consulted with said that this is largely due to the training they had received, a staff member commented: “without the high dependency more time can be spent with residents”. Grosvenor Lodge DS0000014201.V345421.R01.S.doc Version 5.2 Page 21 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 32 33 35 36 and 38 People who use the service experience good, quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. Resident’s benefit from an experienced and established manager who ensures a clear leadership and direction of the home. Further implementation of formal quality assurance and quality monitoring systems would enable the manager to be able to critically evaluate the service and continue to make service improvements where needed. A range of regular health and safety checks helps to ensure the health and safety of residents and staff. EVIDENCE: Grosvenor Lodge DS0000014201.V345421.R01.S.doc Version 5.2 Page 22 The manager has many years relevant experience and holds part of the recommended management qualifications. They are currently in the process of completing the remaining part of the recommended management qualifications. It was evident throughout the inspection and in intelligence gathered before and after the inspection that the manager provides a clear sense of leadership and direction. They demonstrated a sound understanding of good practices in the care of people who have dementia and act as a role model in leading these practices at the home. Comments about the manager included : “helpful”; “supervisors us when she works directly with us”; “Kim very friendly and nice”; “always available”; “very good”; “approachable” and “Very much better now than a few years back”. The manager spoke of the good level of support they receive from the provider and the proactive interest they have in the running of the home. A staff member said “You can ask for the provider now for anything”. Care staff spoke of receiving regular formal recorded supervision with their line manager along with daily direct supervision by the supervisors and managers working alongside staff each shift. All staff consulted with felt well supported. It was previously required that a full quality assurance system be established and used to maintain and improve the provision of care and services in the home. As part of this process feedback questionnaires are sent to relatives and other stakeholders. It was discussed that further work needs to be done on improving ways of obtaining feedback from residents on the services and facilities offered, as the home has had limited success with residents completing written feedback questionnaires. Although there is evidence that some service improvements were made following the outcome of last round of feedback questionnaires this feedback now needs to be integrated into a structured quality assurance system, for the home to use in the selfmonitoring and review of its own practices. Residents are encouraged to retain control of their own finances for as long as they are able to do so and if unable then this responsibility is taken on by a relative or another responsible persons external to the home. The home does manage the personal monies for two residents. Records of any expenditure along with receipts are maintained for these individuals. There are policies and procedures related to health and safety. Records submitted by the manager prior to the inspection stated that all of the necessary servicing and testing of health and safety equipment has been undertaken. The areas of shortfall relating to health and safety noted at the last inspection have now all been addressed. Systems were in place to support fire safety, which included: regular fire alarms and emergency lighting checks, staff training and maintenance of fire equipment and fire drills were reported to have been undertaken. The manager reported that A fire risk assessment had been undertaken by a fire safety Grosvenor Lodge DS0000014201.V345421.R01.S.doc Version 5.2 Page 23 expert, which recorded significant findings and the actions taken to ensure adequate fire safety precautions in the home. Grosvenor Lodge DS0000014201.V345421.R01.S.doc Version 5.2 Page 24 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 3 3 3 3 3 x HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 2 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 2 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 x 18 3 3 3 3 3 x 3 3 3 STAFFING Standard No Score 27 2 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 x 2 x 3 3 x 3 Grosvenor Lodge DS0000014201.V345421.R01.S.doc Version 5.2 Page 25 Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1 Standard OP10 Regulation 12(4)(a) Requirement That the homes practices and procedures ensure the privacy and dignity of service users at all times. That a record of meals provided for service users be maintained which contains sufficient detail as to identify whether a suitable diet is being maintained. Timescale for action 30/11/07 2 OP15 17(2) Sch 4(13) 18(1)(c) (i) 30/11/07 3 OP28 4 OP33 24(1) That persons in charge in the 30/11/07 absence of the manager are suitably qualified. (First made at inspection of 19/1/04 with timescales of 01/09/06 not met) That a full quality assurance 30/12/07 system is established and used to maintain and improve the provision of care and services in the home. (First made at inspection of 30/05/06 with timescales of 01/09/06 not met) Grosvenor Lodge DS0000014201.V345421.R01.S.doc Version 5.2 Page 26 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 Lodge DS0000014201.V345421.R01.S.doc Version 5.2 Page 27 Commission for Social Care Inspection Maidstone Local Office The Oast Hermitage Court Hermitage Lane Maidstone ME16 9NT 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 Lodge DS0000014201.V345421.R01.S.doc Version 5.2 Page 28 - 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!