Inspection on 02/05/07 for Grove Hill Residential Home

This inspection was carried out on 2nd May 2007.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Excellent. 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

Grove Hill Residential Home 23/01/06

Grove Hill Residential Home 09/08/05

Grove Hill Residential Home 07/12/04

Grove Hill Residential Home 27/07/04

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

CARE HOMES FOR OLDER PEOPLE Grove Hill Residential Home Grove Hill Highworth Swindon Wiltshire SN6 7JN Lead Inspector Stuart Barnes Key Unannounced Inspection 2nd May 2007 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 Grove Hill Residential Home DS0000003210.V335602.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. Grove Hill Residential Home DS0000003210.V335602.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Grove Hill Residential Home Address Grove Hill Highworth Swindon Wiltshire SN6 7JN 01793 765317 01793 765553 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 James William Charles Dunn Mr James William Charles Dunn Care Home 27 Category(ies) of Dementia - over 65 years of age (10), Old age, registration, with number not falling within any other category (27) of places Grove Hill Residential Home DS0000003210.V335602.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 23rd January 2006 Brief Description of the Service: Grove Hill is a private residential home offering accommodation and personal care to 27 residents over the age of 65. Grove Hill was first registered in 1986. The home is situated close to the centre of Highworth with easy access to local amenities. There is a regular bus service to Swindon town centre. Ample parking facilities are available at the front of the property. The accommodation consists of 7 shared and 13 single bedrooms, which are located on the ground, first and second floor. A passenger lift has been installed, which services all floors. In addition there is a lounge, a dining room and two small sitting areas on each floor. The sitting area on the second floor is a designated smoking area for residents. There is a laundry room with adequate facilities and residents clothing is washed and ironed by staff. There are choices at breakfast with set meals at lunch and teatimes although alternatives are provided. A wide range of activities is provided which residents can participate in if they wish. The home is normally staffed by four members of staff in the morning and afternoon shifts and three members of staff on the evening shift. There are two waking staff members on duty throughout the night. Grove Hill Residential Home DS0000003210.V335602.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was carried out over two days lasting 16½ hours, of which the first day was unannounced. On the first day the inspector spent time examining the homes statement of purpose and reviewed some of the policies and procedures that the staff are expected to follow. Time was also spent meeting with people living at home and in some cases their relatives, either informally in the communal lounge or in private. Case documentation of four current residents was also examined. On the second day time was spent reviewing care workers training and recruitment files, talking with four care workers as a group and talking with others as they went about their work. There was an opportunity to talk to a visiting general practitioner, and a visiting physiotherapist as well as several relatives. Meal times were observed (in part), as was a birthday celebration. Views were also obtained from a visiting entertainer. Discussion took place with an officer from the Public Guardianship Office. Most of the accommodation was also viewed. The manager/owner assisted with the inspection process and was given feed back as to the inspector’s preliminary findings at the end of the inspection. Prior to the inspection the Commission sent out 15 ‘Have your Say’ leaflets to people living at the home of which six were returned and their comments have been taken into account. Fees for this service depend on assessed need but typically range between £400 to £459 per week. What the service does well: What has improved since the last inspection? The way assessment details are recorded has improved. Satisfaction levels with social activity appear even better than before. Medical checks on staff are more robust than previously. Grove Hill Residential Home DS0000003210.V335602.R01.S.doc Version 5.2 Page 6 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. Grove Hill Residential Home DS0000003210.V335602.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Grove Hill Residential Home DS0000003210.V335602.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 1. 2. 3. 4. Quality in this outcome area is excellent. This home continues to deliver very high standards of care, a view endorsed by residents, their relatives and visiting health and social work professionals. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The statement of purpose and service user guide detail what services are provided. It has been recently updated to include some staff changes. A good attempt has been made to incorporate a view of the quality of the service in these documents, though the way this is done is not in an ‘easy read’ format. The latest inspection report is made available in the reception hallway for residents and visitors. This is a service that currently delivers the highest standards of care. People highly praise the home and they include current residents, relatives who visit them, care managers and health care workers, including the local general practitioner (GP). Their comments about the home include; • “Not only are the staff very kind and friendly they make this a truly wonderful place.” - from a relative. DS0000003210.V335602.R01.S.doc Version 5.2 Page 9 Grove Hill Residential Home • • “My niece is very happy [here] and well cared for – the staff are absolutely wonderful.” - from another relative. “I am very impressed with the home and with the care provided to my husband. Staff are always willing to listen to you and the home is a place of warmth and care.” By a different relative. Quality assurance documentation also confirms high standards of care with comments like; • From a social services reviewing officer – “ the councils clients always appear happy and engage in activities. There has been no negative feedback. The home provides a very good quality of life for those living there.” From a visiting optician - “The staff are welcoming…” From a visiting Community Psychiatric Nurse - “The service continues to get positive feedback [from my patients].” • • Comments by people living at the home also endorse high standards of care. For example: • • • “The staff are always very kind and caring and there is plenty to do.” “I like living here; people are very kind and attentative and my health care needs are met.” “We are all so lucky to be in this home.” A GP told the inspector, “This is a caring residential home.” Notwithstanding these very positive comments two residents expressed a concern that on occasions other residents are noisy or not to their liking. However these accounts appear to be the exception to the rule and in one case illustrated a dilemma with the person wanting to go home not understanding that they had no home to go to. Examination of three randomly selected case files show excellent standards of assessment and care planning. Many of these documents are partly modelled on a person centred format designed to be holistic in nature. They are comprehensive in design. They impress as a professional description of need through the eyes of someone who advocates and champions very high standards of care. They clearly capture people’s situations in a caring, protective and concerned way, though they have a tendency to speak for the person rather than giving voice to the person using the service. This needs to be guarded against. Assessments appear comprehensive and thorough. They link well with individual care plans (See next section). Assessment of needs validate in a meaningful way previous life history, connecting with the persons paid work, family, character and personal preferences along side more functional needs such as health, hygiene, safety and behaviours. They also detail what people can do for themselves, but also highlight important ways that help validate personal worth. An example includes a note that the person likes to help with Grove Hill Residential Home DS0000003210.V335602.R01.S.doc Version 5.2 Page 10 domestic tasks. They cover conditions such as history of falls, nutrition, and pressure sores. For recent admissions the service writes to service users to confirm the extent to which the home can meet their needs. Overall the home is well placed to meet the specific care needs of older people including those who may have difficulties arising from Alzheimer type conditions, but who do not require nursing care. It has a dedicated staff team in place that are appropriately trained and supported (see under staffing). Especially evident is the personal qualities that many of the staff bring to their work. These include a cultural belief that older people must be shown respect and kindness. An outstanding feature of this inspection was the number of comments that acknowledge how care is always delivered with a smile and just how happy the home is. The inspector observed behaviour and conduct which illustrated the caring nature of the staff. For example this included care workers: • • Using people’s names when conversing with the residents. Bending down to get improved eye contact and effective hearing communication Validating that nothing is too much trouble when a request was made to them. • Smiling and using very gentle touch to connect with people • It is the quality of these gestures that clearly show this is a caring community. This clearly is not a home where care workers frequently talk across people or communicate from a distance. The home needs to establish a system that ensures all residents have a contract or terms and conditions of residency regardless of whether people who use the service have a local authority placement agreement or not. Two people who returned ‘Have Your Say’ leaflets said they have no contract. However in three case files examined contracts were available, though these appeared to be local authority ones endorsed by the home. Contracts were available for people who are self funding. Grove Hill Residential Home DS0000003210.V335602.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. Quality in this outcome area is excellent. Care planning is well done and residents confirm that they can access the medical services they need. Medication is well managed though written consents for staff to assist with medication were not evident. This is a service that is outstanding in the way it ensures people who use the service are shown respect and given care in a dignified way. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Examination of three sampled case files indicates that care planning is of a very good standard (see previous section). They clearly focus on need rather than problems, something that helps the care worker to deliver what is required and fits the ethos of the home. Documents are good at capturing any necessary interventions in respect of any identified risks such as pressure sores, risk of falling and nutritional needs along with needs arising from fits, mobility, pain relief or memory loss. Documentation is sensitively written in a non-judgmental way including examples where family histories reflect sad experiences and unresolved conflicts that may continue to impact on the resident. Grove Hill Residential Home DS0000003210.V335602.R01.S.doc Version 5.2 Page 12 Residents also verify that the service is good at supporting them to access the medical services they need. An appointment book is maintained. Relatives confirm that they are kept informed of any changes and updated following appointments at health clinics or surgeries. Case files indicate there is good communication with health care workers such as visiting nurses, dietician, hospital doctors’, chiropodist, optician and dental clinics; a view endorsed by health care workers. The local GP verified that, “staff are patient and willing to work at problems” and that, “Grove Hill is a good residential home.” The visiting physiotherapist said she had, “no concerns whatsoever about the home.” Respecting privacy and promoting dignity is actively promoted in the service user guide and various policies and procedures. Care workers appear to have an innate understanding of what it means to respect older people. Examples where dignity and respect are promoted are wide ranging. For example when someone wants a hot drink in their bedroom the tray is properly prepared and there is a policy to say this must be done to ensure dignity. This allows the person to decide for themselves how much milk or sugar they might want and therefore promotes self respect. Care plans detail how staff should care for dentures or to assist someone using the toilet. They also emphasise the need for care workers to speak with clarity. There is a detailed medication policy in place, which appears satisfactory, save the lack of written consents. Drugs are stored in a lockable container and controlled drugs are kept double locked. Medication was checked and found to be in good order. Only staff that have undertaken the relevant training can issue drugs to residents. Staff who do so are provided with a two day training course that covers related legal issues, side effects, record keeping any limitations as to what they can or cannot do. The home uses a local chemist who undertakes two inspections per year. Records show the last inspection by the chemist was carried out on 22/2/07 and they confirmed that the systems in place met the required standards. Written consents are not being obtained from the people using the service (or if lacking capacity, others acting on their behalf) if they need staff to assist them with any of their medication needs. According to the manager such consents are obtained verbally at the assessment stage and recorded on file. This practice falls short of best practice. People who self-administer their drugs or creams are enabled to keep these secure in a locked container in their bedroom. Potential issues can arise if a person shares a bedroom, as many do. In such circumstances there should be a written risk assessment as to any potential risk of harm that might or might not arise concerning self-medication. The drug records of two people were checked along with the record of controlled drugs. All appeared to be in order with stock counts reconciling with the record keeping. Grove Hill Residential Home DS0000003210.V335602.R01.S.doc Version 5.2 Page 13 Care workers also confirmed that they attend training in medication; some indicating they have attended two different courses. According to care workers the system works well. Grove Hill Residential Home DS0000003210.V335602.R01.S.doc Version 5.2 Page 14 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12. 13. 14. 15. Quality in this outcome area is excellent. People who live at the home are encouraged to be active and a varied range of social events are put on for residents. Relatives and residents praise the arrangement for food and menu planning. Visitors are made welcome. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Feedback from service users in the ‘Have Your Say’ leaflets confirms there are enough activities to do, most of the time. People that were spoken to during the inspection verified this. The service users guide states the service is committed to, ‘encouraging participation in activities and stimulation for those who wish to take part.’ Assessment information details people’s interests and they make suggestions as to how such interests can be maintained. The commitment to facilitate activities is underpinned by the service having a separate amenity fund, staff arranging periodic social events and by employing care workers who like being with older people and see part of their job as having ‘quality time’ with the people who use the service. It is as if they are saying if you care about older people you show respect by socialising with them; so this clearly is not a care home where people just sit around the four walls sleeping between meals. It is much more vibrant and lively than that. Grove Hill Residential Home DS0000003210.V335602.R01.S.doc Version 5.2 Page 15 Special efforts are made to celebrate birthdays and such an event took place during the inspection with a professional entertainer putting on a cabaret. The cabaret artist told the inspector that she visits the home several times a year and that in her opinion it is one of the best care homes she performs at because residents and staff all participate. During the cabaret care workers pointed out service users who typically were inactive during the day but were up dancing and laughing as well as singing. It was a joy to see. Relatives are invited to these events, with one saying they would not believe how much their family member participated if they had not seen it with their own eyes. It is not only birthday and festivals that are celebrated; there is a monthly programme of movement to music and quizzes for all to participate in. These events are advertised so residents know about them in advance and as one relative put it; “this helps us encourage our family member to join in”. The home also provides a video library and a small library of books including large print books and cassettes. The inspector also observed care workers engage individual service users with activities such as scrabble or dominoes. Their approach was to spontaneously ask residents if they would like to play and to play with them for short periods. The regularity in which care workers engage residents in activities was commented on by visiting relatives. A strong feature of this inspection was the number of relatives who visited the home and their comments about the way it cares for their family member and the way it cares about them. They cite the lovely welcome they get, the smiling and polite staff who are always willing to answer any concerns they may have. Above all they cite the caring nature of the people who work in the home. The manager of the home also talks about the significance of it being located in a village, serving the local community and beyond. The inspector observed that people live life here at there own rhythm. It was observed that getting up times vary and residents said times for going to bed also vary. Residents are discreetly supported to be as active as their condition allows. For example residents may, with staff support, help with the dishes, even help bake a cake, or prepare some flowers or do some gentle gardening. Two meals times were observed in a discrete way. Mealtimes appear sociable occasions where care workers support residents to make choices, eat for good health and give any assistance required. It was observed that several residents opt to take meals in their rooms. There is normally a winter and a summer menu plan that is adjusted to any special routines or events that may arise. Additional to the main menu residents can self select a variety of snacks or alternatives. An example of choice and a caring approach is that the menu doesn’t just say, salad sandwich but states, “salad sandwich or separate items of salad in separate sandwich Grove Hill Residential Home DS0000003210.V335602.R01.S.doc Version 5.2 Page 16 and in respect of egg sandwiches it states, “ fried, boiled or scrambled with or without salad cream.” Relatives compliment the home on the quality of the food. As one relative put it, “You don’t see anyone losing weight here do you”. Another said, “The staff have worked very hard to help [my family member] put on weight as she was underweight when she was admitted.” It was also observed that residents are provided with a drink between meals, though in one example a care worker forget what the resident asked for and gave her a different drink. A care worker was also observed to gently encourage a man to take a drink by reminding him it was in front of him and moving the glass even nearer to the person as a discrete prompt. After which she watched to see that they did take some sips. A different care worker was observed to give more direct assistance by holding the containers while the person sipped. These tasks, which seemed appropriate to each persons needs, were carried out in a pleasant manner without any patronising comments that sometimes are heard in other settings when older people do not eat or drink. Satisfaction with meals was found to be high with no one making any adverse comments. One service user said the menu was “always varied.” Another commented on the quantity of food. Several residents simply said the food was good or that they had enjoyed the meal they just had. Two relatives also were positive about the food. The chef impresses as someone who likes older people and who actively listens to what they say about what they want to eat. From discussions with him he appears to know the likes and dislikes of each resident. Grove Hill Residential Home DS0000003210.V335602.R01.S.doc Version 5.2 Page 17 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): 16. 18. Quality in this outcome area is good. Service users continue to be adequately protected from abuse and harm and satisfactions levels about the service appear very high. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Record show there is a very low level of complaints made about his service with no complaints having been recorded at the home in the previous 12 months. The Commission has received no complaints about this home. The home has a detailed complaints policy, which is made available to visitors and to the people who use the service. How to complain is explained on a notice in the entrance lobby and in the service user guide. However two people who completed ‘Have your Say’ leaflets said they did not know how to complain. This may suggest some confusion on their part but as a precaution it is advised that all current service users are reminded about the complaints system. Training records indicate that all current staff receive awareness training in dealing with any disclosures or allegations of abuse, should they occur. The manager said no such incidents have occurred in the previous 12 months and none have been notified to the Commission. Records also show that care workers are provided with the governments policy document titled,’No Secrets’ and the General Social Care Council code of practice, which staff are expected to follow. Staff impress as individuals who would report their concerns to the manager. Grove Hill Residential Home DS0000003210.V335602.R01.S.doc Version 5.2 Page 18 It is the policy of the home not to become involved with residents finances preferring relatives, advocates, social service departments or bank managers take on this responsibility. However systems are in place if person living at the home wants to hand over small sums of money for safekeeping. Grove Hill Residential Home DS0000003210.V335602.R01.S.doc Version 5.2 Page 19 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. 23. 26. Quality in this outcome area is adequate. While being a comfortable and clean home the number shared rooms and the number of bedrooms without locks means this standard is only adequate. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home was found to clean throughout with good standards of comfort and furnishings. The most recent inspection of by the local environmental health office, which took place in Feb. 06 concluded that there were, ’good standards through out the home.’ There are a variety of seating options in the communal lounge providing single seats, shared seating and seating of different heights. The dining area also provides sufficient tables and chairs close to the kitchen and lounge making access easy for people who have difficulty walking. Since the last inspection further improvements have been made to the standard of accommodation. These include refurbishment of the vertical passenger lift, some redecoration and some re-carpeting. Grove Hill Residential Home DS0000003210.V335602.R01.S.doc Version 5.2 Page 20 Currently the service offers seven ‘companion rooms’ i.e. shared bedrooms and thirteen single rooms. No one made any adverse comments about their accommodation or sharing facilities. One of the bedrooms is also on a fire escape route and is left unlocked at all times. It is also noted that one bathroom is used as an escape route should the fire alarm sound. Consequently this room cannot be locked and therefore cannot provide privacy at all times. However the manager reported residents do not use the room. Instead they use a different bathroom that provides a mechanical hoist. Toilets are discretely labelled to assist those who have difficulties with orientation. Hand washing gel is available in the hall and all visitors are encouraged to use it to reduce cross infection. However it was observed not many do. Maybe if staff were seen to use the hand gel themselves, this would serve as an example to follow. All bedrooms are numbered. Locks are only provided if a service user requests one; this again compromises privacy. The inspector saw three bedrooms. They appeared adequately furnished, clean and personalised. Service users said they like their rooms. Grove Hill Residential Home DS0000003210.V335602.R01.S.doc Version 5.2 Page 21 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 27. 28. 29. 30. Quality in this outcome area is excellent. This is a well staffed home with staff who have outstanding personal and professional qualities and experience. They continue to deliver exceptionally high standards of care. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Records show the home is adequately staffed with approx 15.5 full time staff covering 24 hours a day, plus the manager/owner who adopts a hands on approach. These numbers include staff designated as seniors, care workers, cleaning and cooking staff. Some staff have a dual role. Examination of staff rotas provided to the Commission show that there are typically four care workers on in the morning up to late afternoon and three in the evening, with two care workers working nights (awake duty). Additionally during the week there is an assistant manager on duty, typically from 9 a.m. to 6 p.m. The hours worked by the manager/owner are not being recorded. A feature of this service is the stability of the staff team. There has only been one staff change in the previous 12 months. At the time of the inspection approximately four out of five care workers held a National Vocational Qualification level 2 or above. This is significantly more than the required standard of 50 . Records show the home does not employ Grove Hill Residential Home DS0000003210.V335602.R01.S.doc Version 5.2 Page 22 persons under the age of 18 years and all senior staff are aged 21 years or over. Examination of the recruitment records of four selected staff showed that they all completed an application form and a curriculum vitae. All had a relevant criminal record bureau check and where applicable work permits or residency permits were in place. There was evidence to show that at least two references had been obtained before commencement of employment, including one from the person previous employer. Proof of identity was also available in the person’s file. In one application it appeared a person had not detailed of all their employment history, perhaps because the form did not invite the person to use a separate sheet of paper to do so. Care workers confirmed they are provided with written terms and conditions of employment, copies of which were seen on two files. The inspector spoke to four care workers as a group. They spoke with pride about liking older people and the work they do. They described the home as a happy place to work and gave a rounded account of their duties including supporting and assisting residents with any needs they have. They confirmed that they manage to find time to undertake activities with the residents. They cited board games, dominoes, Friday bingo, gentle exercise and music and movement as being the most popular. They stated that each day they would find time to talk with residents either in their bedroom or in the lounge area. What they described was giving residents some ‘quality time’ and that they saw this as a necessary part of the daily task of caring. They were observed to work in this way during the inspection. As one put it, “we will do what we are asked and we are happy to provide them with the care they need.” Another said the work “is hard both mentally and physically but we enjoy it – it is in our culture to respect older people.” They confirmed that an argument between residents and verbal aggression is a rare occurrence in the home. They highly praised the manager/owner for the support he provides including provision of relevant training. They cited supporting them with their National Vocational Qualification training, both in care and in cleaning and support services, and help for overseas staff to improve their language skills. Examination of each individuals training records show staff are provided with a range of relevant courses, including statutory training in first aid, infection control, lifting and handling, and managing medication. Records also show that care workers are provided with induction that meets the industry standard. They also show that awareness training is provided to selected staff in conditions associated with ageing such as dementia awareness, continence care, skin care, disability equality, and nutrition. Grove Hill Residential Home DS0000003210.V335602.R01.S.doc Version 5.2 Page 23 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. 37. 38. Quality in this outcome area is excellent. Grove Hill Care home is well-managed service and is being run in the interests of the residents. The standards of administration, accountability, staff support and the care of residents are all of a high standard. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home is managed by a manager/owner who is deemed suitably qualified and experienced to carryout such responsibilities. Previous reports have indicted that the home has been well managed. Current staff state that the home is well run; a view endorsed by current service users, relatives and visiting professionals. There are a range of written procedures and policies in place that are designed to ensure resident’s comfort, safety and a high quality of life. Values such as privacy, dignity, choice and fulfilment are evident and the emphasis is to Grove Hill Residential Home DS0000003210.V335602.R01.S.doc Version 5.2 Page 24 ensure services are kept happy during their stay. The manager/owner is clearly committed to delivering high standards of care and this inspection continues to show the service is being successful at doing so. The management approach appears to be partly improvement focussed and a passion to exceed national minimum standards. Quality assurance systems are well developed and include accreditation of ISO 9002. Annual quality assurance surveys are sent out and their findings collated. The last such survey was in April 2007. The service actively works with appointees and the public office of guardianship. Systems are in place for handling residents’ personal allowances and their small sums of personal spending, if needed. Proper attention is given to ensuring the safety of the people living at the home, including preventing harm. There are detailed policies and procedures, that underpin safety such as procedures for accident and incident reporting, preventing abuse, conduct expected of staff, care planning and promoting respect and dignity. The local environmental health department inspection report validates high standards. Records show a low level of accidents and incidents occur, the response to which appear appropriate to the circumstances. Significant incidents (which are rare occurrences) are reported to the appropriate bodies. Periodic maintenance checks are undertaken and equipment upgraded where appropriate. Case documentation covers assessment of risk and staff records confirm that staff receive relevant training. Grove Hill Residential Home DS0000003210.V335602.R01.S.doc Version 5.2 Page 25 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 2 4 4 X X HEALTH AND PERSONAL CARE Standard No Score 7 3 8 4 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 4 13 4 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X X 2 X X 3 STAFFING Standard No Score 27 4 28 4 29 3 30 4 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 4 4 X 3 X 4 3 Grove Hill Residential Home DS0000003210.V335602.R01.S.doc Version 5.2 Page 26 Are there any outstanding requirements from the last inspection? No 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 OP2 Regulation 5(1)(a)(b 0 Requirement People who are receiving care must be provided with written terms and condition of residency or a contract that outlines the service to be provided, the facilities available and the amount payable. Timescale for action 02/06/07 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 OP3 OP9 Good Practice Recommendations When undertaking assessments or care planning it is recommended that the ‘voice’ of the person receiving the care be included in these documents. Where care workers provide people using the service assistance with medication, it is recommended that written consents are obtained for them to do so from either the resident or, if they lack capacity, someone else who can act on behalf of the resident. Consideration should be given over time as to how best to reduce the number of shared rooms. DS0000003210.V335602.R01.S.doc Version 5.2 Page 27 3 OP23 Grove Hill Residential Home 4 OP1 Consideration should be given as to the best way to provide (in an easy read format) the residents views on the home, for inclusion in the service user guide. Grove Hill Residential Home DS0000003210.V335602.R01.S.doc Version 5.2 Page 28 Commission for Social Care Inspection Chippenham Area Office Avonbridge House Bath Road Chippenham SN15 2BB 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 Grove Hill Residential Home DS0000003210.V335602.R01.S.doc Version 5.2 Page 29 - 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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