Inspection on 09/08/05 for Grove Hill Residential Home

This inspection was carried out on 9th August 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

Grove Hill Residential Home 02/05/07

Grove Hill Residential Home 23/01/06

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 Bernard McDonald Unannounced 9 August 2005 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 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 DD51_D01_S3210_GROVEHILL_V239176_090805_STAGE4.doc Version 1.40 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 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 Op Old age registration, with number of places Grove Hill Residential Home DD51_D01_S3210_GROVEHILL_V239176_090805_STAGE4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 7 December 2005 Brief Description of the Service: Grove Hill is a private residential home offering accomodation and personal care to 27 residents over the age of 65. Gove Hill was first registered with Mr Dunn in 1986. The home is situated close to the centre of Highworth with easy access to local amenities. There is a regular bus service which stops outside of the home, to Swindon town centre. Ample parking facilities are available at the front of the property. The accommodation consisits 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 on duty throughout the night. Grove Hill Residential Home DD51_D01_S3210_GROVEHILL_V239176_090805_STAGE4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. Two inspectors completed the unannounced inspection over eight hours. The inspectors met and spoke with over twenty service users who wish to be referred to as residents throughout the report. The inspectors viewed all areas of the home including all residents’ bedrooms. The inspectors met with the relatives of four residents who all commented on the high standard of care provided at the home. There were four care staff on duty and the manager who is also the owner was available to assist with the inspection. The inspectors had opportunity to speak with residents in private to obtain their views on the service they receive. The inspectors examined a sample of four care plans, three staff recruitment records, policies and procedures for the safety of residents. There were no requirements from the previous inspection. What the service does well: This is a service where residents are respected and their views are listened to. The inspectors received numerous compliments about the service from residents and their relatives. Residents spoke about “wonderful staff” and “nothing is to much trouble” while relatives, commented about the high standard of care provided at the home. There is a committed and enthusiastic staff team who were aware of the care needs of residents which is due to the high standard of care plans that have been commended in this report. This is a service that has made polices, procedures and inspection reports readily available for anyone who wishes to read them. There is a good system in place for introducing resident to the service, which ensures they are fully informed about what, is available at the home prior to their admission. This practice is commended in the main body of the report. Grove Hill Residential Home Version 1.40 Page 6 DD51_D01_S3210_GROVEHILL_V239176_090805_STAGE4.doc The home has built up relationships with health professionals to ensure the health needs of residents are quickly responded to. 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. Grove Hill Residential Home DD51_D01_S3210_GROVEHILL_V239176_090805_STAGE4.doc Version 1.40 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 Standards Statutory Requirements Identified During the Inspection Grove Hill Residential Home DD51_D01_S3210_GROVEHILL_V239176_090805_STAGE4.doc Version 1.40 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 standard(s) 3, 4, 5, 6. Although taking residents outside the homes category of registration staff have the skills and knowledge to meet the needs of residents. The admission procedures are commended for the way in which residents and families are provided with opportunities to visit the home and assess the quality of care prior to moving. EVIDENCE: The inspector’s examined four residents’ pre admission assessments. The records all contained either a pre admission assessment undertaken by the manager or a community care assessment completed by the purchasing authority. Records examined contained written confirmation on the homes ability to meet the needs of the residents. However the inspectors were concerned to find that two residents’ assessments had a primary need of dementia care. The home is currently not registered to provide care for residents whose primary needs relate to dementia care on admission. It is a requirement that the home must not admit residents outside the homes categories of registration. An application to vary registration must be made to the Commission if the home wishes to accommodate residents whose primary need relate to dementia. Grove Hill Residential Home DD51_D01_S3210_GROVEHILL_V239176_090805_STAGE4.doc Version 1.40 Page 9 The inspector’s found all the care staff had completed dementia awareness training in October 2004 and discussion with staff did demonstrate a clear understanding of the needs of residents and how their needs were being met in the home. The inspectors met with a resident who was admitted to the home on the afternoon of the inspection accompanied by their relatives. The resident and their relatives confirmed they had opportunity to visit the home prior to moving in. This enabled the family to speak with other residents and meet with staff. The relatives confirmed they had received a copy of the last inspection report together with the service user guide outlining the complaints policy and facilities offered at the home. This practice was mirrored throughout the inspection and one resident confirmed they had a choice of room and was able to paint the room the colour of their choosing and also purchase furniture that they had wanted specifically for their room. The resident commented they “could not have asked for anything more”. Discussion with the manager confirmed the home does not provide intermediate care. Grove Hill Residential Home DD51_D01_S3210_GROVEHILL_V239176_090805_STAGE4.doc Version 1.40 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 standard(s) 7, 8, 9, 10. Residents’ personal, health and social care needs are being met. Residents feel supported and that they are treated with respect. EVIDENCE: The home operates a key worker system and their roles and responsibilities are explained at the front of the residents care plan. Discussion with the staff demonstrated an understanding of their role and the care needs of residents. The inspector’s examined four care plans and found they were comprehensive and covered all areas of health personal and social care needs. Care plans provided clear details on how residents needs must be met and what support they required of staff to maintain their independence. One care plan clearly showed improvements to the resident’s health and well-being. Residents commented throughout the inspection on the “wonderful staff” and “nothing is to much trouble”. Observations made during the inspection found staff spending time with residents, talking to them, involving them in activities and ensuring their needs were being met. Discussion with several relatives and visitors to the home also commented on the quality of care provided at the home. Grove Hill Residential Home DD51_D01_S3210_GROVEHILL_V239176_090805_STAGE4.doc Version 1.40 Page 11 Where care plans identify any risk to residents, risk assessments have been completed and in the case of risk from pressure sores appropriate pressure relief support had been obtained. Care plans show residents involvement in the content. The inspector’s had opportunity to meet with the district nurse who confirmed the general care was good. Residents’ notes also provide evidence of access to dental, optical and chiropody services. Since the last inspection the home has purchased a new medication trolley to improve the security, storage and administration of medication at the home. Staff confirmed they had received in house medication training and five members of staff had received intensive medication training. Records examined demonstrated medication was being accurately recorded when administered to residents. Discussion with the manager confirmed residents are mainly registered with the local practice. Grove Hill Residential Home DD51_D01_S3210_GROVEHILL_V239176_090805_STAGE4.doc Version 1.40 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 standard(s) 12, 13. Resident’s benefit from a flexible lifestyle, that provides opportunities for choice in their daily routine. The home welcomes visitors and friends of residents. EVIDENCE: Discussion with residents confirmed they are routinely offered choices in relation to activities, meal times, getting up and going to bed and opportunity to spend time alone. Discussion with staff demonstrated an awareness of residents’ likes, dislikes and interests. Activities are normally provided each afternoon. On the day of the inspection the home was celebrating three residents birthdays and outside entertainment was brought into join in the celebration. Discussion with residents confirmed they were looking forward to this event. Religious needs of residents are being addressed at the home. There is a fortnightly Sunday service and every alternate Wednesday there is a communion service. One resident also meets with their priest on a regular basis. Information on activities is on display and residents’ participation is being recorded. Grove Hill Residential Home DD51_D01_S3210_GROVEHILL_V239176_090805_STAGE4.doc Version 1.40 Page 13 The manager confirmed there are no restrictions on visitors to the home unless requested by the resident. Residents are able to meet their visitors in the privacy of their room or private space is made available in either one of the two communal areas on the stair landings or in the dining area. Relatives spoken to confirmed they could visit at any time and were always made welcome offered a drink and could even share a meal with their relative. Discussion with the relatives of four residents confirmed they were aware of policies and procedures held at the home. These are available at the entrance to the home. Two relatives confirmed they had seen the last inspection report and felt the manager was very approachable. Grove Hill Residential Home DD51_D01_S3210_GROVEHILL_V239176_090805_STAGE4.doc Version 1.40 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 standard(s) 16, 18. The home was making every effort to ensure residents are protected from abuse and are able to raise concerns about the care they receive. EVIDENCE: Discussion with the manager confirmed the home had received no complaints since the last inspection. A copy of the complaints procedures and details of how to contact the CSCI office at Chippenham were on display at the entrance to the home. When residents were asked who they would complain to if were not happy about something residents stated they would speak to the manager and he would “sort it out.” Other residents stated they had nothing to complain about. The families of residents were also aware of the homes complaints procedures. Discussion with staff demonstrated an awareness of what constitutes abuse and what action they would take to report any concerns that affect the welfare of residents. Staff confirmed they had completed a basic abuse awareness course and had received a copy of the local “no secrets” guidance for staff. Grove Hill Residential Home DD51_D01_S3210_GROVEHILL_V239176_090805_STAGE4.doc Version 1.40 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 standard(s) 19, 20, 21, 22, 23, 24, 25, 26. Residents live in home that is clean, tidy, and free from odour with furniture and fittings of a good standard. EVIDENCE: Discussion with residents indicated they were satisfied with the standard of accommodation provided. Residents confirmed they are able to bring items of their own to personalise their room including furniture. One resident confirmed they had their room decorated before moving in. Another resident commented they had “everything they need”. The inspector noted some improvements to the décor of the home with several residents’ rooms having recently been decorated and carpeted. Residents are offered a choice of what furnishing they want in their rooms and whether they require a key to their bedroom door. All residents’ rooms have a call bell in the event of emergency. Discussion with residents confirmed that when they are used staff respond promptly. Discussion with the manager confirmed there was no real written maintenance plan of the building but repairs are completed as required. Grove Hill Residential Home DD51_D01_S3210_GROVEHILL_V239176_090805_STAGE4.doc Version 1.40 Page 16 Furnishings were of a good standard but it is recommended that some commodes found to be corroded in residents’ rooms be replaced. Toilet and bathrooms are sited on all floors and situated close to communal living areas. All toilet doors have been fitted with suitable locks for the privacy of residents. The home is situated over three floors and is accessed by two staircases and a lift. Aids and hoists are in place to assist with the safe moving and handling of residents. Staff confirmed they had received training in their use and records show they are regularly serviced. Discussion with one resident who lives in a shared room confirmed they had chosen to share but would prefer a private room when one becomes available. All rooms are centrally heated and radiators are guarded to ensure residents safety. Water temperatures are regulated close to 43c to reduce any injury from scalding. The laundry area is situated downstairs well away from any food preparation areas. The home has a commercial washer and dryer and sluice facilities are in place in the laundry room. Discussion with residents confirmed washing is promptly returned and ironed. The laundry area was clean and tidy with floors and walls easily cleanable to reduce the risk of any infection. Polices and procedures for the control of infection are in place. Grove Hill Residential Home DD51_D01_S3210_GROVEHILL_V239176_090805_STAGE4.doc Version 1.40 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 considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27, 28, 29. The home is demonstrating a commitment to ensuring staff are competent and trained to meet the needs of residents but is failing to ensure the recruitment procedures are sufficiently robust to demonstrate safe recruitment practices are followed. EVIDENCE: The inspectors looked at three staff recruitment records all of which contained satisfactory references criminal records bureau checks at enhanced level proof of identity two references and a photograph of the staff member. The inspectors met with a member of staff who commenced work the previous day. The home had not obtained Criminal Records Bureau check (CRB) but had relied on the one provided from the staff members previous employer. The inspectors informed the manager that no staff could commence work without the home having first obtained a satisfactory CRB at enhanced level. The manager stated that they were not aware of the change that CRB’s were not transferable and would be applying for a clearance the following day. Since the inspection written confirmation that a protection of vulnerable adults (POVA) check had been received and the staff member would be working in a supervised capacity until suitable clearance from CRB has been received. Discussion with staff and examination of the rota demonstrated there was sufficient staff on duty at all times. There was a low incidence of sickness and no use of bank staff. The staff team were enthusiastic about their work and feel there is a good team spirit. Grove Hill Residential Home DD51_D01_S3210_GROVEHILL_V239176_090805_STAGE4.doc Version 1.40 Page 18 All but one member of staff have completed a minimum of NVQ level 2. A further staff member is currently completing NVQ 3 and the assistant and deputy manager have both completed the registered managers award and NVQ 4 in care. In addition to the care team there are two cleaners and two cooks. Grove Hill Residential Home DD51_D01_S3210_GROVEHILL_V239176_090805_STAGE4.doc Version 1.40 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 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31, 33, 35, 36, 38. Residents’ benefit from a home that is run by a competent and trained and experienced manager who strives to ensure their safety and that their views on the care they receive are obtained and listened to. EVIDENCE: Mr Dunn has been the owner and manager since 1986 and since the last inspection he has completed NVQ 4 in care and the registered managers award. Discussion with staff confirmed there are clear lines of responsibility in the home and staff are aware of the standards expected. Staff confirmed they receive regular supervision a minimum of six times a year. Grove Hill Residential Home DD51_D01_S3210_GROVEHILL_V239176_090805_STAGE4.doc Version 1.40 Page 20 The home was holding money on behalf of residents. Examination of a sample of four records demonstrated the home was accurately recording money held for residents. Following a recommendation made at the previous inspection quality assurance questionnaires has been sent out to stakeholders. Responses were available for inspection all of which commented on the good quality of care provided at the home. The results are published in the service user guide and the manager stated he would be continuing to seek residents’ and stakeholder’s views every six months. The manager also makes the inspection report available to residents their family and visitors to the home. The home has completed generic risk assessments on the environment all had been reviewed in the past year. COSHH risk assessments were in place and all chemicals are kept secure in the home. The last recorded fire drill was in June 2005 and records show staff receive fire safety training every three months. Grove Hill Residential Home DD51_D01_S3210_GROVEHILL_V239176_090805_STAGE4.doc Version 1.40 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score x x 2 3 4 N/A HEALTH AND PERSONAL CARE Standard No Score 7 4 8 3 9 3 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 4 14 x 15 x COMPLAINTS AND PROTECTION 2 3 3 3 3 3 3 3 STAFFING Standard No Score 27 3 28 4 29 2 30 x MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x 3 3 x 3 x 3 3 x 3 Grove Hill Residential Home DD51_D01_S3210_GROVEHILL_V239176_090805_STAGE4.doc Version 1.40 Page 22 NO Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard 3 Regulation Registrati on Regualtion 12. 19(4)(a) (b)(i) Requirement The registered person must not admit residents outside the homes categories of registration. The registered person must ensure they a satisfactory Criminal Records Bureau check at enhanced level before any member of staff commences work. Timescale for action 09/08/05 2. 29 10/08/05 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. Refer to Standard 19 Good Practice Recommendations The registered person should replace the corroded commodes identified at the time of the inspection. The registered person has confirmed this recommendation has now been met. Grove Hill Residential Home DD51_D01_S3210_GROVEHILL_V239176_090805_STAGE4.doc Version 1.40 Page 23 Commission for Social Care Inspection Suite C, Avonbridge House Bath Road Chippenham Wiltshire SN15 2BB 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 Grove Hill Residential Home DD51_D01_S3210_GROVEHILL_V239176_090805_STAGE4.doc Version 1.40 Page 24 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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