Inspection on 12/07/07 for Grove House

This inspection was carried out on 12th July 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

Grove House 15/06/06

Grove House 28/12/05

Grove House 25/10/05

Grove House 09/02/05

Grove House 24/08/04

Grove House 23/03/04

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

CARE HOMES FOR OLDER PEOPLE Grove House Highfield Road Adlington Chorley Lancashire PR6 9RH Lead Inspector Mr Patrick Rooney Unannounced Inspection 10:00 12th July 2007 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 House DS0000036045.V336182.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 House DS0000036045.V336182.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Grove House Address Highfield Road Adlington Chorley Lancashire PR6 9RH 01257 481442 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) Lancashire County Care Services Mr Alan Charles Ridd Care Home 46 Category(ies) of Dementia (24), Old age, not falling within any registration, with number other category (21), Physical disability (10) of places Grove House DS0000036045.V336182.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The home is registered for a maximum of 46 service users to include: Up to 21 service users in the category of OP (Old age, not falling within any other category). Up to 24 service users in the category of DE (Dementia). Up to 10 service users in the category of PD (Physical Disability aged 55 years and above). The service should employ a suitably qualified and experienced manager who is registered with the Commission for Social Care Inspection. All new admissions to the dedicated Dementia Care Unit must be of the category DE (Dementia). 15th June 2006 2. 3. Date of last inspection Brief Description of the Service: Grove House is a purpose built home located in the village of Adlington between Chorley and Horwich. There are shops and many other local facilities available nearby. Grove House caters for older people and also has a unit for people who have care needs associated with dementia and a rehabilitation unit. The home has two floors accessible via stairs and a passenger lift. The home is set out in four separate units, each with its own combined lounge/dining/kitchen. The private accommodation for service users is all in single rooms. The home has a large garden area, with seating, and a greenhouse and courtyard that are secure. The home has recently been extensively refurbished which has resulted in significant improvements to the environment. Grove House DS0000036045.V336182.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced site visit and took place over a seven-hour period. The manager completed an Annual Quality Assurance Assessment. The inspector consulted care records and spoke to most of the residents living at the home. He discussed their care with them and visiting relatives. Surveys were completed and returned by nine relatives and five residents. Comments received positive about the care provided by Grove House. Their comments include: “It is good here”. “I have been here a long time and like it”. “The staff are very helpful and are always there when I want them” A relative said, “I am very impressed with the level of care provided”. “Care staff always appear well trained and professional”. “Residents are treated as individuals. The inspector toured the building, spoke to individual staff, had discussion with management and consulted records and policies and procedures. What the service does well: What has improved since the last inspection? Medication policies and procedures have been improved and better storage and records maintained. Ventilation in drugs cupboards has been improved and Grove House DS0000036045.V336182.R01.S.doc Version 5.2 Page 6 regular temperature checks maintained. Plans are in place to ensure carpets in the dementia unit are replaced and better kitchen cupboards provided. 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 House DS0000036045.V336182.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 House DS0000036045.V336182.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 and3 Quality in this outcome area is good. The homes information and assessment processes ensure that prospective residents can make an informed decision about accepting a place at Grove House. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The assessments for five residents were looked at and discussions were held with these residents. The home is currently transferring assessment and care planning to a new system. Assessments were suitably detailed and had been drawn up with the involvement of the resident and/or their representative. The new system will ensure that a more person centre approach is used in all aspects of assessment and care planning. Grove House DS0000036045.V336182.R01.S.doc Version 5.2 Page 9 All residents are provided with a service users guide and a contract; these were seen in resident’s rooms. Prior to admission prospective residents and their families are provided with information and are able to look around the home. Residents can be admitted for a trial period to ensure that the home is right for them. Residents admitted to the rehabilitation unit are supported by a multi disciplinary team. Assessments and care plans for these residents were seen. Their rehabilitation programmes are well documented and reviewed during their time in the unit. Residents spoken to in the unit spoke very highly of the support and help they receive. One resident was awaiting the final meeting before return home and said that the help received meant that she was able to return home. Grove House DS0000036045.V336182.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,9 and 10 Quality in this outcome area is good. There is a good care planning process in place, which provides each resident with a care plan derived from the initial assessment. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The care plans of five residents were looked at and the care they receive was discussed with them and care staff. Care plans were detailed and there was evidence that that resident and their representatives had been involved in the process. Some of the care plans did not fully include social and personal background. The inspector was told that the new care planning system being implemented would cover all these aspects. Grove House DS0000036045.V336182.R01.S.doc Version 5.2 Page 11 Residents cultural and religious beliefs are recorded and respected, those spoken to said they are happy with the care they receive and that care is delivered in a caring and dignified manner. There comments include, “It is good here”. “I have been here a long time and like it”. “The staff are very helpful and are always there when I want them” A relative said, “I am very impressed with the level of care provided”. “Care staff always appear well trained and professional”. “Residents are treated as individuals. Risks are identified and discussed with residents; there were instructions as to how to deal with these and to promote as much independence for residents as possible. Staff said that they are trained to encourage residents to do as much for themselves as possible. Assistance is offered as and when required. Care plans are reviewed monthly and outcomes recorded on file. Medication policies and procedures have improved and records seen were properly completed and up to date. Staff giving out medication receive training and were aware of their responsibilities regarding this. Regular monitoring of temperatures in storage areas is carried out and ventilation has been improved. The controlled drugs register and administration procedures have been improved and the register was up to date. A recommendation made previously regarding reviewing medication policies and procedures in the rehabilitation unit has still not been carried out. The pharmacy inspector in his report dated 7/9/06 said, “ A dedicated policy for the handling of medicines within the rehabilitation unit is not available. This should be reviewed as soon as possible to ensure carers handle medicines correctly.” A statutory requirement is therefore made regarding this. Grove House DS0000036045.V336182.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,14 and 15 Quality in this outcome area is good. Daily routines are flexible and respect individual’s social, cultural, nutritional and activity needs. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Grove House policies and procedures encourage flexibility and respect resident’s wishes in making choices about everyday life. Residents told the inspector that they can make choices and that they can see visitors in private. Local from different denominations visit and those who wish to attend services are able to do so. A variety of activities are provided by staff, though these have been more limited lately as there is no activity coordinator. The manager said that it is hoped to rectify this soon. Consideration should be given to improving the activity programme. Grove House DS0000036045.V336182.R01.S.doc Version 5.2 Page 13 Most of the residents have assistance in managing their affairs, this is mainly provided by families. For those who wish information is available in the home from independent advocacy services. The manager is aware of the new Mental Capacity Act and its implications for residential homes and training regarding this is being provided. The home provides a weekly rotating menu in which there is a good variety of meals available. Residents said they are happy with the food they receive. Information regarding special diets is available to the kitchen staff. Grove House DS0000036045.V336182.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18 Quality in this outcome area is good. The home has a suitable complaints and protection procedures in place. This judgement has been made using available evidence including a visit to this service. EVIDENCE: A complaints procedure was seen and is available to residents in the service user guide. It is also available on the homes notice board. Complaints received are dealt with appropriately and correct procedures are followed. Residents said they are aware of the procedure and knew what they should do if they have concerns. Survey received from residents and relatives confirmed this to be the case. The ethos of the home is to encourage people to express views, concerns and compliments. There is a policy in place for the protection of vulnerable adults, including a whistle blowing policy. Staff spoken to were aware of these policies and said that they felt able to raise concerns with the management. Staff receive training regarding this, however records showed that not all have received this training and plans should be put in place to improve this. Grove House DS0000036045.V336182.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 19 and 26 Quality in this outcome area is good. The home offers a good standard of décor and furnishings, which provide residents with a homely clean and comfortable environment. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The inspector toured the home and viewed the rooms of residents, he observed them to be comfortably furnished and contained items residents were able to bring with them when they were admitted to the home. Public areas of the home were seen to be comfortably furnished and decorated. All residents spoken to say they were happy with accommodation Grove House DS0000036045.V336182.R01.S.doc Version 5.2 Page 16 provided by the home. Residents rooms can be personalised with their own pictures and ornaments, rooms seen were homely and comfortably furnished. There has been major refurbishment and decoration and on going improvements are planned. Externally there are garden areas available to residents in fine weather. There are very good infection control procedures in place and domestics employed to ensure the home is always kept clean. At the time of the inspection all areas of the home were clean and well maintained. Grove House DS0000036045.V336182.R01.S.doc Version 5.2 Page 17 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 27,28,29 and 30 Quality in this outcome area is good. The home provides the right numbers of staff on rota, with skills and experience to meet the needs of residents. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Duty rotas showed that there are currently sufficient trained/experienced staff to meet the needs of resident. All staff receive induction and training in the policies and procedures of the home. Over 50 of staff are trained to NVQ2 and more staff are completing this training. The homes deployment of staff means that a regular staff team is provided for each of the units, thus ensuring there is consistency of approach and which helps staff members understand the requirements of individual residents. Staff records were seen for recently appointed staff and showed that there are good recruitment procedures in place. Application forms had been completed, interviews held and staff only take up post once Criminal Record Bureau clearances have been obtained. Grove House DS0000036045.V336182.R01.S.doc Version 5.2 Page 18 Staff were spoken to individually and all were positive about working at the home. They felt they receive support and training to perform their duties. Grove House DS0000036045.V336182.R01.S.doc Version 5.2 Page 19 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31,33,35 and 38 Quality in this outcome area is good. The home is well managed, which ensures residents interests are protected and health and safety issues are promoted. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The manager is qualified and has many years experience in providing care in a senior role. The home is part of The Lancashire County Care Services and re support and visits from the local manager. Grove House DS0000036045.V336182.R01.S.doc Version 5.2 Page 20 Residents and staff are happy with how the home is run and there are clear lines of accountability. Resident’s views are taken seriously and resident surveys have been carried out. The inspector viewed that last survey carried out in October 2006. This showed positive results about how the home is run and took on board views of residents, relatives and visitors. Residents meetings are arranged and the manager is in daily contact with all the residents. Both residents and staff feel they are able to approach the manager and staff with any ideas or issues they may have. The home looks after some resident’s personal allowances, these are kept in a safe and good records are maintained of any transactions. Most of the homes policies and procedures have been reviewed and updated. There are health and safety policies and procedures, which are available to staff. Staff training records showed that many of the staff have not had updated moving and handling training and food hygiene training was out of date. A full review of this training including health and safety and first aid needs to be carried out to ensure that they are up to date. Maintenance records are kept regarding electrical installations and items and all maintenance checks are carried out. Grove House DS0000036045.V336182.R01.S.doc Version 5.2 Page 21 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for 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 X 3 X X 3 HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X X X X X 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X X 3 Grove House DS0000036045.V336182.R01.S.doc Version 5.2 Page 22 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 OP9 Regulation 13(2) Requirement The medication policy in the rehabilitation unit must be reviewed to ensure carers handle medicines correctly Timescale for action 01/09/07 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 3 4 Refer to Standard OP3 OP12 OP18 OP38 Good Practice Recommendations Personal profiles and social background should be more fully completed A more varied activities programme should be provided an All staff should receive training in the protection of vulnerable adults. A review of training should be carried out to ensure staff have up to date training in moving and handling, food hygiene, health and safety and first aid. Grove House DS0000036045.V336182.R01.S.doc Version 5.2 Page 23 Commission for Social Care Inspection Lancashire Area Office Unit 1 Tustin Court Portway Preston PR2 2YQ National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Grove House DS0000036045.V336182.R01.S.doc Version 5.2 Page 24 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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