Inspection on 15/06/06 for Grove House

This inspection was carried out on 15th June 2006.

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 found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Grove House 12/07/07

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 15th June 2006 10:00 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.V292753.R01.S.doc Version 5.1 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.V292753.R01.S.doc Version 5.1 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.V292753.R01.S.doc Version 5.1 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). 28th December 2005 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.V292753.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced visit and took place over the period of a full day on 15th June 2006. Two inspectors carried out the visit, Mr P Rooney and Mrs F Lacey. They spoke to residents, staff and management. Records were examined and there was a full tour of the home. Questionnaires were given to residents and visitors. Doctors and social workers with residents in the home were also consulted. What the service does well: What has improved since the last inspection? Grove House DS0000036045.V292753.R01.S.doc Version 5.1 Page 6 Care planning has improved, particularly in the rehabilitation unit, where plans are more focused and progress recorded. Residents or their representatives sign their care plans and reviews to indicate they have taken part in the process and agree to the outcomes. There has been on going training to ensure that staff have a good working knowledge in looking after residents and protecting them from any abuse. 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 House DS0000036045.V292753.R01.S.doc Version 5.1 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.V292753.R01.S.doc Version 5.1 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 3 and 6 Quality in this outcome group is good. The assessment process prior to admission to the home is comprehensive and gives good detail about care required. There is good planning and support in the rehabilitation unit to enable residents to return home. The systems regarding this have been improved since the last inspection. EVIDENCE: Records were examined for four residents and these residents were spoken to about the care they receive. There is a comprehensive needs assessment carried out prior to placement, this forms the basis for a care plan to be developed. Residents admitted for rehabilitation are supported by a multi disciplinary team in one of the homes units. Assessments and care plans for these residents Grove House DS0000036045.V292753.R01.S.doc Version 5.1 Page 9 have been improved and there is now more focus on outcomes for these residents. Weekly reviews of progress take place. Residents in the rehabilitation unit expressed satisfaction with the service they receive and felt they are well supported in the rehabilitation process. Comments received are “I couldn’t wish for better”. “Staff are excellent”. “Staff are mature and understand”. Discussion with staff working in the rehabilitation unit showed that there are concerns regarding lack of space and lack of provision of essential equipment. For instance a practice staircase, currently they have to use one of the main stairs, which is unsuitable as it is too wide. Grove House DS0000036045.V292753.R01.S.doc Version 5.1 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,9 and 10. Quality in this outcome group is adequate Care plans have been improved and areas of risk are included in the plans. The health care needs of residents are effectively met and there are good records contacts with local health providers. Medication policies and procedures need to be reviewed to ensure better records are maintained and storage of medication is improved. Personal care is carried out in a sensitive caring manner in which residents rights, privacy and dignity are upheld and respected. EVIDENCE: The assessments and care plans of three residents were looked at and the care they receive was discussed individually with them. The care plans were easy Grove House DS0000036045.V292753.R01.S.doc Version 5.1 Page 11 to follow and had been drawn up in cooperation with the resident or their representatives. Residents or their representatives can sign care plans. Any risks are identified and discussed with the resident and actions recorded of how to deal with them. Independence of residents is seen as a priority and staff are trained to encourage residents to do as much for themselves as they can. Assistance is offered if and when required. Care plans are reviewed monthly with the involvement of residents. Residents expressed satisfaction with the levels of care they receive and feel that their privacy and dignity is respected in the way staff care for them. Their comments include; “The domestics and carers do a good job, sometimes under difficult circumstances.” “Staff are kind”. “I am well cared for and staff help me a lot”. Resident’s rights and beliefs are respected and taken note of. There is a question on the admissions form, which asks for a persons religious beliefs and festivals they wish to observe. During the inspection it was seen that medication, including eye drops and insulin was stored in food fridges on all the units. This medication was not securely locked away and should be stored in lockable medical fridges. In all medicine cupboards there were unmarked medications out of their containers. In one cupboard there were eye drops, which were out of date. The medication cupboard on Elm unit was recording a temperature in excess of 80 degrees. There were inaccuracies with regards to controlled drugs patches for one resident. According to the controlled drugs register and MAR sheets there should have been five patches left and there were only four in the box. A full audit of medication policies and procedures is required and the inspector has asked for the pharmacy inspector to visit the home. Grove House DS0000036045.V292753.R01.S.doc Version 5.1 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,14 and 15 Quality in this outcome group is good. The home’s routines are flexible and ensure residents are able to exercise choice. Independence is promoted and support provided to enable residents to reach their potential. Activities are provided with the assistance of an activities coordinator. Residents are able to meet friends and relatives in privacy. The home provides a good variety of nourishing food. EVIDENCE: From examination of the homes policies, discussion with residents and staff it was confirmed that the homes routines are flexible and residents are provided with good levels of support to enable them to take part in daily living in the home. There were very positive comments from residents, these include, “I couldn’t wish for better”. “Staff are excellent “. “Staff are mature and understand”. “I hope I stay here forever”. “I am vegetarian and enjoy the meals, there is a good range”. Grove House DS0000036045.V292753.R01.S.doc Version 5.1 Page 13 Most of the residents have assistance in managing their own affaires, this is mainly provided by families, however, for those who wish information is provided in the home for independent advice from advocacy agencies. Residents said that they are able to take part in a variety of activities with the help of the activities coordinator. These include a reminiscence group, music sessions, darts, life story books, cards, board games, baking, trips out to the local community, library visits, walks, shopping, and local church involvement. The home provides a weekly rotating menu in which there is a good variety of meals with choices available. All residents spoken to were happy with the food they receive and confirmed that they are able to have choices and provide ideas for the menus. Grove House DS0000036045.V292753.R01.S.doc Version 5.1 Page 14 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18 Quality in this outcome group is good. A clear complaints procedure is available to residents and their relatives. Residents are confident any concerns they have will be listened to and acted upon. There are good policies and procedures in place to ensure residents are protected from abuse. EVIDENCE: The homes complaints procedure was seen and is available to residents, they receive a copy of it in the service users guide and it is displayed on the notice board. There have been one complaint received since the last inspection. Residents said they are happy with the care they receive and are able to tell staff and management if they have any concerns. They felt confident that any concerns would be properly dealt with. There is a policy in place for the protection of vulnerable adults including a whistle blowing policy. Staff spoken to were aware of this and said that they would be able to channel any concerns they have to the management. Grove House DS0000036045.V292753.R01.S.doc Version 5.1 Page 15 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19 and 26 Quality in this outcome group is good. The premises are well maintained and clean. Patterned carpets in the dementia unit are not considered to be suitable for residents with dementia. There is lack of space on work surfaces in the different units kitchens, which could prove to be hazardous. Some areas of the building are poorly ventilated and the environment is very hot. There is a lack of storage space. EVIDENCE: Grove House DS0000036045.V292753.R01.S.doc Version 5.1 Page 16 Grove house has received a major refurbishment and is well maintained and decorated throughout. There is new furniture and curtains and carpeting. The carpet in the dementia unit is patterned and a district nurse has commented that such carpet is not safe for residents with dementia. Residents have been observed trying to pick the patterns off the carpet and placing themselves at risk of falling. These residents may also view the patterns as holes, which they must step over, again providing circumstances where they may fall. Consideration should be given to changing this and providing more suitable carpeting for residents with dementia. From discussion with staff and from observation it was evident that work surfaces in the kitchen areas of all units were too small and could prove hazardous when trying to give out food or pouring hot water from the kettle. Some areas of the home, particularly on the first floor were poorly ventilated and the atmosphere was very hot. Staff commented that it is sometimes difficult working in the heat. Items of furniture, cushions and various aids were seen in corridors around the home. When the inspectors asked about this they were told that there is a problem due to lack of storage space, this is particularly a problem in the rehabilitation unit. The home was observed to be clean and hygienic in all areas. Grove House DS0000036045.V292753.R01.S.doc Version 5.1 Page 17 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27,28,29 and 30 Quality in this outcome group is good. The skill mix and number of staff on duty is sufficient to meet the needs of residents. The policies and procedures for recruitment of staff are good and provide safeguards for the protection of residents. Staff are provided with induction and training to ensure they can competently provide care needed. EVIDENCE: The duty rota was seen and showed that there are sufficient experienced and trained staff available to meet the needs of residents. Staff records were examined and showed that there are good recruitment policies and procedures in place including Criminal Records Bureau clearances, which are obtained prior to a person taking up post. Grove House DS0000036045.V292753.R01.S.doc Version 5.1 Page 18 Staff induction records were available; these showed that there is a good induction system in place, which includes appropriate training. Staff spoken to said they had the opportunity to take part in training and felt well supported in this. There is a training programme in place that covers mandatory training; a training matrix has been developed to show areas of training needs. The majority of staff working in the home are qualified to NVQ2 and more staff are undertaking this training. Staff spoken to were positive about working in the home and felt they receive good levels of support. One member of staff has been involved in dementia training and had put information regarding dealing with people with dementia on the notice board. This was very informative and provided a good insight to the needs of residents. Grove House DS0000036045.V292753.R01.S.doc Version 5.1 Page 19 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31 ,33,35 and 38 Quality in this outcome group is good. There is good management in the home by a qualified and registered manager. Resident’s interests are promoted and safeguarded. The homes health and safety polices and procedures ensure that the health and safety of residents and staff is promoted and protected. EVIDENCE: Residents or their families manage their finances. All residents have a lockable facility in their rooms for safekeeping of valuables. The home keeps a small amount of personal allowances for residents. Written records of these were Grove House DS0000036045.V292753.R01.S.doc Version 5.1 Page 20 checked and were up to date and correct. A register is kept of any valuables in the safe keeping of the home. The registered manager is qualified and discussion Staff and residents confirmed that they are happy with how the home is managed and there are clear lines of accountability. There are good health and safety policies and procedures in place and all maintenance records were up to date. Staff records showed that they receive training in moving and handling and health and safety. As stated in the environment section carpeting in the dementia unit needs attending to. Also attention is needed to ensure work surface areas in kitchens are adequate. Grove House DS0000036045.V292753.R01.S.doc Version 5.1 Page 21 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X 3 X X 3 HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 1 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 2 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.V292753.R01.S.doc Version 5.1 Page 22 Are there any outstanding requirements from the last inspection? yes 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. 2. Standard OP9 OP9 Regulation 13(2) 13 (2) Requirement Recording of controlled drugs must be accurately maintained Medication records must be accurately completed and all medicine kept in suitable lockable cabinets. Policies and procedures for medicines management must be reviewed in line with the guidelines of the Royal Pharmaceutical Society. (previous timescale of 30/04/05 was not met.) All medication kept in medicine cupboards must be in marked containers indicating what they are and to which resident they are for. Timescale for action 07/07/06 25/07/06 3. OP9 13 (2) 25/07/06 4 OP9 13(2) 07/07/07 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Grove House Refer to Good Practice Recommendations DS0000036045.V292753.R01.S.doc Version 5.1 Page 23 1 2 3 4 4 Standard OP19 OP19 OP19 OP6 OP19 Carpets in the dementia unit should be replaced with suitable carpets for a dementia unit. Worktops in unit kitchen areas should be improved to ensure there is adequate space to safely serve meals and hot drinks. Ventilation in the home should be improved. More storage space should be provided in the rehabilitation unit. More storage space should be provided in the home Grove House DS0000036045.V292753.R01.S.doc Version 5.1 Page 24 Commission for Social Care Inspection North Lancashire Area Office 2nd Floor, Unit 1, Tustin Court Port Way Preston PR2 2YQ 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. 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