Inspection on 08/02/06 for Grove House & Grove Lodge

This inspection was carried out on 8th February 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. 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 no outstanding requirements from the previous inspection report, but made 2 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Grove House & Grove Lodge 15/05/07

Grove House & Grove Lodge 26/09/06

Grove House & Grove Lodge 11/10/05

Grove House & Grove Lodge 23/11/04

Grove House & Grove Lodge 29/07/04

Grove House & Grove Lodge 24/02/04

Similar services:

Coopers Mill Ltd

Bramley Avenue (73)

Paradise Lodge

Grangewood

Upaya Ananda

Newton Court (1-2)

Kings Lane (32)

Pemdale

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

CARE HOME ADULTS 18-65 Grove House/Grove Lodge 13 & 14 Norton Close Borehamwood Hertfordshire WD6 5DW Lead Inspector Mrs Jan Sheppard Unannounced Inspection 8th February 2006 10:00 Grove House/Grove Lodge DS0000019398.V281905.R01.S.doc Version 5.1 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/Grove Lodge DS0000019398.V281905.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 Adults 18-65. 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/Grove Lodge DS0000019398.V281905.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Grove House/Grove Lodge Address 13 & 14 Norton Close Borehamwood Hertfordshire WD6 5DW 0208 953 6443 0208 953 6443 H 3071@mencap.org.uk H4037@mencap.org.uk Royal Mencap Society 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) Ms Simone Boatwright Care Home 9 Category(ies) of Learning disability (9) registration, with number of places Grove House/Grove Lodge DS0000019398.V281905.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 12th October 2005 Brief Description of the Service: Grove House and Grove Lodge, known as numbers 13 and 14 Norton Close, are a pair of semi-detached houses situated at the end of a cul-de-sac in a residential area about one mile from Borehamwood Town Centre. Each House is self-contained with its own kitchen, dining room, lounge and bathroom. The home has a garden to the rear of the building, accessible via a ramp and including a patio area with barbeque, and a parking area to the front. Grove House accommodates six service users and Grove Lodge accommodates three service users who each have their own single room. The service users residing in the Lodge are more independent than those in the House. The service users receive care and support according to their assessed needs in a homely environment where they are encouraged to live as independently as possible. Grove House/Grove Lodge DS0000019398.V281905.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. Since the last inspection the registered manager Ms Simone Boatwright has left, the temporary manager in charge of the home on the day of this inspection was Mrs Terese Brunswick. This was the second unannounced inspection of this inspection year and took place over one day when the staff on duty and the residents at home were spoken with, records examined and a tour of Grove House undertaken. The statements in this report reflect what was observed by the inspector on that day, takes account of written information supplied by the new acting manager and also takes into account the comments made by the residents. Not all of the standards were examined as they were all inspected during the previous inspection on 11th October 2005 to which reference may be made. The home had a relaxed and homely atmosphere where the residents who expressed their contentment with their environment appeared to be happy, stimulated, occupied and obviously at ease with the staff. Since the last inspection the registered manager has left and because of the failure to make an appointment at the first round of interviews a temporary manager commenced duties at the home during January 2006. Staff and residents told the inspector that these new arrangements were working well. Requirements and recommendations made at the last inspection have all been met or are in the process of being met. Three requirements and one recommendation are made following this inspection. What the service does well: What has improved since the last inspection? Since the last inspection repairs and improvements have been made to the internal facilities of the home including redecorations, the provision new soft furnishings and some bedding. Floor coverings had been professionally cleaned and are now subject to regular shampooing. The home now presents as clean and well maintained and has a fresh welcoming and homely appearance. Grove House/Grove Lodge DS0000019398.V281905.R01.S.doc Version 5.1 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. Grove House/Grove Lodge DS0000019398.V281905.R01.S.doc Version 5.1 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Grove House/Grove Lodge DS0000019398.V281905.R01.S.doc Version 5.1 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1and5. The home has the required information so that prospective new residents have the information they require to make a realistic choice about entering the home. All new residents are provided with an individual tenancy contract before entering the home. EVIDENCE: As no new residents have been admitted since the last inspection this section was not fully inspected. Grove House/Grove Lodge DS0000019398.V281905.R01.S.doc Version 5.1 Page 9 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6,7,8 and 9. The residents care plans are kept confidentially and give good evidence of their involvement in the compiling of these. Good attention is given to resident consultation. EVIDENCE: The home maintains detailed individual care plans, which reflect the personal needs and aspirations of each resident. Care plans examined were all found to be maintained to a good standard to be kept up to date and to contain risk assessments, which were subject to regular review. The records of residents meetings evidenced that every consideration is given to their consultation on all matters relating to their manner of life. The residents are all very vocal and confident to have their say and to make their own choices known. One resident in talking with the inspector about the changes that had recently been made to her activity programme now that she has reached retirement age said “ At the moment I only have one days structured activity programme and I have to decide what else I should do on some of the other days, I am talking to the new manager about this”. Grove House/Grove Lodge DS0000019398.V281905.R01.S.doc Version 5.1 Page 10 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,15, 16 and 17. The residents day centre and college activity programmes offer them the opportunity for personal development and recreation alongside peers of a similar age and ability. Weekend and evening events are enjoyed but more staff hours available at the weekends would enable more comprehensive activities to be undertaken which would be beneficial for residents who are not able to go out unaccompanied. Improvements and changes are currently being made to the menu planning and food preparation activities. EVIDENCE: All these residents continue to have activity and college programmes which are individually designed to meet their individual needs interests and skills Several attend for five days a week while others who are older or less able have a less onerous programme arranged for them. The residents spoken with during this inspection all confirmed that they were happy with their programmes and enjoyed being regularly away from the home and maintaining different friendships with others who attend the classes. Grove House/Grove Lodge DS0000019398.V281905.R01.S.doc Version 5.1 Page 11 The residents are able to maintain close relations with friends and relations to whom they often make day and weekend staying visits. Two relatives visited the home during this inspection. All the residents had one holiday away from the home during the past year some residents chose to have another shorter break as well. The residents told the inspector that they are currently planning this next summer’s holiday. The residents, many of whom are able to go out unaccompanied, have made various links with the local community visiting shops and cafes and one enjoys a game of snooker at a local club. One resident who sings with a local choir had participated in a public concert on the evening previous to this inspection. The new manager has worked with the residents to make changes to the homes menu planning and two residents described to the inspector how they are now experimenting with new dishes and foods, e.g. pate and tropical fruit, that some of them had not tried before. The fridge in the main kitchen was seen to be well stocked with a variety of fresh meat, vegetables, yogurts and milk. Bowls of fresh fruit were found in all the lounge dining areas. The dietician continues to visit regularly to monitor weights and give advice. The manager explained that she noticed that although fresh ingredients were regularly available in the home, ready made frozen meals were often being prepared by the residents especially when they were in a hurry to attend evening activities. She felt it was important for all the residents to learn home cooking skills, meal planning and nutrition (less salt and fat) even when time was short. She added that this was particularly important for residents who were hoping to eventually move away from residential care into other forms of sheltered accommodation and had quickly introduced these changes which have so far been well received by the residents. Grove House/Grove Lodge DS0000019398.V281905.R01.S.doc Version 5.1 Page 12 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 18,19 and 20 Personal care and Health care is offered to the residents in an individually planned manner so as best to meet their needs. A specialist assessment is required for one resident whose needs are currently changing quite rapidly. The home has a robust medication storage and administration system with detailed recordings kept. Two areas where improvements could be made to this system were noted. EVIDENCE: Care and assistance was seen to be being delivered in a calm and kindly manner with emphasis being given to enabling the residents to do as much for themselves as it is safely possible for them to so do. The care plans evidenced that the home maintains good working relationships between local GPs and the community nursing services. Since the last inspection two residents have been subject to planned hospital admissions for operations and both are continuing to receive follow up treatment. They both confirmed to the inspector that they had been well supported by the home during this period and that they were now recovering satisfactorily. Another resident whose sight is currently deteriorating should be referred for a specialist assessment to ensure that her needs are being met in the best possible manner. Grove House/Grove Lodge DS0000019398.V281905.R01.S.doc Version 5.1 Page 13 There have been no major changes to the homes medication system since the last inspection but a small drugs fridge has been provided so that non dossetted medications do not now have to be stored in the main fridge. The medication is appropriately stored in a drugs cupboard of an approved design. The home does not have a controlled medications cupboard or register. The MAR, (medication administration record) sheets examined were seen to be accurately recorded with good detail concerning the recording of medicines received in the home and numbers returned for destruction. A manager surveillance routine for these records was seen to be in operation. Three points for improvement of these systems were noted. An up to date list of signatures of staff who administer medication should be compiled. Liquid medication must be stored at the recommended temperature and an acceptance signing system and a risk assessment must be compiled for the one resident who self medicates. Grove House/Grove Lodge DS0000019398.V281905.R01.S.doc Version 5.1 Page 14 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 22 and 23 The home has a robust complaints procedure and follows the Adult Protection Procedures as set out in Hertfordshire’s Joint Agency guidelines. EVIDENCE: There have been no complaints since the last inspection. Residents spoken with were fully aware of the complaints procedure and of what actions they could take if needed. There have been no incidents concerning adult protection since the last interview. Staff were familiar with the requirements of these procedures and of what their actions should be if they became aware of any incident. Two previous incidents which are still the subject of investigation and joint strategy meetings were discussed with the inspector. Grove House/Grove Lodge DS0000019398.V281905.R01.S.doc Version 5.1 Page 15 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 24 and 30. The home meets the space and environmental requirements of this standard. It provides a pleasant comfortable safe and homely environment for its residents. The home was clean and tidy and had a hygienic atmosphere. EVIDENCE: The routine maintenance works of refurbishment redecorations cleaning of carpets and provision of some new soft furnishings have greatly improved the appearance of the home that now has an altogether better kept ambiance. The new manager evidenced to the inspector the tasks that had been completed over recent weeks to achieve this improvement and also demonstrated that others were planned and that routine maintenance and cleaning arrangements had been set up to ensure that these improved standards are maintained. The environmental requirements made at the last inspection have been met or have been ordered with works dates set. Residents spoken with all said that they were happy with their rooms and the accommodation provided. Grove House/Grove Lodge DS0000019398.V281905.R01.S.doc Version 5.1 Page 16 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 32,33, 35 and 36. The home has a stable staff team sufficient to meet the care needs of the residents. Staff are experienced and regularly attend training but none has achieved the NVQ level 2 qualification. EVIDENCE: The home is fully staffed and no staff have left since the last inspection. One carer who was formally employed by an agency but had worked at the home for many months has now become permanently employed the company. She confirmed that she is well supported by the homes management and demonstrated that she is undertaking the company’s Induction Foundation Training course prior to commencing an NVQ course in the summer. The home currently has no staff holding NVQ level 2 although all the staff have been studying for this for some months. The manager explained because of dissatisfaction with the tutor company the home had now withdrawn from their scheme and all staff are expecting to recommence their studies with another local company in the spring. The home does not currently meet the requirement that 50 of care staff hold an NVQ level 2 qualification. The home compiles a training needs plan from the individual training needs of each member of staff these usually compiled during their individual supervision meetings. The records evidenced that staff receive regular supervision and an annual appraisal. Grove House/Grove Lodge DS0000019398.V281905.R01.S.doc Version 5.1 Page 17 Regular up dating of training in the core subjects was seen to be maintained. Specialist training concerning the care of a resident with deteriorating sight should be considered. Grove House/Grove Lodge DS0000019398.V281905.R01.S.doc Version 5.1 Page 18 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. 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 are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 37,39 and 42. The home is well run by experienced staff many of whom have worked with the residents for many years and who work well together as a team. The residents interests and safety are supported by the good maintenance of the homes records and the following of procedures concerning risk and safety. EVIDENCE: Since the last inspection the homes registered manager who had been in post for several years has left and a temporary manager has commenced duties pending a permanent appointment. This temporary manager who is qualified and experienced holding NVQ level 4, the Registered Managers award and the Assessors qualification, had been in post for less than three weeks on the day of this inspection. She was able to demonstrate the actions she had already taken and also plans for other requirements that needed attention. Residents and staff appeared to have a relaxed and easy relationship with her and confirmed that the transition had gone smoothly .One resident told the inspector, “I knew Mrs.X (new manager) in the past from another home, she understands about my needs very well”. Grove House/Grove Lodge DS0000019398.V281905.R01.S.doc Version 5.1 Page 19 Records relating to staff and residents meetings were seen to have been well maintained with recording indicating action points that needed to be carried forward. Risk assessments to meet individual needs and for the building and its environments were found to be well maintained and reviewed. The manager discussed the frequency of these reviews with the inspector. The residents bedroom doors all have fire door guards fitted and no door wedges were seen in use during this inspection. Grove House/Grove Lodge DS0000019398.V281905.R01.S.doc Version 5.1 Page 20 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 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 3 2 x 3 x 4 x 5 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 3 25 x 26 x 27 x 28 x 29 x 30 3 STAFFING Standard No Score 31 x 32 2 33 3 34 x 35 3 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 3 3 x LIFESTYLES Standard No Score 11 x 12 3 13 3 14 x 15 3 16 3 17 x PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 2 2 x 3 x 3 x x 3 x Grove House/Grove Lodge DS0000019398.V281905.R01.S.doc Version 5.1 Page 21 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 YA20 Regulation 13(2) Requirement Timescale for action 28/02/06 2. YA19 14 (2) The resident who self medicates needs to sign to evidence that he has accepted his weekly medication. A current list of signatures of staff who administer medication needs to be compiled. Liquid medication must be stored at the correct temperature. An appropriate sensory needs 30/04/06 assessment is required for the resident with failing sight Grove House/Grove Lodge DS0000019398.V281905.R01.S.doc Version 5.1 Page 22 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 YA20 YA32 Good Practice Recommendations It is recommended that the home obtain a controlled drugs cupboard and register. It is a recommended that at least 50 of the care staff achieve an NVQ level 2 in care. Grove House/Grove Lodge DS0000019398.V281905.R01.S.doc Version 5.1 Page 23 Commission for Social Care Inspection Hertfordshire Area Office Mercury House 1 Broadwater Road Welwyn Garden City Hertfordshire AL7 3BQ 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 House/Grove Lodge DS0000019398.V281905.R01.S.doc Version 5.1 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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