Inspection on 26/10/06 for Halmer Grange

This inspection was carried out on 26th October 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 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

Halmer Grange 22/08/07

Halmer Grange 27/02/06

Halmer Grange 27/07/05

Halmer Grange 08/03/05

Halmer Grange 07/10/04

Halmer Grange 17/03/04

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

CARE HOMES FOR OLDER PEOPLE Halmer Grange Grange Drive Spalding Lincs PE11 2DY Lead Inspector Mr David Bacon Key Unannounced Inspection 26th October 2006 09:00 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 Halmer Grange DS0000041786.V316996.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. Halmer Grange DS0000041786.V316996.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Halmer Grange Address Grange Drive Spalding Lincs PE11 2DY 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) 01775 723251 www.lincolnshire.gov.uk Lincolnshire County Council Anne Ward Care Home 22 Category(ies) of Old age, not falling within any other category registration, with number (19), Physical disability (3) of places Halmer Grange DS0000041786.V316996.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 27th February 2006 Brief Description of the Service: Halmer Grange is a detached three-storey property operated by the Local Authority. It is registered to provide personal care for up to nineteen older people and three people who have needs associated with physical disabilities. Accommodation for residents is provided on the ground and first floor, which is accessed by stairs or a lift. The home is a purpose built property, opened in 1963 and originally designed to care for up to 44 long-term residents. It currently provides accommodation for its two remaining permanent residents. Following a policy of not accepting any more long-term residents the home now provides care to people who need short-term or regular periods of respite care. It also provides intermediate care for up to eight people. The intermediate care bedrooms are all located on the ground floor, with the exception of a room that is used for wheelchair users. There is a separate kitchen, which is used to assist residents’ rehabilitation if needed. Residents who are at the home on a long-term basis have a separate living room but join other residents in the main dining room for meals. In addition on the first floor there is a day centre, which provides day care for up to eight people on a daily basis. Day care is not currently registered or inspected by the CSCI. The home is located in a residential area of the Fenland town of Spalding, which has a range of facilities and services. The range of fees is from £61.50 to £300 per week. Halmer Grange DS0000041786.V316996.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This key inspection was unannounced and the fieldwork visit took place over a four hour period. The main method of inspection used was called ‘case tracking’ which involved selecting two service users and tracking the care they receive. Discussion was held with five service users, eight staff members and care records were checked. A tour of the premises was conducted and documents connected with the running of the care home were also inspected. What the service does well: What has improved since the last inspection? What they could do better: Staff receive induction upon commencing work at the home although this is not always fully documented. Halmer Grange DS0000041786.V316996.R01.S.doc Version 5.2 Page 6 The care staff within the home must be aware of safeguarding adults policies and procedures and the staff spoken with requested training regarding dementia awareness. Service users are not afforded with a sufficient provision of activities (it is acknowledged that some activities take place but that these are not always recorded). A record of the meals provided to service users should be maintained. 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. Halmer Grange DS0000041786.V316996.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 Halmer Grange DS0000041786.V316996.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, 3, 6. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. There are procedures in place overall for the introduction of service users to the home although minor alterations are required regarding this. EVIDENCE: Service users are provided with a copy of the homes statement of purpose and service users guide upon admission to the home, copies of which are maintained on the premises. A care assessment of each service user is not undertaken by the home, instead staff use the social care assessment to form a plan of care, which is undertaken within 48 hours of a service users admission to the home. Whilst it is acknowledged that service users may often be admitted at short notice the assessment information may not fully inform staff as to service users care Halmer Grange DS0000041786.V316996.R01.S.doc Version 5.2 Page 9 needs, particularly if the service user is unable to fully express their views. For example, the assessment record of one service user did not identify their nutritional needs or preferences and the moving and handling assessment had not been fully completed. The care records viewed did not fully document where service users or their representatives had been consulted with regarding their plan although it is acknowledged that one service user had only just been admitted to the home. The service users spoken with were fully satisfied with admission arrangements. Comments included: “I am very happy with how it all went, they were very supportive and helpful”. “The staff provided me with the right care and attention, wonderful”. “They certainly put me at ease”. “I have no complaints”. The home provides intermediate care services for which staff receive specific training. Halmer Grange DS0000041786.V316996.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, 10. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users are treated with respect and they are satisfied with the care provided. Procedures for the administration of medication are appropriate. EVIDENCE: The service users spoken with expressed high levels of satisfaction about the care provided, they confirmed their care needs were met and that staff respected their privacy and dignity at all times. Comments included: “You just have to ask, you don’t wait for long for assistance”. “They come quickly to assist you, really you just press the buzzer”. “The standards of care here are truly wonderful”. Staff members during the visit were observed being courteous and respectful to the service users. Halmer Grange DS0000041786.V316996.R01.S.doc Version 5.2 Page 11 The care records viewed instructed staff how to meet any care needs, they were updated daily and where service users care needs change and reviewed each month. The care plans viewed identified any health care needs and how these were being met. The homes medication system was well maintained and documented medicines as receipted into the building, where administered and disposal procedures are in place although these were not available during the visit. Medicines are securely stored and staff who administer medication receive training regarding this. Halmer Grange DS0000041786.V316996.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, 15. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The services users enjoy the homes provision of meals, they can spend their time as they like although there are insufficient activities provided overall. EVIDENCE: The service users spoken with said that they were able spend their time as they liked and that their visitors were made welcome. Service users were satisfied overall with the homes provision of activities but said that these were not regular, which was further evidenced by the homes records of activities undertaken. Service users comments included: “There is bingo and a church service but we mainly watch television or talk”. “There is not much to do I suppose although you can do as you please and the staff are kind and helpful”. “More activities would be nice although with people coming and going it is difficult to please everyone”. Halmer Grange DS0000041786.V316996.R01.S.doc Version 5.2 Page 13 The service users spoken with were satisfied with the foods provided. Comments included: “Very, very good food here, really, it’s tasty and looks appealing”. “If you didn’t like something then they would happily make you something different, its lovely food”. Most of the foods provided are home produced. A five-week menu is in place and a choice of foods is available at each mealtime. Meal temperatures are recorded and equipment checks are undertaken although it is recommended that a record of the foods provided is maintained. The home cook said that kitchen staff speak daily to seek their choice of foods for the following day, which was further confirmed by the service users spoken with who appreciated this. Halmer Grange DS0000041786.V316996.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, 18. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. There are procedures in place overall to ensure that service users are protected and service user feel that they can raise concerns should they wish to. All staff are not fully aware of the homes whistle blowing and safeguarding adults policies and procedures. EVIDENCE: Complaint policies and procedures are in place and information regarding these is provided to service users and displayed in the home. The service users spoken with said they felt able to complain and service user comments included: “The information leaflet tells you how to complain, but you really would not have any reason too” “How could you complain, when the care and everything is so good”. “Yes, I know I could complain but they have been really quite something, faultless”. No complaints have been received by the CSCI since the last inspection. Safeguarding adults policies and procedures provide guidance to staff and some abuse awareness training is provided although not all of the staff spoken Halmer Grange DS0000041786.V316996.R01.S.doc Version 5.2 Page 15 with were fully aware of these or the correct procedures required to be taken in the event of an issue of abuse being identified. Halmer Grange DS0000041786.V316996.R01.S.doc Version 5.2 Page 16 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, 26. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users stay in a clean, tidy and very well maintained environment. EVIDENCE: The service users spoken with were satisfied with the physical environment and their own accommodation. Comments included: “It’s like a first class hotel, it is kept beautifully”. “It’s home from home”. “You could not better it really”. Service users personal accommodation was viewed, which was cleanly decorated. Furniture is of a domestic style and is in good order. Sufficient numbers of domestic staff keep the home clean and odour free and health and safety policies and procedures provide guidance to staff. Halmer Grange DS0000041786.V316996.R01.S.doc Version 5.2 Page 17 The home is well maintained. Water temperature restrictors are fitted to water outlets and these are monitored. Fire safety systems are appropriately maintained and comprehensive risk assessments are in place. Halmer Grange DS0000041786.V316996.R01.S.doc Version 5.2 Page 18 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29, 30. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is staffed to meet the current needs of residents and staff are appropriately recruited and receive induction and training to ensure this although minor adjustments are recommended. EVIDENCE: The staff records viewed clearly evidenced that appropriate recruitment procedures had been followed. The staff members spoken with confirmed that they had received an induction upon commencing work at the home although the records viewed did not evidence that all staff had signed as receiving this. The staff spoke with confirmed that they received overall training for their roles, including obtaining National Vocational Qualifications but requested being provided with dementia awareness training to meet the changing care needs of some service users. The manager agreed to follow up this matter. The service users spoken with confirmed that the homes care staff met their individual care needs and that they did not have to wait for assistance. Comments included: “They are there immediately to help”. “You press the buzzer or just ask, you couldn’t complain about them, they are excellent”. Halmer Grange DS0000041786.V316996.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, 38. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The service users are satisfied with the standards of care provided and the management of the home and quality assurance systems are in place. The health and safety of service users is promoted overall. EVIDENCE: The service users and staff members spoken with confirmed that they were satisfied with the management of the home and the care provided. Service users said they felt able to express their views regarding life within the home and that these would be acted upon. The short stay service users are provided Halmer Grange DS0000041786.V316996.R01.S.doc Version 5.2 Page 20 with questionnaires upon leaving the home and a service users meeting has recently been held. Health and safety policies and procedures are in place; giving guidance to staff and servicing records are maintained. The staff members spoken with said that they receive awareness training specific to their roles. For example, infection control, health and safety and basic health emergencies. Risk assessments have been completed for all service users and for the safety of the premises. Systems are not in place to minimise risks to residents prone to wandering. For example, the fitting of door alarms to external doorways although the acting manager said that this is being addressed. The home refrain from involvement in service users finances where possible although safeguards and records are in place where this occurs. Halmer Grange DS0000041786.V316996.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 2 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 2 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 2 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 Halmer Grange DS0000041786.V316996.R01.S.doc Version 5.2 Page 22 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 OP3 Regulation 14 (1) c and 13 (4) c 13 (6) 15 and 16 (2) (n) Requirement Timescale for action 30/11/06 2 3 OP18 OP12 A full needs assessment must be completed for all service users who are admitted. Care assessments must detail all items included within standard 3. All staff must be aware of 30/11/06 policies and procedures to safeguard service users. The registered person shall 30/11/06 demonstrate fully how the recreational needs of service users are met. 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 OP30 OP15 Good Practice Recommendations Staff should sign where they receive induction to the home. A record of the meals provided to service users should be maintained. Halmer Grange DS0000041786.V316996.R01.S.doc Version 5.2 Page 23 Commission for Social Care Inspection Lincoln Area Office Unity House, The Point Weaver Road Off Whisby Road Lincoln LN6 3QN 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 Halmer Grange DS0000041786.V316996.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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