Inspection on 27/02/06 for Halmer Grange

This inspection was carried out on 27th February 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 26/10/06

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 Sue Hayward Unannounced Inspection 27th February 2006 11:00 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.V280684.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. Halmer Grange DS0000041786.V280684.R01.S.doc Version 5.1 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 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.V280684.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 27th July 2005 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 three 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. Halmer Grange DS0000041786.V280684.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was the second inspection required by law from April 2005 to March 2006. It was carried out by one inspector over five hours and was unannounced. The main method of inspection used was “case tracking”. This involves selecting a sample of three residents and tracking the care they receive through their records, discussions with them and two care staff on duty. It also included discussion with the manager who was present throughout the inspection and inspecting a sample of regulatory records, policies and procedures. In addition a pre-inspection questionnaire had been submitted prior to the inspection, which gave information about the home. One other resident was spoken with whilst inspecting communal areas of the home. What the service does well: What has improved since the last inspection? The requirement of the last inspection in relation to medication has been addressed. This related to risk assessments being completed in respect of residents who take responsibility for looking after their own medication and ensuring that they are provided with adequate storage facilities. The requirement in relation to the home providing radiator guards has been removed on the basis that there is an on-going programme to cover radiators that pose potential risks to residents and there are documented risk assessments in place. Halmer Grange DS0000041786.V280684.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. Halmer Grange DS0000041786.V280684.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 Halmer Grange DS0000041786.V280684.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 The assessment process ensures that residents’ needs are identified and can be met at the home. It also ensures residents have sufficient information about the service and facilities the home provides. EVIDENCE: All three residents files checked contained assessment information, care plans and risk assessments. There is a thorough assessment procedure in place. This includes obtaining information from other professionals such as nurses and social workers about residents’ needs as well as from residents and relatives. Care plans had been signed by residents to denote their involvement with them and contained information to demonstrate that they had been given information about the service such as terms and conditions of residency. Information is available in the entrance hall of the home for anyone to access. Staff members had a good knowledge of the needs of residents and residents were complimentary about the care provided. Halmer Grange DS0000041786.V280684.R01.S.doc Version 5.1 Page 9 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, 9 and 10 Care records are well kept and contribute to ensuring residents health and care needs are met. Residents’ privacy and individuality is respected. Medication administration procedures need to be reviewed to ensure that residents are being safeguarded as far as possible from any risks. EVIDENCE: Care records checked were detailed and laid out in an easily accessible format. Care plans had been signed by residents and contained risk assessments, for example in relation to risk of falls and moving and handling needs of residents. They made reference to matters such as residents’ social and nutritional needs as well as their health care needs. Significant events are recorded which demonstrated that residents’ health is promoted. For example district nurse and general practitioner visits are noted. Staff had a good knowledge of residents’ needs, which reflected the care plans seen and residents were complimentary about the care they receive. Halmer Grange DS0000041786.V280684.R01.S.doc Version 5.1 Page 10 The administration of the lunchtime medications was observed. Whilst this was generally satisfactory, it was observed that on some occasions records of medication given were being signed prior to ensuring that residents had taken medication. A requirement was made during the previous inspection in relation to ensuring that residents who are responsible for their own medication had been provided with satisfactory storage facilities and that a risk assessment was in place for residents who self medicate. Both matters have been addressed. Discussion and records indicated that staff have medication training. The storage arrangements were satisfactory and a pharmacist visits the home on a regular basis to check the systems in place. The last visit had occurred on 04/01/06 and there were no issues arising at the time of this visit. Discussion with residents indicated that they felt staff respected their privacy and observations made indicated staff treated residents in a kind and courteous manner. Halmer Grange DS0000041786.V280684.R01.S.doc Version 5.1 Page 11 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): 14 and 15 Residents’ independence and choice is promoted. Residents are provided with a well balanced diet that caters for their individual needs and preferences. EVIDENCE: Residents gave examples of ways in which staff respect their wishes, for example in choices of times that they get up and go to bed. A resident who lives at the home permanently said they had been able to choose the decoration of their room. Staff gave clear examples of how they ensure that residents are treated as individuals and how residents’ privacy is respected in the home such as knocking on doors before entering rooms and asking residents what they would like to wear. Residents all commented positively about the food that the home provides. One said, “the food is good and I’m faddy about my food” another that there was a choice of menu. Care records contained information about residents’ nutritional needs and preferences, which is gained on assessment and passed Halmer Grange DS0000041786.V280684.R01.S.doc Version 5.1 Page 12 on to kitchen staff, as well as care staff. Discussion with staff and training records demonstrated that basic food hygiene training is provided. Menus seen were varied and well balanced and staff were noticed to be available and assisted residents appropriately who needed help with their lunchtime meal. Halmer Grange DS0000041786.V280684.R01.S.doc Version 5.1 Page 13 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 There are satisfactory systems in place for handling complaints and for ensuring the protection of residents. EVIDENCE: The organisation has satisfactory policies and procedures in relation to complaints and adult protection matters. Residents said that they would feel comfortable to raise any concerns they had and felt that they would be listened to. The CSCI has received one complaint about the service since the last inspection. This matter was referred to the organisation to conduct its own investigation. Information demonstrated that the home had taken action to address the concerns raised and that the matter had now been resolved satisfactorily. Appropriate records are kept of any complaints received by the home and staff were aware of how to respond should any concerns be raised with them. The complaints procedure is contained in the information given to residents and also on display in the home. There have been no adult protection issues raised in the last twelve months. Staff were aware of the forms of adult abuse that can occur and of what to do should any issues arise. Adult Protection is included as part of staff’s induction training. Residents’ comments were that they felt safe at the home. Halmer Grange DS0000041786.V280684.R01.S.doc Version 5.1 Page 14 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, 22 and 25 The home is comfortable, clean and well maintained and provides an environment, equipment and aids to promote as far as possible residents independence and safety. EVIDENCE: Three residents bedrooms, lounges, a sample of bathrooms and toilets, dining room and kitchen were seen during this inspection. All areas seen were clean and well maintained. Communal rooms such as lounges were comfortably furnished. The kitchen area was clean and tidy and records demonstrated the cleaning routines of the home. No safety hazards were noted on the day of the visit of those areas seen. There is a programme to guard all radiators. It was confirmed by the manager that no further radiators had been guarded since the last inspection. Records were in place to demonstrate that risk assessments had been undertaken in relation to those radiators that had not yet been guarded. Halmer Grange DS0000041786.V280684.R01.S.doc Version 5.1 Page 15 Residents described their rooms as comfortable. Aids and equipment were seen around the home to assist residents with mobility problems and to promote their independence such as walking frames, hoists, hand-rails and signs on doors indicating where bathrooms and toilets are. Information provided prior to the inspection indicated that safety checks on equipment used such as hoists and lifts are carried out. It was noted that two bathrooms were being used as storage areas, however the CSCI have been notified that there are plans to convert one into a hairdressing room. This room is not currently in use as a bathroom and will ensure that residents have a greater degree of privacy when the hairdresser visits. Furniture is moved out of the other as needed. Halmer Grange DS0000041786.V280684.R01.S.doc Version 5.1 Page 16 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 and 29 The home is being staffed to ensure that residents’ needs are met. There is an on-going training programme to ensure that staff have the necessary skills and knowledge to care for residents safely and the staff recruitment procedure ensures as far as possible that residents are protected. EVIDENCE: Comments from residents about staff were very positive such as “nothing is too much trouble for them”. Staff were of the opinion that most of the time staffing levels were sufficient to meet current residents needs and there was flexibility about staffing arrangements depending on the needs of residents. On the day of the inspection 2 senior staff, 4 care staff plus the manager, Team Leader and administrator were on duty. In addition there were 2 housekeeping staff and 2 kitchen staff on duty. At night there are always 2 wakeful night staff on duty. 14 residents were in the home on the day of the inspection. Residents meetings are held at the home. Records were checked and demonstrated comments that residents had made about the service such as, “Staff are very good from support staff to manager”, “It is like being part of a family” and I could go to any member of staff with a problem”. Records checked indicated that there is a thorough recruitment procedure in operation which consists of ensuring checks are undertaken such as references and criminal record bureau checks prior to staff commencing work at the Halmer Grange DS0000041786.V280684.R01.S.doc Version 5.1 Page 17 home. There is a consistent staff team with few changes since the last inspection, which helps to ensure continuity of care for residents. It was confirmed at the time of the visit that 52 of the staff team had now completed National Vocational Qualification awards level II or above however further staff were in the process of working towards achieving them. It was anticipated that when complete 71 of staff would have attained this award. Halmer Grange DS0000041786.V280684.R01.S.doc Version 5.1 Page 18 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 and 35 The home is being well managed and effective systems are in place to ensure the quality of the service, which include seeking residents’ views about how it may be improved. Satisfactory systems are in place to ensure that residents’ financial interests are protected. EVIDENCE: The manager has obtained the registered managers award. Residents were complimentary about the service and indicated that they felt comfortable to raise any concerns or make suggestions with staff on an individual basis or through residents meetings. Records of a recently held residents meeting indicated that one comment made was that “staff are very good from support staff to the manager” and “its like being part of a family”. In addition Halmer Grange DS0000041786.V280684.R01.S.doc Version 5.1 Page 19 questionnaires are used for residents or their relatives to comment on the service. Records and discussion with staff also provided information to confirm the systems in place ensure that residents’ money or valuables in safe keeping are as far as possible protected. Halmer Grange DS0000041786.V280684.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 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 X HEALTH AND PERSONAL CARE Standard No Score 7 3 8 X 9 2 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 X 13 X 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X 3 X X 3 X STAFFING Standard No Score 27 3 28 3 29 3 30 X MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X X X Halmer Grange DS0000041786.V280684.R01.S.doc Version 5.1 Page 21 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) & 4 (c) Requirement The medication administration procedure must be reviewed to ensure that staff do not sign records prior to ensuring that residents have taken medications. Timescale for action 27/04/06 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 Refer to Standard OP22 Good Practice Recommendations It is recommended that bathrooms are not used as storage areas. Halmer Grange DS0000041786.V280684.R01.S.doc Version 5.1 Page 22 Commission for Social Care Inspection Lincoln Area Office Unity House, The Point Weaver Road Off Whisby Road Lincoln LN6 3QN 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 Halmer Grange DS0000041786.V280684.R01.S.doc Version 5.1 Page 23 - 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. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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