Inspection on 27/07/05 for Halmer Grange

This inspection was carried out on 27th July 2005.

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

Halmer Grange 22/08/07

Halmer Grange 26/10/06

Halmer Grange 27/02/06

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 27 July 2005 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 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 C53-C04 S41786 HalmerGrange V239463 270705 Stage 4.doc Version 1.20 Page 3 SERVICE INFORMATION Name of service Halmer Grange Address Grange Drive Spalding Lincs PE11 2DY 01775 723251 Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Lincolnshire County Council Anne Ward Care home only 22 Category(ies) of OP Old age (19) registration, with number PD Physical disability (3) of places Halmer Grange C53-C04 S41786 HalmerGrange V239463 270705 Stage 4.doc Version 1.20 Page 4 SERVICE INFORMATION Conditions of registration: None. Date of last inspection 08 March 2005 Brief Description of the Service: Halmer Grange is a detached three storey property operated by the Local Authority which is registered to provide personal care for up to nineteen older people and three with people who have needs associated with physical disabilities. Accommodation for residents is provided on the ground and first floor which can be 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 C53-C04 S41786 HalmerGrange V239463 270705 Stage 4.doc Version 1.20 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was conducted over two days, the first being unannounced and starting at 9:30 a.m. and the second being announced and starting at 2:00 p.m. In total it lasted 7 ½ hours. It was carried out by one inspector as the first of two statutory inspections for 2005/6. The main method of inspection used was called “case tracking”. This involved selecting three residents and tracking the care they receive through their records, discussions with four residents and a relative who was visiting and two care staff on duty. It also included brief discussion with three other professionals. A sample of regulatory records policies and procedures was also inspected. What the service does well: What has improved since the last inspection? There is a programme in place to provide guards to radiators and a further six have now been provided with covers, in the meantime those radiators that have not yet had guards provided have been risk assessed and warning notices are in place. There is an ongoing programme of maintenance and redecoration and a bedroom has been redecorated since the last inspection. The garden is well maintained and work has been in progress to ensure that the access to it is safe and ramps are well maintained. Halmer Grange C53-C04 S41786 HalmerGrange V239463 270705 Stage 4.doc Version 1.20 Page 6 What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The full report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Halmer Grange C53-C04 S41786 HalmerGrange V239463 270705 Stage 4.doc Version 1.20 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 Standards Statutory Requirements Identified During the Inspection Halmer Grange C53-C04 S41786 HalmerGrange V239463 270705 Stage 4.doc Version 1.20 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 standard(s) 1, 2, 3 and 6 The systems in place for the introduction and assessment of resident’s to the home ensure care needs are identified and met. Written information about the home is made available to residents and their representatives to ensure that they are fully aware of the facilities and services the home provides. EVIDENCE: The statement of purpose is available and on display in the entrance hall for any persons who wish to refer to it. It contains various pieces of information including the most recent inspection report and copies of comments from residents who have completed questionnaires about the service. A brochure, “Welcome to Halmer Grange” giving brief information about the home and its purpose is given to residents on their admission to the home and was seen in those rooms inspected on the day of the inspection and in the entrance hall. The copy provided for inspection needs to be reviewed in relation to the name of the inspector for the home. Discussion with staff indicated that where possible prospective residents and/or relatives are able to visit the home or staff will visit residents prior to a decision being made about admission. Halmer Grange C53-C04 S41786 HalmerGrange V239463 270705 Stage 4.doc Version 1.20 Page 9 All records checked included information, which indicated that a thorough assessment had been made prior to residents being admitted to the home. Assessments involve other professionals such as social workers and nursing staff. There are admission policies and procedures in place, which include admissions that occur on an unplanned basis. Terms and conditions of residency were contained on each residents file inspected and a copy is also contained in the information on display. Discussion with a resident’s relative indicated that she had been given written information about the home although could not recall exactly what this consisted of. She did however, feet that she had received sufficient information from this and from talking with staff about the home. There are separate facilities for those residents who are receiving intermediate care and rehabilitation. A relative confirmed she had been involved with the development of the plan of care and programme of rehabilitation of her relative. All residents spoken to commented positively about the care provided at the home. Halmer Grange C53-C04 S41786 HalmerGrange V239463 270705 Stage 4.doc Version 1.20 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 standard(s) 7 and 8. Part of the criteria for Standard 9 was inspected on this occasion. The care planning system in place provides detailed information and contributes to ensuring that resident’s health and care needs are being met. Risk assessments must be in place for those residents who are responsible for their own medication, which demonstrate that any possible risks have been identified and appropriate action taken to reduce them to ensure residents safety. EVIDENCE: Three residents records inspected contained a detailed plan of care and demonstrated residents’ involvement with them. A resident and relative seen confirmed they were aware of the records that the home holds about them. Care plans were noted to contain information about individual preferences and likes and dislikes of residents. They included information, which demonstrated that residents’ health care needs are monitored and addressed. For example a weight monitoring chart was being kept in relation to a resident. Care plans cover a range of matters such as mobility, night care and personal hygiene needs. Written risk assessments were in place for some matters identified however not for a resident who is currently responsible for her own Halmer Grange C53-C04 S41786 HalmerGrange V239463 270705 Stage 4.doc Version 1.20 Page 11 medication. Neither was there a secure area for her to keep her medication in the bedroom that she was occupying at the time of the inspection. This was drawn to the attention of the person in charge for immediate attention. Written confirmation was received the day after the inspection that both matters had been attended to. Records demonstrated the involvement of other professionals such as district nurses, G.P’s and continence advisor. A resident also confirmed that he was having regular visits from a physiotherapist. Residents’ comments were positive about the care they received at the home indicating that they received attention promptly when they needed it. There is a “key worker” system in place. This gives staff responsibilities for specific residents. Staff had a good knowledge of the needs of residents and assisted residents in a kind and courteous manner. Halmer Grange C53-C04 S41786 HalmerGrange V239463 270705 Stage 4.doc Version 1.20 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 standard(s) 12 and 13 Visitors are made welcome at this home. Residents have choices as to how they live their life at the home and there are opportunities for residents to participate in social and religious events should they wish. EVIDENCE: Most of the residents are at the home for short periods of time e.g. those for intermediate care are at the home for up to six weeks. There are however three residents whose stay at the home is permanent. From the information provided by residents and staff there are opportunities for residents whether at the home on a short or long-term basis to be involved with some of the activities that occur within the day care unit. On the second day of the inspection for example one of the long-term residents was participating in a game of dominoes with some of the day care residents. Information about Church services was displayed on a notice board. A resident said that there are services held on a weekly basis at the home, which alternate between the Church and Chapel and she chose whether she wished to participate in them or not. Staff comments indicated that there are occasional trips out arranged and that residents are consulted through “residents” meetings that are held and all residents are invited to attend. There are books available and the library service visits the home. Staff also said that a strawberry tea had been held last week, there is generally a weekly Halmer Grange C53-C04 S41786 HalmerGrange V239463 270705 Stage 4.doc Version 1.20 Page 13 bingo session held and a VJ celebration event has also taken place. Individual records of residents contained information about the social activities they enjoyed. Residents said that they are able to have visitors when they wish. A visitor said she was always made to feel welcome and drinks were always offered or she could help herself from the residents kitchen. Information about visiting is included in the “Welcome to Halmer Grange” brochure. Residents comments indicated that they have choices as to how they lead their life in the home, for example in relation to times that they get up and go to bed. Halmer Grange C53-C04 S41786 HalmerGrange V239463 270705 Stage 4.doc Version 1.20 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 standard(s) 16 and 18 There are satisfactory systems in place for handling complaints and for ensuring the protection of residents. EVIDENCE: There are satisfactory policies and procedures in place relating to how to raise complaints and the reporting of adult protection matters. Information about how to make a complaint was seen on display in residents’ rooms and in brief in the “Welcome to Halmer Grange” leaflet, which is given to relatives. Staff spoken to gave a good account of the actions they would take should complaints or adult protection matters be raised and were aware of correct reporting procedures. Residents said that they would feel comfortable to talk over problems with staff, as did the relative who was spoken to. Records of complaints are kept. The record showed that three concerns had been raised with the home since the last inspection all of which had been addressed. A staff member spoken to confirmed that she had had training relating to adult abuse. Recruitment procedures demonstrated that staff undergo Criminal Records Bureau checks prior to their employment. Halmer Grange C53-C04 S41786 HalmerGrange V239463 270705 Stage 4.doc Version 1.20 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 standard(s) 19, 25 and 26 This home provides a clean, comfortable and homely environment for residents, which is being well maintained. Staff have training to ensure residents health and safety. EVIDENCE: The areas of the home inspected on this occasion, included lounges, dining room, staff rooms and offices a sample of bathrooms and toilets and three bedrooms. All areas seen were clean and tidy and were generally being well maintained. The home smelt fresh. Residents and relatives commented that the home is always clean. Residents said that they found their rooms to be comfortable. There are ramps provided to entrances and there is a lift to assist those residents or visitors who are unable to manage stairs. There is a large garden to the rear and sides of the property and car parking to the front. Gardens were being well maintained and discussion with a staff member indicated that residents are consulted about them. For example they had been involved in the decision to have a wishing well. Halmer Grange C53-C04 S41786 HalmerGrange V239463 270705 Stage 4.doc Version 1.20 Page 16 The Local Authority is in the process of providing radiator guards and since the last inspection a further six have been provided. Risk assessments have been documented in relation to radiators and warning signs have been put in place. Two bathrooms were being used as storage areas as storage space is limited at the home however staff said that one is not used by residents and the furniture is moved out of another when residents wish to use it. Gloves and aprons were readily available for staff to use. There is an on-going programme of maintenance and redecoration and it was noted that a bedroom had been redecorated since the last inspection. A maintenance person is employed to work at the home five days a week. Records were available to demonstrate when the fire brigade last visited the home. This occurred on 17/03/04 and precautions were considered to be satisfactory. An environmental health officer visited the home on 07/07/05 and the report was satisfactory indicating that the home had been successful in retaining its food status award. A sample of service records were checked including checks of equipment such as lifts and hoists which demonstrated that they had been serviced this year. Bedrooms are furnished according to the needs of residents and those who are at the home on a permanent basis have larger rooms. Doors are lockable should residents choose to do so. There is a separate laundry room and sluice and there are policies and procedures in relation to infection control as well as training provided for staff in relation to health and safety matters. Halmer Grange C53-C04 S41786 HalmerGrange V239463 270705 Stage 4.doc Version 1.20 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 considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27 and 30 The home is being staffed to ensure that residents’ needs are being met. Staff are provided with training to ensure that they have the necessary skills and knowledge to care for residents safely. EVIDENCE: Inspection of rotas and discussion with residents indicated that staffing levels at the home ensured that their needs are being met, for example comments from two residents indicated that staff attended to them promptly when they rang their call bells. Residents comments about the staff were positive such as “they’re lovely”, “you can’t fault them”. Discussion with staff confirmed that there is always a minimum of 3 and sometimes 4 care staff on duty in the mornings plus a senior staff member and 3 staff members in the afternoon. Domestic, catering and administrative staff are employed in addition to care staff. At night there are always 2 wakeful night staff on duty. Four staff records were checked on this occasion and all demonstrated that they were not employed to work in the home until a satisfactory Criminal Records Bureau check and POVA check had been obtained. Discussion with staff and records confirmed that staff have a range of training that includes statutory as well training which is more specific to meet the needs of residents. The deputy manager discussed and was able to show how she was reviewing the format for recording individual staff members training Halmer Grange C53-C04 S41786 HalmerGrange V239463 270705 Stage 4.doc Version 1.20 Page 18 which when complete will provide an easier method of identifying when staff require updated training. There are now 10 staff that have completed National Vocational Qualification (NVQ) award Level II in care and 4 at NVQ level III. 4 Staff are in the process of achieving level 11, 1 at Level III and 1 at level IV. There is a range of training, which has taken place since the last inspection including Induction and Foundation training for new employees. Some staff have attended advanced medication training, updated Fire training, Health and Safety training and First Aid training. Halmer Grange C53-C04 S41786 HalmerGrange V239463 270705 Stage 4.doc Version 1.20 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 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 33 and 38 The record keeping systems in place and policies and procedures help to ensure the health and welfare of residents. The quality assurance systems in place enable residents to make their views known about and influence the service provided. EVIDENCE: There are systems in place for residents to raise their views about the service. These include being given a questionnaire to complete at the end of their stay and the option of attending residents meetings as well as having opportunities to raise matters individually with staff. Other professionals spoken to on the day of the visit commented that communication between the home and themselves was good and they were complimentary about the service provided. A comment made was that “there should be more homes like this one”. Halmer Grange C53-C04 S41786 HalmerGrange V239463 270705 Stage 4.doc Version 1.20 Page 20 Residents said they would feel comfortable to raise any problems or concerns they may have with staff. In addition a representative of the Local Authority who provides a report on the service visits the home on a monthly basis. Residents’ completed questionnaires and letters received relating to the service were included in the information on display along with the statement of purpose. As letters contained addresses and names in some instances it was discussed whether consent had been gained to include these. It was not known whether or not it had been. It was therefore recommended that any comments used ensured anonymity unless the consent of the person writing them had been obtained. There are comprehensive health and safety policies and procedures in place to ensure the safety of residents and staff. A sample of records were checked which demonstrated that fire tests are carried out weekly, equipment is regularly serviced such as hoists and the lift and a fire risk assessment had been conducted. Staff have training in relation to health and safety matters, which is regularly updated. Inspection of the premises demonstrated that COSHH materials were being stored securely and there were no obvious safety issues noticed during the tour of the premises. Residents commented that they were well cared for at the home and one resident who had been at the home for 18 years said, “coming here was a decision that I have not regretted” Halmer Grange C53-C04 S41786 HalmerGrange V239463 270705 Stage 4.doc Version 1.20 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. Where there is no score against a standard it has not been looked at during this inspection. 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score 3 3 3 x x 3 HEALTH AND PERSONAL CARE Standard No Score 7 3 8 x 9 2 10 x 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 x 15 x COMPLAINTS AND PROTECTION 3 x x 3 x x 2 3 STAFFING Standard No Score 27 3 28 x 29 x 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x 3 x x 3 x x x x 3 Halmer Grange C53-C04 S41786 HalmerGrange V239463 270705 Stage 4.doc Version 1.20 Page 22 Yes 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 7&9 Regulation 13 (2) & (4) (c) Requirement Risk assessments must be in place to demonstrate that any possible risks have been minimised for those residents who self-medicate and adequate storage arrangements must be provided. It is noted that confirmation was received the day after the inspection which indicated that both matters had been satisfactorily addressed. The registered person must ensure that radiators and pipework that have been identified as posing a risk to residents are guarded or have guaranteed low surface temperatures. This requirement was made at the previous inspection of 08/03/2005. It is acknowledged that there is an on-going programme of work to cover radiators and six further radiators have now been completed. Risk assessments are in place for unguarded radiators. The timescale for completion has been extended. Timescale for action Immediate 2. 25 13 (4)(a) & (c) 1st February 2006 3. Halmer Grange C53-C04 S41786 HalmerGrange V239463 270705 Stage 4.doc Version 1.20 Page 23 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 33 Good Practice Recommendations It is recommended that any written comments about the quality of the service ensures residents or relatives anonymity or their consent is obtained to include any personal details such as addresses when information is being displayed in the home. It is recommended that bathrooms are not used as storage areas. 2. 22 Halmer Grange C53-C04 S41786 HalmerGrange V239463 270705 Stage 4.doc Version 1.20 Page 24 Commission for Social Care Inspection 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 C53-C04 S41786 HalmerGrange V239463 270705 Stage 4.doc Version 1.20 Page 25 - 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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