Inspection on 16/10/07 for Herrington Grange Nursing Home

This inspection was carried out on 16th October 2007.

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

Herrington Grange Nursing Home 05/10/06

Herrington Grange Nursing Home 16/03/06

Herrington Grange Nursing Home 13/11/05

Herrington Grange Nursing Home 09/03/05

Herrington Grange Nursing Home 01/10/04

Herrington Grange Nursing Home 09/03/04

Similar services:

Turret Villa Retirement Home

Moor House

Mendip House

Beaconsfield Court Care Home

Little Sisters Of The Poor

Manor House

Middleton Hall Ltd

Middlesbrough Intermediate Care Centre

Extracts from inspection reports are licensed from CQC, this page was updated on 09/07/2008.

CARE HOMES FOR OLDER PEOPLE Herrington Grange Nursing Home Southburn Terrace New Herrington Houghton Le Spring Tyne & Wear DH4 7AW Lead Inspector Mr Tom Moody Unannounced Inspection 16th October 2007 09:30 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 Herrington Grange Nursing Home DS0000018196.V352896.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. Herrington Grange Nursing Home DS0000018196.V352896.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Herrington Grange Nursing Home Address Southburn Terrace New Herrington Houghton Le Spring Tyne & Wear DH4 7AW 0191 584 5854 0191 512 0958 herrington.grange@fshc.co.uk www.fshc.co.uk Tamaris Healthcare (England) Ltd 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) Alison Jean Johnson Care Home 50 Category(ies) of Old age, not falling within any other category registration, with number (50), Physical disability (10), Physical disability of places over 65 years of age (30) Herrington Grange Nursing Home DS0000018196.V352896.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The registered person may provide the following category of service only: Care home with nursing - Code N To service users of the following gender: Either Whose primary care needs on admission to the home are within the following categories: Old age, not falling within any other category - Code OP, maximum number of places: 50 Physical Disability, over 65 years of age - Code PD(E), maximum number of places: 30 2. Physical Disability - Code PD, maximum number of places: 10 The maximum number of service users who can be accommodated is: 50 5th October 2006 Date of last inspection Brief Description of the Service: Herrington Grange is a privately owned care home, which is located in a village in a semi-rural area. It is reasonably close to a range of local facilities including shops and a Church, and is also near to a bus stop. The home may provide permanent accommodation with personal care support and nursing for up to fifty older people, some of whom may have a physical disability. A limited number of physically disabled adults under the age of sixty-five may also be accommodated within this total number. The home’s entrance is level, and a shaft lift provides access between floors. Accommodation is laid out over both the ground and first floors. Each has selfcontained lounges and adequately equipped bathrooms. All bedrooms have en-suite toilet facilities. The building shares it grounds with another care home owned by the same company. The grounds are well kept, there are accessible paved areas for service users, and car parking is available. Herrington Grange Nursing Home DS0000018196.V352896.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was carried out by one inspector over a period of time including a site visit on one day 16 October 2007. The views a number of people living at the home were gathered from comment cards submitted earlier in the year. At the site visit two relatives were spoken with and three service user case files were read. A small sample audit of the home’s system for receiving, storing, administering and disposing of medication was carried out, along with examples of other records. A tour of the premises looked at the standard of accommodation and facilities on offer and arrangements for maintaining safe living and working conditions. The manager, qualified nurses, care staff, domestic and catering staff were all asked about how the home meets service user’s needs. The fees range from £372 to £511. What the service does well: Service user’s healthcare needs are well met by committed nursing staff. The home is well equipped and has recently added a number of adjustable beds to the equipment available for service users. Care staff offer personal care in a sensitive way that is unhurried and focussed on the individual. Visitors are made welcome by cheerful staff who are happy in their work. Relatives and friends are invited to take part in regular meetings where service users are consulted about the running of the home. The home is well managed by an experienced and well-motivated manager who has made a number of improvements in the service since she has been there. The home has accessible grounds, that are nicely planted and contain sheltered areas that service users can enjoy. The home has a good social programme that includes regular trips out in a mini bus. Herrington Grange Nursing Home DS0000018196.V352896.R01.S.doc Version 5.2 Page 6 What has improved since the last inspection? 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. The summary of this inspection report can be made available in other formats on request. Herrington Grange Nursing Home DS0000018196.V352896.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 Herrington Grange Nursing Home DS0000018196.V352896.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): Quality in this outcome area is good. This judgment has been made from evidence gathered both during and before the visit to this service. The assessments of needs seen by the inspector were accurate and comprehensive and should ensure service users needs are met. Service users and their relative receive a range of information and are able to visit the home before deciding to use the service. EVIDENCE: Most service user comments cards indicated they received information to inform their choice. This was confirmed when I talked to service users although several said their relatives had made this visit because they were too frail or ill. Some service users said they were unaware of having a contract, but the service users who’s records were examined all had these. The manager spoke of relatives visiting before placing service user’s in the home, although the physical condition of some service users may prevent them visiting in person. Herrington Grange Nursing Home DS0000018196.V352896.R01.S.doc Version 5.2 Page 9 Relatives who were spoken to confirmed they are able to visit the home before relatives are placed there, and that they were kept informed of what was happening. They also spoke of their satisfaction with the accomodation that was provided. The manager stated that the assessment of service users needs is carried out by placing authorities and this was confirmed by documentary evidence in service users care plans. Care planning documentation portrays an accurate assessment of service users needs before they are admitted to the home and should ensure that their needs are matched to the homes ability to deliver the service. Herrington Grange Nursing Home DS0000018196.V352896.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): Quality in this outcome area is good. This judgment has been made from evidence gathered both during and before the visit to this service. Care plans record good information in relation to healthcare needs. The care that was observed was good and demonstrates that the home is meeting service user’s healthcare needs. The homes medication systems are being adhered to and service users are protected by as safe system of medication that is properly operated by staff. EVIDENCE: Doctor’s visits are recorded in the care plan and there was other evidence that primary care teams were involved in service user’s care. Hospital appointments and letters indicated that service users saw clinical specialists when this was necessary. These included dieticians tissue viability and wheelchair assessors. Risk assessments are carried out and recorded. The home has a good range of equipment and 11 adjustable beds with built in rails have been purchased. Herrington Grange Nursing Home DS0000018196.V352896.R01.S.doc Version 5.2 Page 11 The written observations, by the nursing staff are much improved form the last inspection. The manager said that a lot of training had been given to help nursing staff improve their care-planning skills and keep better records. Medication storage was secure and administration was properly carried out and recorded. Clinical rooms are well organised and suitably equiped and furnished. Staff showed respect for service users in almost all aspects of care, supporting them appropriately during meals, knocking on bedroom doors before entering and when helping with their mobility. One episode of care involving a hoist left the service user rather exposed and this was pointed out at the time. Herrington Grange Nursing Home DS0000018196.V352896.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): Quality in this outcome area is good. This judgment has been made from evidence gathered both during and before the visit to this service. The service users can make use of all of the homes facilities and many have their own interests and possessions. There is evidence of visitors involvement in service users care and recreation. All of this indicates that most service users needs and preferences are being met by the home and that they have choice and control over many areas of their lives. Service users enjoy an appetizing selection of meals in well-decorated and pleasant surroundings. EVIDENCE: A number of service users had their own selection of books or music in their own rooms. The manager spoke of service user’s preferences and patterns of activity throughout the day. Some service users were able to use all of the communal space and they spoke of enjoying the patio area during the summer. The manager said the home had appointed an activities co-ordinator to improve recreational opportunities for service users and that they planned to plant bulbs and involve service users in making the Christmas Pudding. A music quiz was taking place during the site visit. Herrington Grange Nursing Home DS0000018196.V352896.R01.S.doc Version 5.2 Page 13 The people who live at the home said that they are able to have visitors at any time, and the manager said they are helped to keep in touch with families by telephone. The home has a cordless phone that service users can user anywhere in the home. The manager said that service users enjoy regular trips out in a minibus and staff choose a route that takes in residents former villages. Resident’s and relatives meetings, are regularly held. The manager said that the home’s news letter was read out to service user’s who had difficulty in reading it themselves. Almost all of the service users told of enjoying their meals and comments such as, The food is good and the meals are nice, were typical. The standard of hygeine in the kitchen was very good and there was a good range of foodstuffs, including fresh vegetables. The meal on the day of the site visit looked appetising and was well presented. The dining area was attractive with table decorations and condiments on tables. The meals that were taken to service user’s rooms were in individual covered dishes. Herrington Grange Nursing Home DS0000018196.V352896.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): Quality in this outcome area is good. This judgment has been made from evidence gathered both during and before the visit to this service. Service users and most relatives are comfortable about raising issues with staff and the manager. They are sure that issues will be dealt with appropriately by the manager. Staff have had training and have a good awareness of protection issues. The local authoritys strategy, the managers ethical approach and the company’s policy should combine to protect service users from abuse. EVIDENCE: The home has appropriate polices and procedures. The providers self assessment indicates complaints are recorded and dealt with in accordance with company policy. There was only one recently recorded complaint and this was well documented. Staff are aware of protection issues and have received training in the local authority procedures on protecting vulnerable adults. Past incidents have been dealt with promptly and staff have behave correctly in alerting management to problems. The manager spoke of encouraging contact with service users famillies to ensure any dissatisfaction with the service could be dealt with quickly. Herrington Grange Nursing Home DS0000018196.V352896.R01.S.doc Version 5.2 Page 15 Relatives and visitors comments indicate confidence in the staff and manger. One service user said, Ive got no complaints at all, but if I did the staff would sort things out straight away. Herrington Grange Nursing Home DS0000018196.V352896.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): Quality in this outcome area is good. This judgment has been made from evidence gathered both during and before the visit to this service. The home is well maintained and cleaned and provides a safe and comfortable environment. Rooms are well furnished with service user’s possessions and are generally suited to their needs. The home has the appropriate aids and adaptations to meet service users needs. EVIDENCE: The home has met registration requirements and, in general, provides a suitable environment. The providers self-assessment indicates regular maintenance is carried out by the homes handyman and reputable companies, where this is appropriate. The home has pleasanlty planted grounds and sheltered areas for service users to use. Herrington Grange Nursing Home DS0000018196.V352896.R01.S.doc Version 5.2 Page 17 The home is free from odour and it is pleasantly warm and well ventilated. Some of the Sluicing facilities contain old fashioned equipment that is not appropriate for modern infection control practice. The dining area has wood-effect flooring and the dining room furniture is of good quality and well constructed. Tables are set with clothes and there is an arrangement of flowers on each table. There is a menu board displaying the choices available for the current day. Bedrooms are suitably furnished and decorated and the replacement of carpet in the bedrooms has improved the appearance of many rooms. Handrails are available throughout the building to assist service user mobility. The home has suitable grab rails fitted in toilets and bathrooms. Hoists are available in several areas and there is level access to showers. There is a loop system in the home to help those with hearing loss. The home is clean and tidy in all areas occupied by service users. The company has provided a number of adjustable beds with built in safety rails. Herrington Grange Nursing Home DS0000018196.V352896.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): Quality in this outcome area is good. This judgment has been made from evidence gathered both during and before the visit to this service. The number of staff on duty was sufficient to meet service users care needs. The homes recruitment policy and practice safeguards service users. EVIDENCE: The providers self assessment list appropriate skill mix of staff. The home has appropriate policies and procedures on training, recruitment and selection. Service users comments indicate satisfaction with the qualities of staff but some doubts about the levels of staff available at some times. The manager said that the levels of staff in the home were maintained above those of similar homes because of he dependency of service users. There were sufficient staff on the day of the site visit. Support was available for service users and care was delivered in an unhurried manner. The call system was answered promptly. Staff records that were seen indicated staff were able to access a variety of in service training as well as induction and mandatory training. Recruitment processes are thorough and all necessary checks are recorded including identity and criminal records bureau. Herrington Grange Nursing Home DS0000018196.V352896.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): Quality in this outcome area is good. This judgment has been made using available evidence including a visit to this service. The manager is experienced and competent and the home is well managed. The manager is professional in her approach and service users will benefit from the way she carries out her duties. EVIDENCE: The self assessmnet indicates that the company carries out regular audits and has quality assurance sytem. regular visits are carried out by senior managers. The manager has maintained regular contact with CSCI and informed us of the progress towards meeting the requirements from previous inspections. Comment cards indicate a high degree of satisfaction with the manager and an appreciation of the changes she is making to the home. Herrington Grange Nursing Home DS0000018196.V352896.R01.S.doc Version 5.2 Page 20 The manager is a registered nurse who has experience of managing care settings in the NHS and independant healthcare sector. The manager has clear ideas of how she wants the the home to progress and is delivering improvements that improving the environment and care delivery in the home. The manager feels she is well supported by the senior management team of Four Seasons The manager spoke of supervision being carried out and showed a good understanding of the process. The staff records confirm this takes place. She also stated that the home was subject to regular audit as part of Four Seasons quality assurance system and there is written evidence of this feedback being received by the home. The moral of staff is good and the staff look happy. Those who were spoken to said, “ I like working here” and “this is a nice place to work.” The service users are equally complimentary about the manager and all who were spoken to have a good relationship with her. One service user said, “The home is Brilliant”. Herrington Grange Nursing Home DS0000018196.V352896.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 3 3 3 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 2 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 x 18 3 3 3 2 3 3 3 3 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 3 3 x x 3 3 3 Herrington Grange Nursing Home DS0000018196.V352896.R01.S.doc Version 5.2 Page 22 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 OP26 Regulation 13(3) 16(2)(k) 23(2)(k) Requirement The home must replace out of date sluicing equipment and replace these with equipment that do not present a potential hazard for users. Timescale for action 30/12/07 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 Refer to Standard OP10 Good Practice Recommendations Moving and handling practice must preserve the dignity and privacy of those service users who are subject to it. Herrington Grange Nursing Home DS0000018196.V352896.R01.S.doc Version 5.2 Page 23 Commission for Social Care Inspection South Shields Area Office St Nicholas Building St Nicholas Street Newcastle upon Tyne NE1 1NB 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 Herrington Grange Nursing Home DS0000018196.V352896.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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