CARE HOMES FOR OLDER PEOPLE
Hunningley Grange 327 Doncaster Road Stairfoot Barnsley S70 3PJ Lead Inspector
Steve Vessey Unannounced 25 May 2005 09:50am 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. Hunningley Grange J51 S18258 Hunningley Grange V227917 25.05.05 UI Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION
Name of service Hunningley Grange Address 327 Doncaster Road Stairfoot Barnsley S70 3PJ 01226 287578 01226 287578 None Mr Azad Choudhry 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) Mrs Patricia Smith PC Care Home Only 36 Category(ies) of OP Old age - 36 registration, with number of places Hunningley Grange J51 S18258 Hunningley Grange V227917 25.05.05 UI Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION
Conditions of registration: None Date of last inspection 23rd September 2004 Brief Description of the Service: Hunningley Grange is a detached residence with a purpose built extension, registered to provide personal care for 36 residents. All accomodation and services are on the ground floor. The home is located in the centre of Stairfoot, approximately two miles from Barnsley town centre and situated on a main bus route. The home is within walking distance of a full range of shops i.e. Chemist, Newsagent, Hairdressers, dentist, Supermarkets, Post Office, Helath Centre, Cafes and fast food outlets. There is car parking at the front and side of the home. Hunningley Grange J51 S18258 Hunningley Grange V227917 25.05.05 UI Stage 4.doc Version 1.30 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This unannounced inspection took place over approximately seven hours from 9:50 to 16:45. The inspection process included a partial tour of the premises, inspection of a sample of records and policies, discussions with, the manager, the operations manager, staff, residents and relatives and observation of staff carrying out their duties. The majority of residents and staff were seen during the inspection and the inspector had the opportunity to speak to six staff four residents and relatives in detail. What the service does well: What has improved since the last inspection?
The dining room had been redecorated, bathrooms and toilets were being kept clean and the corridor carpet was clean. Care plans had improved with the daily entries being made at more appropriate times and a record of activities being included. A copy of the report following the monthly visit by a representative of the company was available at the home. Hunningley Grange J51 S18258 Hunningley Grange V227917 25.05.05 UI Stage 4.doc Version 1.30 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. Hunningley Grange J51 S18258 Hunningley Grange V227917 25.05.05 UI Stage 4.doc Version 1.30 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 Hunningley Grange J51 S18258 Hunningley Grange V227917 25.05.05 UI Stage 4.doc Version 1.30 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) 3, standard 6 was not applicable at the home. Resident’s needs had been assessed prior to admission to the home. EVIDENCE: Four care plans included an assessment of residents needs carried out by the home prior to admission, information from the placing authority was also evident in some care plans. Hunningley Grange J51 S18258 Hunningley Grange V227917 25.05.05 UI Stage 4.doc Version 1.30 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 standard(s) 7,8 and 9. Residents had a detailed up to date plan of care reflecting their identified assessed needs, however these could be improved by the addition of more information relating to medication administration. Resident’s health care needs were in the main met, however the inclusion of more detailed risk assessments and information relating to medication allergies on medication administration records would improve this. Medication was managed safely and stored securely. EVIDENCE: Four care plans included detailed information as to the actions required from staff to meet the needs of the individual residents and were reviewed regularly by staff. However the care plan of a resident receiving medication for agitation did not identify this or the circumstances when medication should be administered. Some residents and relatives spoken to were aware of their care plan and some care plans had been signed by residents. Hunningley Grange J51 S18258 Hunningley Grange V227917 25.05.05 UI Stage 4.doc Version 1.30 Page 10 Residents seen were well cared for, they were clean, hair and nails had been attended to and male residents were shaved. Risk assessments were in place for, development of pressure areas and moving and handling. Resident’s health care needs were not fully met, as all four care plans did not include risk assessments relating to falls, nutrition and the administration of medication. Records were kept of medication being received into and leaving the home. There was medication administration records for residents, which were in the main completed appropriately, however allergies to medication identified in two residents care plans were not identified on the medication administration record sheets. Staff administering medication confirmed that they had received training from other staff at the home and had recently completed a distance learning course on the administration of medication. All medication, including controlled drugs were stored appropriately and securely, maintaining the health safety and welfare of residents. Hunningley Grange J51 S18258 Hunningley Grange V227917 25.05.05 UI Stage 4.doc Version 1.30 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 standard(s) 12, 13 and 15 Residents are given choice in many aspects of their lives, allowing them to maintain their independence. Residents were happy with the activities, but stated that they would like more outings. Residents receive a choice of food, which is of good quality and can choose where they eat. EVIDENCE: Residents and staff stated that residents could choose when they get up and go to bed and could spend time in their room when they want to. Staff stated that if residents did not like the food on the menu they could have an alternative; the majority of residents spoken to confirmed this. One resident had an alternative meal maintaining choice and independence. A relative stated that she was aware that residents had a choice of food at teatime and that the cakes and buns served were of good quality. Residents were generally positive about the food, comments included, “we can’t grumble about the food and “I get enough to eat”. Residents stated that hot drinks were served at suppertime with a choice of cakes, biscuits or sandwiches. Residents were observed receiving visitors in communal areas of the home and stated that they could receive visitors in their room, a relative stated that she visited at various times and that staff were always welcoming and friendly.
Hunningley Grange J51 S18258 Hunningley Grange V227917 25.05.05 UI Stage 4.doc Version 1.30 Page 12 Staff stated activities are provided for residents, entertainment is provided on special occasions and sometimes residents go out locally with their relatives or with staff. A notice advertising a social event and an activities plan were displayed in the foyer, and staff was planning a trip into the town centre within the next few days. Staff and residents spoken to stated that more outings would improve the quality of the service offered at the home and one resident stated that she would like more things to do during the day. The dining room was pleasant at lunchtime; tables were appropriately set, with cloths, serviettes, cutlery and cruet. Meals were served in an unhurried manner giving residents adequate time to eat. Residents were asked if they would like a hot dessert, if not they were offered alternatives. The menu for lunch and tea was displayed on a board in the dining room. Hunningley Grange J51 S18258 Hunningley Grange V227917 25.05.05 UI Stage 4.doc Version 1.30 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 standard(s) 16 and 18. Residents and relatives were aware how to complain and thought that their complaints would be listened to and dealt with. Staff were aware of the policies and procedures in place to protect residents from abuse and had received or have training planned. EVIDENCE: Residents and relatives spoken to stated that they would speak to the manager if they had anything to complain about and stated that they thought complaints would be listened to and sorted out. A copy of the complaints procedure was displayed in the foyer and a detailed complaints log was available, which had recent complaints recorded. Staff were aware of policies and procedures in place relating to recognising and reporting of abuse including whistleblowing. Most staff spoken to had attended abuse awareness training, the manager stated training was ongoing with the local authority. All staff spoken to were aware of the action to take if they suspected abuse was taking place. A copy of the Barnsley and Rotherham local authority adult protection policies and procedures were available and accessible to staff. Residents spoken to stated that they felt safe. Hunningley Grange J51 S18258 Hunningley Grange V227917 25.05.05 UI Stage 4.doc Version 1.30 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 standard(s) 19, 21, 24 and 26 Areas of the home accessible to residents were in the main well maintained. Bathrooms and toilets were clean. Residents were happy and comfortable in their rooms, however two rooms had stained bedding. The home was in the main clean, pleasant and hygienic. EVIDENCE: In the main the home was well decorated and well maintained, there was an ongoing programme for the redecoration of some residents rooms. The previous requirements to redecorate the dining room and clean the corridor carpet had been met. Bathrooms and toilets were clean. Residents stated that they were happy and comfortable in their rooms and that they were always kept clean however stained bedding was found on two beds. Hunningley Grange J51 S18258 Hunningley Grange V227917 25.05.05 UI Stage 4.doc Version 1.30 Page 15 Residents and relatives stated that all areas of the home were kept clean, and residents stated that they in the main they were happy with the standard of the laundry service. Policies and procedures were in place for control of infection, some staff had received training and staff reported that they had sufficient provision of protective clothing. Hunningley Grange J51 S18258 Hunningley Grange V227917 25.05.05 UI Stage 4.doc Version 1.30 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 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, 28, and 29 Sufficient staff was on duty to meet the needs of residents. Fifty percent of care staff are NVQ level 2 qualified. Recruitment policies and procedures need to be more robust to fully protect residents. EVIDENCE: On the morning of the inspection there was the Manager, one senior care assistant, three care assistants, a cook, a kitchen assistant, domestic and laundry staff and the handyman on duty. Staff, some residents and relatives stated that there was sufficient staff on duty to meet the needs of the residents. One resident stated that there was not always enough staff on duty, another resident stated there should be more staff on duty at night. Three out of four staff files had detailed recruitment information including two written references and, a CRB disclosure. One file did not have a CRB disclosure; the manager confirmed that three staff employed did not have completed CRB disclosures. The manager confirmed that nine out of eighteen care staff had a level 2 NVQ. Hunningley Grange J51 S18258 Hunningley Grange V227917 25.05.05 UI Stage 4.doc Version 1.30 Page 17 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) 31, 33, 34 and 38 The manager has had some management experience, however she is not registered with the Commission for Social Care Inspection and needs to undertake the level 4 NVQ in management and care. Residents need to be consulted about the running of the home in a more formal way. Residents and relatives feel that the home is safe, however the insurance certificate displayed indicated that insurance cover had expired and some improvement could be made in health and safety records. EVIDENCE: The manager has recently been appointed, but has worked at the home for a number of years, most recently as the Deputy Manager. The manager is not currently registered with the Commission for Social Care Inspection. There are plans in place for the manager to commence NVQ level 4 in the near future.
Hunningley Grange J51 S18258 Hunningley Grange V227917 25.05.05 UI Stage 4.doc Version 1.30 Page 18 A representative of the company visits the home regularly and provides a monthly report; residents stated that they are asked about the home, the manager confirmed that this was not done in a formal way. Records were in place stating fire equipment had been checked, regular fire drills take place and that staff have received fire training. Staff confirmed that they had received fire and moving and handling training, promoting resident safety. Recommendations following a recent environmental health officer visit had been completed. The manager stated that the gas appliances had been serviced and the electrical testing had been carried, however the certificates were not available. The manager stated that water temperatures were checked, however records were not available, hot water temperatures checked were around 43 degrees centigrade. The manager stated that servicing of equipment had been carried out, however records were not available to evidence this. Accident records were fully completed, however accidents were not always recorded in the residents care plan. The insurance certificate displayed indicated that insurance cover had expired on the 8th May 2005. Hunningley Grange J51 S18258 Hunningley Grange V227917 25.05.05 UI Stage 4.doc Version 1.30 Page 19 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score x x 3 x x N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 2 9 2 10 x 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 x 15 3
COMPLAINTS AND PROTECTION 3 x 3 x x 2 x 3 STAFFING Standard No Score 27 3 28 3 29 2 30 x MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x 3 2 x 2 2 x x x 2 Hunningley Grange J51 S18258 Hunningley Grange V227917 25.05.05 UI Stage 4.doc Version 1.30 Page 20 Are there any outstanding requirements from the last inspection? Yes 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 Regulation 15 Requirement The residents care plans must include information relating to the arrangements for medication administration and the circumstances in which staff should administer medication prescribed as when required. The residents care plan must contain risk assessments relating to falls and nutrition. Residents must be consulted about outings they wish to undertake. Adequate supplies of clean bedding must be available Staff must not be employed without a completed CRB disclosure. The manager of the home must be registered with the Commission for Social Care Inspection (CSCI). Residents, relatives and representatives must be consulted in a more formal way and the results of the consultation must be published. (Previous timescale of 29/12/04 not met). Evidence must be provided that adequate insurance cover is in Timescale for action 25/07/05 2. 3. 4. 5. 6. 8 12 24 29 31 15 16 23 19, Schedule 2 9 25/07/05 25/08/05 25/06/05 25/06/05 25/08/05 7. 33 24 25/09/05 8. 34 25 25/06/05
Page 21 Hunningley Grange J51 S18258 Hunningley Grange V227917 25.05.05 UI Stage 4.doc Version 1.30 9. 38 13 place, this must be forwarded to the CSCI office. Health and safety records, including records of servicing, records of water temperarures and accident records must be fully completed and available. 25/07/05 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 9 31 Good Practice Recommendations Information relating to residents identified medication allergies should be included on medication administration records. The manager should have a qualification at NVQ level four in management (or equivalent) by 2005. Hunningley Grange J51 S18258 Hunningley Grange V227917 25.05.05 UI Stage 4.doc Version 1.30 Page 22 Commission for Social Care Inspection Ground Floor, Unit 3 Waterside Court Bold Street Sheffield S9 2LR National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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