Inspection on 17/07/06 for Innage Grange

This inspection was carried out on 17th July 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Excellent. 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

Innage Grange 31/05/07

Innage Grange 26/10/05

Innage Grange 26/04/05

Innage Grange 03/12/04

Innage Grange 09/08/04

Similar services:

Maple Lodge

Heathlands

Aston Court Nursing Home

Breme

Ravenhurst

Bank House

Inspirations

Westmead

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

CARE HOMES FOR OLDER PEOPLE Innage Grange Innage Lane Bridgnorth Shropshire WV16 4HN Lead Inspector Pat Scott Unannounced Inspection 17th July 2006 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 Innage Grange DS0000020726.V296981.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. Innage Grange DS0000020726.V296981.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Innage Grange Address Innage Lane Bridgnorth Shropshire WV16 4HN 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) 01746 762112 01746 765802 www.coveragecareservices.co.uk Coverage Care Services Ltd Mrs Julie Roberts Care Home 52 Category(ies) of Dementia (21), Old age, not falling within any registration, with number other category (31) of places Innage Grange DS0000020726.V296981.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 26th October 2005 Brief Description of the Service: Innage Grange is a care home registered to provide accommodation and personal care for a total of fifty two older people; twenty one of whom may have an associated mental health disorder, and eight beds being dedicated to the provision of respite care. The Home is leased by Coverage Care Services Ltd, and managed by Mrs Julie Roberts. It is a purpose built, single storey, brick building, divided into five discrete units, each providing single-room en-suite accommodation. Two of the Units cater for residents with dementia, and the remaining three are for elderly frail clients. The units are linked by an internal street setting, incorporating a small shop - leading to communal space for the whole Home, a small library and craft room - with each Unit having its own communal, recreational and dining space. The gardens are well maintained, with sitting areas, and are accessible to individuals of all abilities. Bridgnorth Town Centre is within walking distance of the Home allowing relatively easy access to all amenities, including a variety of shops, library, pharmacy and local hospital. Innage Grange has the additional benefit of its own minibus enabling access to all local health-care community amenities, and for social outings. Coverage Care Services Ltd make their services known to prospective service users in: The Statement of Purpose, Company Brochure and web site which also contain their contact e mail address. The inspection report is mentioned in the statement of purpose and summarised in the service user guide. It is also on display in all homes’ entrance halls with a note stating the document can be made available to copy and take away. Coverage Care Services rates are reviewed annually on 1st April each year and service users are notified one month in advance. The only additional charges to service users are for toiletries, hairdressing, newspapers and escorting to hospital for routine appointments. This is clearly laid out in the terms and conditions. Fees for Innage Grange as of 1st April 2006 are: £318.76-£429. All service users pay monthly by standing order or by cheque usually on the 15th of the Innage Grange DS0000020726.V296981.R01.S.doc Version 5.2 Page 5 month. This is two weeks in advance and two weeks in arrears. Innage Grange DS0000020726.V296981.R01.S.doc Version 5.2 Page 6 SUMMARY This is an overview of what the inspector found during the inspection. A range of evidence was used to make judgements about this service. This includes: information from the provider, staff records kept in the home, medication records, discussion with people who use the service, discussions with the staff team, discussion with the duty manager, tour of the premises, previous inspection reports, quality assurance process, Fire Authority reports, Environmental Health Office reports, observation of care experienced by people using the service. What the service does well: What has improved since the last inspection? What they could do better: It is considered that this home is currently performing very well, setting its own objectives for continual improvement. Innage Grange DS0000020726.V296981.R01.S.doc Version 5.2 Page 7 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. Innage Grange DS0000020726.V296981.R01.S.doc Version 5.2 Page 8 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 Innage Grange DS0000020726.V296981.R01.S.doc Version 5.2 Page 9 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): 1,2,3,4 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The homes statement of purpose and service user guide provides service users and prospective users with details of the services the home provides, enabling an informed decision about admission to the home. Assessment of need is conducted in a respectful and plain speaking way so that service users understand their needs will be met during their stay. EVIDENCE: The statement of purpose and service user guide have been reviewed for 2006/7 and were on display in the home. Evidence from previous inspections show that the organisation of Coverage Care regularly reviews its information for service users and their families/supporters/advocates. Innage Grange DS0000020726.V296981.R01.S.doc Version 5.2 Page 10 Admission assessments on the care files that were read during this visit were comprehensive, clearly written and staff were aware of their content. Staff spoken with said that they spend time with new service users to ensure that they settle in and understand the services and facilities on offer. When people are very frail this can take a while and varies between individuals. Staff were sensitive to the fact that entering a care home is a big change in their life and some need plenty of reassurance and patience, particularly those with dementia care needs. Innage Grange DS0000020726.V296981.R01.S.doc Version 5.2 Page 11 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): 7,8,9,10,11 Quality in this outcome area is excellent . This judgement has been made using available evidence including a visit to this service. The medication at this home is well managed promoting good health. There is a clear, consistent care planning system in place to adequately provide staff with the information they need to satisfactorily meet service users needs. The attitude of staff is excellent and service users are treated with dignity and respect. Personal and healthcare support in this home is offered in such a way as to promote and protect service users’ dignity and privacy in their daily life and at the end of life. EVIDENCE: Innage Grange DS0000020726.V296981.R01.S.doc Version 5.2 Page 12 The care plans that were read were very clearly written. Information from the initial assessments had been written into the plan of care. Care plans are reviewed monthly and annually with signed input from the keyworker, service user and family. Medication is well managed by the home with safe systems in place. Records of spot checks on staff were seen. The home notifies the CSCI through its obligation under the legislation about any incidents which affect the well being of service users. They record the action taken to remedy problems. The manager and staff at Innage Grange have been working towards providing good end-of-life care for service users. The manager was away attending a palliative care training session. During the visit staff were seen and heard to treat service users with dignity and respect. They had patience with those who, for health reasons, were confused or agitated and staff allowed them to go at their own pace in all aspects of care. They were seen to spend time with individuals to ensure they understood decisions and actions. Health care information is displayed on the notice board next to the hair salon. A community nurse was in the home visiting her clients and stated that communication and care were excellent. Innage Grange DS0000020726.V296981.R01.S.doc Version 5.2 Page 13 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): 12,13,14,15 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Staff have an excellent understanding of the service users support and leisure needs and use this to assist them to exercise choice and control in their lives. Service users have many opportunities for community/family contact which enables them to make a choice about who they see and when and where they see them. Dietary needs of service users are very well catered for with a balanced and varied selection of food available that meets service users tastes and choices. EVIDENCE: Service users were very complimentary about the food provided. They were able to relate what they had chosen for lunch and that staff come round and ask them their preference from the menu each day. Menus are displayed on the dining room tables. Innage Grange DS0000020726.V296981.R01.S.doc Version 5.2 Page 14 The home participates in the ‘healthy eating award’. Activity preferences are discussed at the resident meetings. Service users confirmed that they can participate in anything and can go down to the day centre as and when they wished. Or, they could sit quietly in their lounge or their room. A service user stated that “since it has been particularly hot, the staff have been very attentive and provided us with more drinks”. Service users can also speak privately to friends and family in their rooms. They can use the private pay phone or have one in their room. There are many activities for service users to choose from. Some innovative and simple such as the ice cream van visit which has been a popular item. A visitor made the comment that “ people are treated differently, not just as a group”. Another service user from a different country of origin has her social needs addressed with reference to her preferred pastimes and work life. She was spoken to very clearly and patiently so that she could understand staff. Church service are arranged according to individuals’ faiths. Service users were asked politely with some encouragement if they wanted to attend the performance by local school children in the lounge. Innage Grange DS0000020726.V296981.R01.S.doc Version 5.2 Page 15 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): 16,18 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service.” The home has a satisfactory complaints system with evidence that service users feel that their views are listened to and acted upon. Staff are provided with induction and on-going training regarding adult protection. This provides staff with the relevant knowledge to safeguard service users from many types of abuse. Service users are provided with up to date information about adult protection so they can maintain self awareness on this subject. EVIDENCE: The CSCI has not received any complaints about the home. The CSCI holds evidence that Coverage Care Services, as an organisation, respond quickly to complaints, with full records kept of any actions needed to be taken as a result of investigations. Service users spoke of their ability to talk to any staff. They didn’t have any complaints but would feel very comfortable to speak with the manager or staff at any time. The reviews that take place give a forum for concerns to be aired. Innage Grange DS0000020726.V296981.R01.S.doc Version 5.2 Page 16 Information regarding adult protection/whistleblowing from various authorities is on display on the notice board by the hairdressing salon. The activity board displayed the arrangements made for Age Concern to visit the home to provide confidential advice to service users. Innage Grange DS0000020726.V296981.R01.S.doc Version 5.2 Page 17 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): 19,26 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. The standard of the environment within this home is excellent providing service users with an attractive, homely and hygienic place to live. EVIDENCE: The home has a programme for the review of décor and equipment. Works carried out are recorded. All bedrooms and communal areas were in excellent order with clear signage to assist service users to find their way around. The organisation has provided an improvement plan for the home. The premises are regularly reviewed during the monthly visits to the home by the Head of Operations who supplies a report to the CSCI and during the health and safety audits. Innage Grange DS0000020726.V296981.R01.S.doc Version 5.2 Page 18 The gardens are very well maintained, accessible and with an improvement plan for a sensory garden outside a dementia unit. A garden competition takes place between the homes of Coverage Care. Staff at all levels are well trained in using equipment needed for their role. Call bells were left within reach of the service users and were seen to be responded to promptly. Innage Grange DS0000020726.V296981.R01.S.doc Version 5.2 Page 19 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): 27,28,29,30 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. The standard of vetting and recruitment practices is excellent with appropriate checks being carried out. This ensures that suitable staff are employed to care for service users. The arrangements for the induction and training of staff are good with the staff demonstrating a clear understanding of their roles. There is a good match of well-qualified staff offering consistency of care within the home. EVIDENCE: The file of a new recruit, on her induction period in the home, was seen which showed that robust recruitment practices are carried out. Management information provided detailed the induction and training planned for all levels of staff. Staff files were sampled which evidenced that the training plans have been put into place. The induction standards have been amended to meet those for ‘Skills for Care’. Staff confirmed that training is provided and there are many equal opportunities to improve themselves for the benefit of service user care. Innage Grange DS0000020726.V296981.R01.S.doc Version 5.2 Page 20 NVQ qualifications, as of April 2006, stand at 69.6 qualified with 21.7 on the course. A service user stated “ staff are very helpful and I feel safe”. Information sent to CSCI demonstrates that if staff make mistakes in any area of practice then management are quick to resolve any issues and put plans in place to prevent re-occurrence. The organisation benefits from having the post of a personnel and training officer. Coverage Care Services provide opportunities for all abilities of staff within its recruitment processes. An example of this was seen in the staff compliment within the home. Innage Grange DS0000020726.V296981.R01.S.doc Version 5.2 Page 21 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): 31,32,33,34,35,37,38 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. The systems for resident consultation are excellent with evidence suggesting that their views are sought and acted upon The home is managed by an experienced, suitably qualified individual who carries out her responsibilities fully. The manager has sound leadership skills and promotes a professional ethos within the home The management team are developing and maintaining a wellsupported staff group in the home’s quest to constantly improve the service to meet residents’ aspirations The organisation continues to improve and make progress towards raising the standards in all areas for the benefit of its service users. Health, safety and welfare of service users and staff are promoted fully by safe working systems in place Innage Grange DS0000020726.V296981.R01.S.doc Version 5.2 Page 22 EVIDENCE: The CSCI has been provided with information regarding the manager’s training events and updates to complement her role within the home. Senior management of Coverage Care review the conduct of the home on a regular basis through the visits under Regulation 26, management meetings, board meetings etc. Quality assurance takes place throughout the service in both a formal and informal manner. Meetings, surveys, audits, day to day contact all provide records to show that service user satisfaction is at the heart of the service. The home keeps records to show that the health and safety of service users is promoted and protected. Complaints, incidents/accidents are all monitored to identify trends and failings and the need for reassessments. Improvements plans are on display in the office as well as in service user information areas. Plans are in place for maintenance of the premises aswell as furniture and equipment. From talking to service users and observing staff practice there is strong evidence that the ethos of the home is open and transparent with the views of both staff and service users listened to, and valued. Innage Grange DS0000020726.V296981.R01.S.doc Version 5.2 Page 23 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 4 X N/A HEALTH AND PERSONAL CARE Standard No Score 7 4 8 4 9 3 10 4 11 4 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 4 13 4 14 4 15 4 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 4 X X X X X X 3 STAFFING Standard No Score 27 4 28 4 29 4 30 4 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 4 4 4 3 3 3 4 4 Innage Grange DS0000020726.V296981.R01.S.doc Version 5.2 Page 24 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. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Innage Grange DS0000020726.V296981.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Shrewsbury Local Office 1st Floor, Chapter House South Abbey Lawn Abbey Foregate SHREWSBURY SY2 5DE 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 Innage Grange DS0000020726.V296981.R01.S.doc Version 5.2 Page 26 - 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. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!