Inspection on 31/05/07 for Innage Grange

This inspection was carried out on 31st May 2007.

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 17/07/06

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 Keith Salmon Key Unannounced Inspection 31st May 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 Innage Grange DS0000020726.V341573.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.V341573.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.V341573.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 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 - with five beds being dedicated to the provision of respite care. Leased by Coverage Care Services Ltd, and managed by Mrs Julie Roberts, this purpose built, single storey, brick building, is 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, a communal space provision for the whole Home, a small library and craft room. Each Unit having its own communal, recreational, and dining space. The gardens are well maintained, have 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, pharmacy library, and post office. Innage Grange benefits from having its own minibus enabling access to all local health-care facilities, community amenities, and for social outings. Weekly fees for Innage Grange as of 1st April 2006 are £375 to £480. Additional charges are applied for hairdressing, toiletries, newspapers, and for escort to routine appointments, e.g. hospital. Innage Grange DS0000020726.V341573.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This Unannounced Inspection commenced at 9.30am, concluded at 12.30pm, and was conducted by Mr Keith Salmon. Present on behalf of the Home were Gill Shelton (Relief Care Manager), and Margaret Court (Administrator). With no Requirements from the previous Inspection, held in July 2006, this Inspection focussed on the Home’s performance, relative to all ‘Key’ Standards, observations made during a tour of the premises, a review of care related documentation, staff duty rotas and staff files, plus a range of other documents/records reflecting the general operation of the Home. The Inspector also held individual discussions with 7 Residents, 3 Visitors, and several members of Staff. What the service does well: What has improved since the last inspection? What they could do better: The Inspector can specify no area of care provision, which requires improvement, and is assured the home will continue to monitor and re-assess it’s performance to sustain their high level of service provision, and to build on any aspect of care if, and where, possible. Innage Grange DS0000020726.V341573.R01.S.doc Version 5.2 Page 6 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. Innage Grange DS0000020726.V341573.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 Innage Grange DS0000020726.V341573.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): 3. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Processes to ensure appropriate and thorough care needs assessment, prior to admission, are effectively applied. These findings are utilised to ensure appropriate placement. EVIDENCE: Review of care plans, and related documentation, provided evidence that appropriate and thorough care needs assessment is undertaken by suitably experienced staff, prior to admission. Information gathered is utilised to enable an informed decision regarding the Home’s capability of meeting the individual care needs of each prospective Resident. Innage Grange DS0000020726.V341573.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9, & 10. Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. The model of Care Plan utilised by the Home is comprehensive, easy to follow and current. Care provided by the Home is very effective in meeting the Residents’ assessed care needs, and is delivered considerately. Residents are treated with respect, their privacy and dignity upheld. The storage, administration, and disposal of medicines are in accordance with accepted good practice. EVIDENCE: Review of care related documentation relating to four ‘case tracked’ Residents’ demonstrated Care Plans were very well organised, easy to understand and up-to-date. Innage Grange DS0000020726.V341573.R01.S.doc Version 5.2 Page 10 The high level of detail included in Care Plans, which relate to the Residents’ individual needs, together with clear statements of care to be provided, is commendable. This detail ensures Carers are enabled to fully meet those needs in an informed and safe manner, regardless of who is providing direct care at any given time, and this was confirmed by discussions with ‘case tracked’ Residents. Evidence was also observed, which confirmed a regular care needs review by the Manager on at least a monthly basis. Inspection of medicine storage provision and administration records demonstrated the Home’s practices meet the guidelines of the Royal Pharmaceutical Society. Innage Grange DS0000020726.V341573.R01.S.doc Version 5.2 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. 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. The Home excels in ensuring full involvement of Residents in promoting choice and control over their lives wherever possible, including their day-to-day life pattern. There are many opportunities for community/family contact. Staff have an excellent understanding of the Service Users support and leisure needs and utilise this to assist them in exercising choice and control in their lives. The Home provides a daily choice of attractive and nutritious meals based on Residents’ preferences. EVIDENCE: Activity preferences are discussed at the Resident Meetings and Residents confirmed to the Inspector they participate in any activity as and when they wish, including going to the day centre. Innage Grange DS0000020726.V341573.R01.S.doc Version 5.2 Page 12 Alternatively, if they choose they simply sit quietly in their own room or in one of the lounge areas. Privacy is maintained through Service Users speaking to friends and family in their own rooms, and in addition to a ‘pay phone’ for Residents use, arrangements can be made for them to have a telephone in their own bedroom. There are many, and varied activities for Service Users to choose from, some innovative and yet simple, such as the ice cream van visit, which continues to be a popular occurrence. A visitor commented to the Inspector that… “ people are treated differently, not just as a group”. Weekly services are provided by a Church of England Ministry team, as well as input from an Interdenominational Group. The Roman Catholic Priest visits individuals of this faith on a regular basis and whenever requested. Service Users were very complimentary about the food provided, particularly that they can make a choice each day, either from menus placed on the dining room tables, or when Staff come round and ask them for their preference from that day’s menu. Menus evidenced meals are varied and nutritious, and the home is a participant in the ‘healthy eating award’ scheme. Innage Grange DS0000020726.V341573.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 16 & 18. Quality in this outcome area is good. 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 have the relevant knowledge through well-planned induction and on going training to safeguard service users from abuse. Service users are provided with up to date information about adult protection. EVIDENCE: CSCI has received no complaints relating to the home since the previous Inspection of July 2006, and previous experience has shown that Homes within the ‘Coverage Care’ Group respond quickly to complaints, with full records kept of any actions necessitated as a result of investigations. Residents and Visitors stated they had no concerns or complaints, but would feel very comfortable raising matters with the Manager or staff at any time. Information from various authorities regarding adult protection/’whistleblowing’ is on display on the notice board adjacent to the hairdressing salon. Accident Records were reviewed and found to be current, presenting no areas for concern. Innage Grange DS0000020726.V341573.R01.S.doc Version 5.2 Page 14 In addition, the activity board was seen to display forthcoming arrangements for Age Concern to visit the home to provide confidential, unbiased advice to service users. Innage Grange DS0000020726.V341573.R01.S.doc Version 5.2 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. 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. Innage Grange is of an interesting and innovative design, which is decoratively of a very high standard, providing Residents with a safe, well furnished, homely, comfortable place in which to live. The standard of cleanliness in the Home is excellent. EVIDENCE: A particular effect of the design of the Home is that although it is relatively large (52 beds) it has the feeling of a much smaller home due in large part to the self-contained (though not isolated) separate units. Lounge/sitting and dining areas offer a good variety of size and outlook, with furnishings and decoration being of excellent order and presenting a ‘domestic’ Innage Grange DS0000020726.V341573.R01.S.doc Version 5.2 Page 16 ambience. All bedrooms and communal areas were in excellent order with clear signage to assist service users in finding their way around. The parent organisation has provided an improvement plan for the home, which is backed by an on-going review of décor and equipment. This is undertaken as part of the monthly health and safety audit visits to the home, by the Head of Operations. A report of which is forwarded to the CSCI. The gardens are very well maintained, and accessible, with an improvement plan in place for the addition of a sensory garden situated outside one of the dementia units. Call bells were left within reach of Residents and were responded to promptly. The standard of cleanliness in the Home is excellent. Innage Grange DS0000020726.V341573.R01.S.doc Version 5.2 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 consider all the above are key standards to be inspected. 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. Staff numbers on duty and skill-mix were sufficient to meet the assessed care needs of current Residents. There is a committed, effective, and well-supported staff group, with the skills and knowledge to ensure Residents enjoy a quality of life, which meets their individual requirements and aspirations. Recruitment and employment practices are consistent with the safeguarding of Residents. The Home’s approach to providing training for Care Staff is commendable. EVIDENCE: A review of duty rosters, and discussion with staff confirmed that staffing numbers and skill-mix enable a service provision, which meets the care needs of the Service Users. Staff were observed to carry out their duties in an enthusiastic and professional manner. Staff are subject to a thorough, and relevant, orientation/induction programme with evidence of on-going training, including a very high proportion having attained relevant NVQ Qualifications. Innage Grange DS0000020726.V341573.R01.S.doc Version 5.2 Page 18 The home has continued to maintain its well-organised systems and detailed records for staff. Records examined showed they contained all the necessary information, which demonstrates potential staff are well screened before they are deemed suitable to start work at the home. Innage Grange DS0000020726.V341573.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): 31, 33, 35, 36, & 38. Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. The home is managed by an experienced well-qualified individual, who possesses sound leadership skills, carries out her responsibilities to the full, and promotes a professional ethos. The systems for consultation with Residents are excellent with evidence suggesting their views are acted upon. The organisation continues to improve and make progress towards raising the standards in all areas for the benefit of its service users. Service Users are safeguarded by the financial procedures operated in the home. Health, safety, and welfare of service users and staff are promoted fully by safe working systems in place. Innage Grange DS0000020726.V341573.R01.S.doc Version 5.2 Page 20 EVIDENCE: Through conversation with Residents and staff, plus observation of staff practice, there is strong evidence the ethos of the home is open and transparent, with the views of staff and service users listened to, and valued. Staff appeared involved and happy in their work. Quality assurance is evident throughout the service, in both a formal and informal manner, through meetings, surveys, audits, day-to-day contact, all of which provide records to show service user satisfaction is at the heart of the service. A review of staff personal files, and related records, demonstrated Staff are subject to regular supervision. The financial management of small amounts of cash, to cover incidental items, for a few Residents, is conducted in accordance with the Standard, including records/cash amounts being subject to audited on a regular basis. All other records were seen to be secure and well maintained. Observation and review of relevant records provided evidence that Health and Safety Policies/Procedures/Practices are satisfactory, maintenance and servicing of equipment regularly undertaken, and appropriately documented, and all COSHH requirements met. Records are maintained for hot water supply to outlets accessible to Residents. Water temperatures tested during the Inspection were found to be satisfactory. Innage Grange DS0000020726.V341573.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 X X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 4 8 4 9 3 10 4 11 X 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 4 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 X 4 X 3 3 X 4 Innage Grange DS0000020726.V341573.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. 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.V341573.R01.S.doc Version 5.2 Page 23 Commission for Social Care Inspection Shrewsbury Local Office 1st Floor, Chapter House South Abbey Lawn Abbey Foregate SHREWSBURY SY2 5DE 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 Innage Grange DS0000020726.V341573.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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