Inspection on 18/04/07 for Jonathan Grange Nursing Home

This inspection was carried out on 18th April 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

Jonathan Grange Nursing Home 07/03/06

Jonathan Grange Nursing Home 04/10/05

Jonathan Grange Nursing Home 09/03/05

Jonathan Grange Nursing Home 01/09/04

Jonathan Grange Nursing Home 01/03/04

Similar services:

Chirnside House

Keer Sands Residential Home

Ruskin Lodge

Bushell House

Langrigg House

Parkside

Dystlegh Grange

Thornton Lodge

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

CARE HOMES FOR OLDER PEOPLE Jonathan Grange Nursing Home Micklehurst Road Mossley Tameside OL5 JL Lead Inspector Mr Steve Chick Unannounced Inspection 10:00 18th April 2007 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 Jonathan Grange Nursing Home DS0000025437.V333409.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. Jonathan Grange Nursing Home DS0000025437.V333409.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Jonathan Grange Nursing Home Address Micklehurst Road Mossley Tameside OL5 JL 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) 01457 837288 01457 837143 jonathongrange@highfield-care.com Southern Cross Care Homes Limited Lorraine Andrew Care Home 28 Category(ies) of Dementia - over 65 years of age (10), Old age, registration, with number not falling within any other category (8), of places Physical disability (5), Physical disability over 65 years of age (20) Jonathan Grange Nursing Home DS0000025437.V333409.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. 4. No more than 24 places can be used for nursing care. No service user under the age of 55 years to be admitted into the establishment. A minimum of 1 first level registered nurse to be on duty throughout each 24 hour period. In addition between the hours of 8 am & 12 midday, Mon - Fri there shall be 1 additional registered nurse on duty. 7th March 2006. Date of last inspection Brief Description of the Service: Jonathan Grange is a purpose built home, situated on the outskirts of Mossley. The home provides nursing and personal care for up to 28 service users. The home is owned by Southern Cross Care Homes Limited, a private company, and is under the day-to-day control of a full-time manager who is also a registered nurse. Accommodation is provided over two floors and consists of 28 single rooms, none of which have en-suite facilities, although toilet and bathing facilities are situated close by. There are four communal areas that provide space for service users to dine and socialise together. A pleasant seating area outside allows service users to enjoy the small garden/patio in safety and comfort. At the time of this report (April 2007) the fees ranged from £331.75 to £552.00. Jonathan Grange Nursing Home DS0000025437.V333409.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. For the purpose of this inspection three service users were interviewed in private, as was one relative of a service user. Additionally discussions took place with the manager and three staff members were interviewed. The inspector also undertook a tour of the building and looked at a selection of service user and staff records as well as other documentation, including staff rotas, fire records and the complaints log. Two ‘comment cards’ were received from local GPs. This key inspection included an unannounced site visit to the home. All key standards were assessed. This report also uses information gathered since the previous visit and information provided by the manager. What the service does well: What has improved since the last inspection? Jonathan Grange Nursing Home DS0000025437.V333409.R01.S.doc Version 5.2 Page 6 All issues raised at the last visit had been addressed. Some, such as the décor and staff training were part of a continuing process. Over half of the staff now held an appropriate professional qualification. The good standards of care have been maintained. 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. Jonathan Grange Nursing Home DS0000025437.V333409.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 Jonathan Grange Nursing Home DS0000025437.V333409.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 and 6. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users needs are appropriately assessed before moving to the home, to ensure that their needs can be met. EVIDENCE: A selection of service users’ files was looked at. All had evidence of an appropriate assessment having been undertaken before the service user moved to the home, unless the admission was an emergency. Examples were seen where an emergency placement had been made. These demonstrated that appropriate initial enquiries had been undertaken and a full assessment quickly completed at the home. Jonathan Grange Nursing Home DS0000025437.V333409.R01.S.doc Version 5.2 Page 9 Discussion with the manager indicated that she was very clear about the importance of assessing the impact of new service users on existing service users, as well as ensuring that the home can meet the needs of a prospective service user. The manager was able to cite examples of where she had not been able to offer a place to someone whose needs she was not confident could be met at Jonathan Grange. Jonathan Grange does not offer intermediate care. Jonathan Grange Nursing Home DS0000025437.V333409.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): 7, 8, 9 and 10. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users’ health, personal and social care needs are met by the consistent implementation of the home’s policies and procedures. Staff practices also serve to promote the dignity of the service users. EVIDENCE: A selection of service users’ files was looked at. All had a detailed written plan of care which was based on an assessment of their needs. The written plans of care presented as being very thorough covering a wide range of potential needs. Similarly there was good documentary evidence of the care plans being regularly reviewed. As with the other documentation in connection with care planning the reviews presented as being very thorough. Apart from the regular monthly reviews there are less frequent, but more structured reviews Jonathan Grange Nursing Home DS0000025437.V333409.R01.S.doc Version 5.2 Page 11 which involve the service user, to ensure that they are in agreement with the care which is being offered. Discussion with staff confirmed that care is offered in an individual way. Staff reported that they would discuss the specific detail of how somebodys needs would be met with that individual. There was also documentary evidence that, when appropriate, family members are involved in the care planning process. Discussion with the activities coordinator indicated that she was developing a comprehensive biography for each service user (subject to their agreement) which would further reinforce the individuality of each service user. Documentary evidence was seen to confirm that this process was being undertaken. All service users and visitors spoken to expressed confidence that appropriate medical support would be obtained if necessary. There was also documentary evidence that service users had access to the full range of medical and paramedical services available in the community. Since the last visit to the home, two comment cards had been received by the Commission for Social Care Inspection from GPs who have patients at the home. Both reported positively. At the time this visit, coincidentally, the home was visited by a prescribing support technician from the local PCT, who was undertaking an audit of the medication storage and administration procedures. She reported that in her judgement there were no identified problems with the medication, which was appropriately stored and administered. In the light of this independent information the inspector did not personally inspect the medication administration or storage. All service users who were asked reported that they were treated with respect and dignity. Interactions between staff and service users were observed to be relaxed, with assistance and support being offered in a sensitive manner. Staff who are asked, were able to cite practical examples of how they sought to maintain the dignity of service users living at Jonathan Grange. Service users and visitors reported positively on their experience of the care being offered at Jonathan Grange. One relative reported that the care is marvellous. One service user said of the staff if you ask for anything they will do it, they are very kind. Jonathan Grange Nursing Home DS0000025437.V333409.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): 12, 13, 14 and 15. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Appropriate social contacts and activities are facilitated within the home to give service users the opportunity for social fulfilment. Service users are able to maximise their autonomy within the context of communal living and the provision of food to maintain service users’ health and well-being is good. EVIDENCE: Jonathan Grange continues to employ the services of a member of staff whose role is to coordinate social activities for service users on weekday afternoons. A notice board in the hallway advertises the daily activities. These included bingo, board games, crafts, music and armchair aerobics. Discussion with the activities coordinator indicated that this was not a rigid timetable and service users were always asked what they wanted to do. It was also reported that an entertainer comes in approximately once a month. There was good Jonathan Grange Nursing Home DS0000025437.V333409.R01.S.doc Version 5.2 Page 13 documentary evidence of ‘life-story’ work being undertaken with service users on an individual basis. This would serve to further reinforce the individuality of service users. Discussion with service users and the visitor, confirmed that activities are regularly available. One service user spoken to confirmed that she attended communion which was provided at the home on a monthly basis. Service users and the visitors spoken to confirmed that there were no unreasonable restrictions on visiting. The visitor spoken to described Jonathan Grange as having a nice, family atmosphere. Service users and staff spoken to all confirmed that service users had a high level of control over their daily lives. Service users were free to access their rooms or any of the communal areas at any time. There was no expectation as to what time service users got up and went to bed. Service users are free to go out when they want, unless restrictions are agreed due to health and safety considerations. One service user spoken to was appreciative of the fact that the home assisted her to go out with her friends. Another service user reported that the staff dont stop you doing what you want to, nobody is bossy. Observation and discussion with service users confirmed that, subject to space and health and safety considerations, service users are able to bring into the home any furniture or personal effects. During the site visit one meal was sampled. This was pleasantly presented and tasty. Service users spoken to during the visit reported positively on the provision of food at Jonathan Grange. This included a choice at mealtimes and individuals personal preferences being respected. For example one service user reported that he had told staff he did not like sauces, so his food was not presented with sauces. Another service user said what you dont want just tell them and you dont get it. Jonathan Grange Nursing Home DS0000025437.V333409.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): 16 and 17. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users are confident that any complaint they may have would be dealt with appropriately. Service users are protected from abuse or exploitation by the homes policies and practices. EVIDENCE: Jonathan Grange has a written complaints procedure which was prominently displayed in the foyer. The home keeps a written record of formal complaints which presented as being appropriately maintained. All service users and visitors who were spoken to were confident that any complaint would be dealt with appropriately. One service user reported that he would see the manager if there was a problem and she sorts them out. Similarly staff are confident that not only they, but also the management team, would take any complaint seriously and deal with it appropriately. Jonathan Grange Nursing Home DS0000025437.V333409.R01.S.doc Version 5.2 Page 15 One visitor described staff is being very approachable, which would make the raising of a concern or complaint easier. All service users spoken to express the view that they were safe at Jonathan Grange. Visitors and staff who were spoken to also expressed the view that service users were safe. Staff who were spoken to demonstrated an understanding of the need to be vigilant about the possibility of abuse. Similarly staff demonstrated an understanding of action they should take if they were concerned about service users not being protected. This included an understanding of the whistleblowing procedure. Jonathan Grange Nursing Home DS0000025437.V333409.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): 19 and 26. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is appropriately maintained, decorated and cleaned to enable service users to live in a pleasant, safe and hygienic environment. EVIDENCE: During the visit to Jonathan Grange a tour of the building was undertaken. This included a selection of the service users bedrooms. No remedial issues were identified in connection with the building. The home presented as clean and tidy throughout with no unpleasant odours. This was confirmed as the usual state of the home by staff, service users and visitors. Jonathan Grange Nursing Home DS0000025437.V333409.R01.S.doc Version 5.2 Page 17 In several areas of the home, the decor presented as being very tired. The manager reported that there was a rolling programme of redecoration and refurbishment. Service users spoken to expressed the view that they liked their accommodation. No evidence was found to indicate that the state of the decor had a negative impact on the quality of life of service users. One service user described the building as being okay and added but its whats in it that counts. One visitor described Jonathan Grange as having a homely feel. All bedrooms were single and there was clear evidence that people could personalise their own rooms. Issues identified at the last inspection in connection with cleaning equipment not working had been satisfactorily resolved. Jonathan Grange Nursing Home DS0000025437.V333409.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): 27, 28, 29 and 30. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The numbers and skill mix of staff on duty promotes the independence and well-being of service users. Recruitment and vetting procedures are predominantly effectively applied to minimise the risk to service users of inappropriate staff being employed. EVIDENCE: The staff rota for the week beginning 09/04/07 was seen. This demonstrated that a minimum of four staff, and usually five staff were on duty during the day (08:00 -- 20:00) and three staff at night. The manager reported that these staffing levels were considered by her to be adequate given the number and dependency levels of the service users. The manager reported that additional hours had been provided for domestic work since the previous visit. Jonathan Grange Nursing Home DS0000025437.V333409.R01.S.doc Version 5.2 Page 19 The manager reported that of the nine care staff employed, five currently held an NVQ II qualification. Staff spoken to confirmed that they had undertaken the training. The manager reported that all staff undertook an induction programme. This was confirmed by inspection of a selection of training records and discussion with staff. There was evidence of a range of training activities being available to staff. Staff who were interviewed confirmed that the local management team were supportive of staff pursuing training opportunities, to further improve the service. A selection of files relating to the recruitment and vetting of staff was looked at. These demonstrated that the majority of required vetting procedures were undertaken before new staff started work. This included the taking up of references and obtaining a criminal records bureau disclosure. In one example no application form could be located although both the manager and deputy manager confirmed that they had personally seen this document. It was thought that the document may have been mislaid when staff files were being tidied up by a temporary administrator. Two examples were seen where there were gaps in the applicants recorded employment history, with no recorded explanation of the reason. Service users and visitors spoken to were positive about the attitude and competence of the staff team. One service user reported that one of the best things about the home was the friendliness of the staff and said he likes to have a chat with the girls, particularly of an evening. One visitor cited the comparatively low turnover of staff as one of the best things about the home, as this meant their relative received a consistent service. Jonathan Grange Nursing Home DS0000025437.V333409.R01.S.doc Version 5.2 Page 20 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 and 38. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The manager is competent to run the home, use the quality audit systems and implement the health and safety procedures for the benefit of service users and staff. EVIDENCE: The manager works alongside the nursing and care staff and consequently is closely involved in all aspects of the service users’ treatment and care. Service users and staff stated that the manager was accessible and approachable. She operated an open door policy whereby everyone felt comfortable to discuss concerns with her at any time. Jonathan Grange Nursing Home DS0000025437.V333409.R01.S.doc Version 5.2 Page 21 The manager has been found at previous visits to be well qualified and has many years of experience in caring for older people. At this visit she reported that she has now started the Registered Managers Award, which is a requirement to be fully compliant with the National Minimum Standards. As stated elsewhere in this report, staff are experienced by service users and visitors as being approachable and friendly. This would give service users and their relatives or representatives a means of commenting on the running of the home. The home also, periodically, sends out questionnaires for service users and relatives to comment on the running of the home. Examples of completed questionnaires from October 2006 were seen. Whilst there was no specific written action plan provided by the manager, there was documentary evidence of a written response to a negative comment. Similarly the manager reported that she had spoken to another respondent to resolve an issue raised through the questionnaire. The manager also holds a relatives surgery once a week, when she ensures she is specifically available for discussion. A selection of records relating to money held by Jonathan Grange on behalf of service users was looked at. The record presented as being predominantly appropriately maintained to safeguard the interests of the service users. In a selection of records looked at one receipt could not be located. There was a record of the receipt number, but several receipts from that particular receipt book had become detached from the back of the book. Previous inspections have identified appropriate procedures are followed to maintain the health and safety of service users and staff. The manager reported that the company was maintaining all appropriate health and safety testing and compliance. A small sample of documentation regarding these tests was looked at and indicated that standards were being maintained. Jonathan Grange Nursing Home DS0000025437.V333409.R01.S.doc Version 5.2 Page 22 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 3 8 3 9 3 10 3 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 X X X X X X 3 STAFFING Standard No Score 27 3 28 3 29 2 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X X 3 Jonathan Grange Nursing Home DS0000025437.V333409.R01.S.doc Version 5.2 Page 23 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. 1 Refer to Standard OP29 Good Practice Recommendations The registered person should ensure that all the necessary aspects of vetting staff are fully documented. This includes explanations of gaps in someone’s employment history. This would help to ensure that the home can demonstrate it has taken reasonable steps to protect the service users from unsuitable staff. Jonathan Grange Nursing Home DS0000025437.V333409.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection North West Regional Office 11th Floor West Point 501 Chester Road Old Trafford M16 9HU 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 Jonathan Grange Nursing Home DS0000025437.V333409.R01.S.doc Version 5.2 Page 25 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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