Inspection on 07/03/06 for Jonathan Grange Nursing Home

This inspection was carried out on 7th March 2006.

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 found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Jonathan Grange Nursing Home 18/04/07

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 Mrs Fiona Bryan Unannounced Inspection 7th March 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 Jonathan Grange Nursing Home DS0000025437.V283821.R01.S.doc Version 5.1 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.V283821.R01.S.doc Version 5.1 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.V283821.R01.S.doc Version 5.1 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 one 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 one additional registered nurse on duty. 4th October 2005 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. Jonathan Grange Nursing Home DS0000025437.V283821.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection was the second inspection of the year. It was undertaken by one inspector who spent time talking to residents and staff. At the last inspection in October 2005 the home was performing satisfactorily in many areas so the purpose of this inspection was to review progress in the areas that were identified as needing improvement. This was mainly related to the maintenance of the home and what training staff had received. Four other key standards, which have to be assessed at least once year, were not examined at the last inspection and were therefore considered at this inspection. These standards included how the home dealt with staff recruitment, residents’ personal finances, the management of medicines and how the home obtains feedback from residents about how the home meets their needs. Standards which were not assessed at this inspection, were considered to be satisfactory at the last inspection. For further information about how the home met these standards please refer to the report of the inspection on 4th October 2005. What the service does well: What has improved since the last inspection? Very few issues were identified at the last inspection that needed addressing. The manager and staff have remained as a stable working team with sound, well tested systems in place to deliver individual care to residents. Jonathan Grange Nursing Home DS0000025437.V283821.R01.S.doc Version 5.1 Page 6 Since the last inspection a new carpet has been laid in the ground floor hallway and work has nearly finished on refurbishing the shower room on the first floor. 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. Jonathan Grange Nursing Home DS0000025437.V283821.R01.S.doc Version 5.1 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.V283821.R01.S.doc Version 5.1 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 the following standard(s): None of the standards in this section were assessed. EVIDENCE: Jonathan Grange Nursing Home DS0000025437.V283821.R01.S.doc Version 5.1 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 the following standard(s): 9 Staff adhere to medicine management procedures, thereby ensuring that the safety of residents is maintained. EVIDENCE: Examination of a number of residents’ medication administration records indicated that medicines were generally managed satisfactorily at the home. An accurate record is maintained of medication received by the home. A record is also maintained of all medicines sent for disposal by the home. The home utilises resident photographs as a formal system of identification prior to medication administration. Staff members with responsibility for medication administration can be identified by the means of a staff signature sheet, which is located in the medication administration record file. Controlled drugs were stored, administered and recorded satisfactorily. Jonathan Grange Nursing Home DS0000025437.V283821.R01.S.doc Version 5.1 Page 10 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): None of the standards in this section were assessed. EVIDENCE: Jonathan Grange Nursing Home DS0000025437.V283821.R01.S.doc Version 5.1 Page 11 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): 18 Procedures within the home and staff training ensure that residents are protected from abuse. EVIDENCE: Since the last inspection all staff have received training in the prevention of abuse. Staff and residents were confident that they could bring any concerns to the attention of the manager and they would be dealt with appropriately. Jonathan Grange Nursing Home DS0000025437.V283821.R01.S.doc Version 5.1 Page 12 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, 25 and 26 There have been slight improvements to the décor and furnishings in the home in the last six months but the lack of fully functioning equipment has led to some difficulties in maintaining standards of hygiene and cleanliness. EVIDENCE: Since the last inspection the ground floor hallway has been fitted with new carpets. Some bedrooms have been redecorated although the hallways still need to be redecorated as the paintwork and wallpaper are showing signs of wear and tear. The refurbishment of a shower room on the first floor is almost completed, but other bathrooms also need redecorating. Jonathan Grange Nursing Home DS0000025437.V283821.R01.S.doc Version 5.1 Page 13 A strong malodour was present on the first floor, which staff thought was due to two leaks that had occurred several weeks previously in two residents’ rooms. It was also reported that as a result of the leaks the water supply to five bedrooms had been shut off. Residents were in occupancy in two of the bedrooms and the inspector was informed that staff were carrying bowls of hot water into these rooms for the purposes of enabling the residents to wash. As this posed a risk to the health and safety of staff an immediate requirement was made that repairs were carried out to ensure that the water supply could be reinstated. Since the inspection it has been confirmed that repairs have been carried out and the water supply has been reinstated. Although the malodour on the first floor was attributed to the leaks, which had dampened the floorboards underneath the carpets, other carpets within the home were also stained and the cleaner said that the carpet cleaner was broken. Inspection of the laundry facilities indicated that only one of the two washing machines was in working order and the laundry staff said this caused some difficulties in ensuring that all the laundry was dealt with during the working hours of the laundry. Feedback was provided to the manager and requirements were made to ensure that the equipment stated above was repaired or replaced within a short timescale. It has since been confirmed that these requirements have been complied with. The rotary iron was also not fully working. A sink was sited in the laundry for the use of laundry staff but no liquid soap dispenser or paper towels were provided. As bar soap can harbour bacteria, liquid soap should be provided in all staff hand washing areas. The ancillary staff ratios are discussed in more detail in the following section regarding staffing; it appeared that the hours actually designated to staff for cleaning were below previously agreed guidance regarding ancillary staff hours. Jonathan Grange Nursing Home DS0000025437.V283821.R01.S.doc Version 5.1 Page 14 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 and 29 A reduction in the number of staff hours allocated for cleaning may lead to deterioration in the standards of cleanliness within the home. The percentage of care staff working at the home who have completed NVQ training does not meet the required targets. Therefore it cannot be certain that the staff have the skills and knowledge to care for the residents competently. Residents are protected by the home’s recruitment procedures. EVIDENCE: Discussion with the manager regarding the staffing hours for the ancillary staff highlighted that the cleaner spent until approximately 10am every morning assisting staff to serve the breakfast to residents and went on cleaning duties after this for only a further 3.5 hours exclusive of the 30 minute break she was entitled to. Another cleaner who had worked 33 hours per week had reduced their hours; thus 22 hours per week previously allocated for cleaning had effectively been lost. Jonathan Grange Nursing Home DS0000025437.V283821.R01.S.doc Version 5.1 Page 15 Guidelines laid down by the previous registering authority indicated that the home should allow a minimum of 15 minutes per day per bed space for cleaning and 1.25 hours per resident per week for laundry; thus with the home’s present occupancy of 24 residents the home should staff to a minimum of six hours per day for cleaning and 30 hours per week for laundry rising to seven hours per day for cleaning and 35 hours per week for laundry when the home is fully occupied. The manager agreed to consider the deployment of the ancillary staff in order to provide slightly more hours for cleaning. None of the care staff have achieved or are near to completing NVQ training. It was reported that enquiries have been made to Tameside Training Consortium and it is anticipated that staff will commence training in the near future. Examination of staff personnel files indicated that staff were recruited via a thorough vetting and recruitment process. Personnel files contained staff CV’s, employment histories, records of interview, contracts and records of induction. Two references had been obtained in all cases and disclosure certificates had been applied for from the Criminal Records Bureau. In instances where staff had commenced employment prior to receipt of the disclosure certificate a POVA First check had been undertaken. Employees’ certificates of qualifications and training were also on file. Jonathan Grange Nursing Home DS0000025437.V283821.R01.S.doc Version 5.1 Page 16 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, 33 and 35 The manager is well qualified and competent to safely manage the home but needs to complete the Registered Manager’s Award to fully comply with this standard. The ethos and management style of the home allows residents the opportunity to give feedback on how the home meets their needs. Procedures are in place to ensure residents’ finances are safeguarded. EVIDENCE: The manager is well qualified and has many years of experience in caring for older people but still needs to complete the Registered Manager’s Award in order to fully comply with this standard. Jonathan Grange Nursing Home DS0000025437.V283821.R01.S.doc Version 5.1 Page 17 Since the last inspection the manager has enrolled to undertake the Registered Manager’s Award but is still waiting for a start date to commence the course. The manager works the majority of her hours alongside the nurses and carers, delivering care to the residents; thus all the residents see her on a daily basis and feel they can discuss any concerns informally at any time. Residents and relatives meetings are not routinely held as they have in the past been poorly attended. Because the manager has an open door policy and is highly visible and accessible to all stakeholders, formal meetings are not necessary and the present system works well for this home. Similarly, due to the small staff team and the close working conditions, staff meetings are only held occasionally on an ad hoc basis as all members of staff regularly see each other at shift handovers and throughout the working day. Residents’ questionnaires were last sent out in July 2005 and the manager said she intended to distribute them again in the near future. It is company policy that resident and relative surveys are obtained periodically. The procedure for the administration of residents’ personal allowances is in the process of being changed from its current system to an electronic format. The home does not have a bank account for residents’ monies and only deals with small amounts of money that relatives provide as a “float” for residents’ sundry expenses. Records and receipts are maintained of all transactions made on behalf of the residents and each resident has an individual ledger sheet detailing the balance of money that is kept on their behalf at the home. Jonathan Grange Nursing Home DS0000025437.V283821.R01.S.doc Version 5.1 Page 18 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 X X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 X 8 X 9 3 10 X 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 X 13 X 14 X 15 X COMPLAINTS AND PROTECTION Standard No Score 16 X 17 X 18 3 2 X X X X X 2 2 STAFFING Standard No Score 27 3 28 1 29 3 30 X MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 X 3 X 3 X X X Jonathan Grange Nursing Home DS0000025437.V283821.R01.S.doc Version 5.1 Page 19 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 OP19 Regulation 23 Requirement The registered person must ensure that the hallways are redecorated. (Previous timescale of 31/12/05 not met). The registered person must ensure that repairs are made to ensure that the water supply to bedrooms 23, 24, 26, 27 and 29 is reinstated. The registered person must ensure that the washing machine is repaired or replaced. The registered person must ensure that the carpet cleaner is repaired or replaced. The registered person must ensure that systems are in place to keep the environment free from offensive odours. The registered person must ensure that liquid soap is provided in all staff hand washing areas. The registered person must ensure that at least 50 of care staff are enrolled to undertake NVQ training. Timescale for action 31/05/06 2 OP25 23 14/03/06 3 4 5 OP26 OP26 OP26 13, 16 13, 16 13, 16 07/04/06 21/03/06 30/04/06 6 OP26 13, 16 30/04/06 4. OP28 18 31/07/06 Jonathan Grange Nursing Home DS0000025437.V283821.R01.S.doc Version 5.1 Page 20 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. 5 Standard OP31 Regulation 18 Requirement The registered person must ensure that the registered manager undertakes the Registered Managers Award. Timescale for action 31/08/06 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. 3 Refer to Standard OP19 OP19 OP27 Good Practice Recommendations The registered person should ensure that the bathrooms are redecorated. The registered person should ensure that the rotary iron is repaired. The registered person should consider the deployment of ancillary staff to ensure that appropriate hours are designated for the cleaning of the home. Jonathan Grange Nursing Home DS0000025437.V283821.R01.S.doc Version 5.1 Page 21 Commission for Social Care Inspection Ashton-under-Lyne Area Office 2nd Floor, Heritage Wharf Portland Place Ashton-u-Lyne Lancs OL7 0QD 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 Jonathan Grange Nursing Home DS0000025437.V283821.R01.S.doc Version 5.1 Page 22 - 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!