Inspection on 12/04/06 for Latimer Grange

This inspection was carried out on 12th April 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is (sorry - unknown). 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

Latimer Grange 16/03/10

Latimer Grange 31/01/09

Latimer Grange 20/08/07

Latimer Grange 19/04/07

Similar services:

Byars Care Home

St Marys Nursing Home

Bramble Lodge

Parkmanor Residential Home

Thornham Grove

Hunter`s Lodge

London Road Neurological and Specialist Care Unit

Carlton Care Home

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

CARE HOMES FOR OLDER PEOPLE Latimer Grange Ltd 119 Station Road Burton Latimer Northants NN15 5PA Lead Inspector Ms Sarah Jenkins Unannounced Inspection 12th April 2006 07:30 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 Latimer Grange Ltd DS0000064335.V288807.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. Latimer Grange Ltd DS0000064335.V288807.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Latimer Grange Ltd Address 119 Station Road Burton Latimer Northants NN15 5PA 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) 01536 722456 01536 725217 Latimer Grange Limited Mrs Sharon Elizabeth Payne Care Home 27 Category(ies) of Dementia - over 65 years of age (10), Old age, registration, with number not falling within any other category (27) of places Latimer Grange Ltd DS0000064335.V288807.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. No one falling within category DE(E) may be admitted into the home where there are 10 persons of category DE(E) already accommodated within the home. To be able to admit the male service user who is 57 years of age as applied for in Variation Application No.V29167 dated 1st February 2006 12/09/05 Date of last inspection Brief Description of the Service: Latimer Grange is a residential care home providing personal care for up to 27 older people over the age of 65 years, of which number, up to 10 can be older people with Dementia. Latimer Grange is situated close to the town centre of Burton Latimer. Accommodation consists of 19 single bedrooms, 14 of which have ensuite facilities, and 4 double bedrooms, two of which are en-suite. 5 of the single ensuite rooms were provided through an extension and have only been recently opened. One of the double rooms is currently being used as a single. The range of fees at the home is £329-£450 per week. Optional services such as hairdressing, newspapers and private chiropody services are charged separately. Information is made available to Service Users and their relatives in the form of the Service Users guide. Other relevant leaflets and items of information (for example access to advocacy) are available in the hallway. Consideration is being given to the best way to ensure Service Users all have access to the Inspection reports. Latimer Grange Ltd DS0000064335.V288807.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The focus of inspections undertaken by the Commission for Social Care Inspection (CSCI) is upon outcomes for Service Users and their views of the service provided. The primary method of inspection used was ‘case tracking’ which involved selecting three service users and tracking the care they receive through review of a selection of records, discussion with the care staff and observation of care practices. Where possible Service Users care was discussed with them. A Number of service users at Latimer Grange have disorders relating to their Dementia and thereby memory and communication difficulties. Establishing their choices and informed decisions is dependant to a large extent upon the training and consistency of staff, service users relationships with staff, and the quality of records and communication. Feedback obtained from Service Users in this report was partially through observations of Service Users responses to staff, and interpretations of their general levels of happiness with their routines. The inspector reviewed the history of the home over the last 12 months to inform the inspection process and met with a District Nurse who was visiting the home and a visiting Community Psychiatric Nurse. The regular visiting hairdresser also offered her views about how the home was running. Neither recent feedback forms from Service Users or relatives nor self-assessment details from the home were due or available in relation to this inspection. The inspector spent 2.5 hours preparing for the inspection and 6.5 hours on the site visit to the home. What the service does well: Service Users told the inspector that they were largely content with their quality of life at the home and felt that the staff were very kind and helpful. When asked whether there was anything that they would like improved they informed the inspector that they would tell the manager, the staff or the owner if there was, and that they were confident that their comments would be responded to. The Inspector observed from the breakfast routine that Service Users quality of life in this respect was similar to living in a good hotel. Breakfast tables were very well presented complete with a menu offering fruit and juices, cereals, toast and hot options including a full cooked breakfast. Service Users were Latimer Grange Ltd DS0000064335.V288807.R01.S.doc Version 5.1 Page 6 seen to enjoy this meal and staff were attentive and alert to their individual needs and wishes. What has improved since the last inspection? 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. Latimer Grange Ltd DS0000064335.V288807.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 Latimer Grange Ltd DS0000064335.V288807.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): 3 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Although Service Users have access to general information and there is flexibility in the admission/assessment process, there was a serious shortfall earlier in the year when an inappropriate admission was made. EVIDENCE: Service Users informed the inspector that they were perfectly happy with the admission process although those who spoke with the inspector said that relatives had made all the arrangements but they were happy with the choices that had been made on their behalf. Staff described a flexible process including a full assessment of Service Users needs prior to admission. It was felt that some Service Users were more able to be closely involved with the admission process than others. Service Users have relevant information in the form of the Service Users guide. Latimer Grange Ltd DS0000064335.V288807.R01.S.doc Version 5.1 Page 9 The Registered Owner and Registered Manager have both been formally advised of the breech of category (a Service User being inappropriately admitted to the home since the last inspection, without an appropriate application having been submitted). Intermediate care is not offered at the home. Latimer Grange Ltd DS0000064335.V288807.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,9,10 Quality in this outcome is adequate. This judgement has been made using available evidence including a visit to this service. Service Users personal and healthcare needs are generally well met and staff uphold Service Users rights to privacy, dignity and respect. EVIDENCE: Service Users were generally content with the personal care at the home and felt staff were very attentive. Mostly they were not concerned with knowing about their care plans or review but were fully satisfied with care delivery, which they felt met their needs. Staff were observed to treat Service Users with sensitivity and respect and to be aware of their rights and dignity. One Service User felt that the procedures at the home had caused unnecessary delay with access to community healthcare services and had discussed this with the Registered Manager. The Registered Manager had followed this up as quickly as possible on the telephone but had no record of this. A visiting healthcare professional said that staff had failed to record issues requested for assessment. Health care records were not always fully completed Latimer Grange Ltd DS0000064335.V288807.R01.S.doc Version 5.1 Page 11 and a Notification to the Commission for Social Care Inspection had been delayed. Medication training, administration and procedures were seen to be fully professional at the time of the inspection. Latimer Grange Ltd DS0000064335.V288807.R01.S.doc Version 5.1 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 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 good. This judgement has been made using available evidence including a visit to this service. Service Users lead lifestyles, which include occupational input from staff and visiting entertainers. Some have regular access to the community. Choice in some areas could be improved. EVIDENCE: Service Users spoke enthusiastically about entertainers visiting, and periodic parties held by the home, and there was a photographic record of this in the form of an album whereby Service Users could remind themselves of special occasions. Visitors are welcomed, often included in invitations to social events, and always offered hospitality. Staff at the home strive to maintain good communication with families but are currently investigating a complaint about communication. Service Users generally feel that they have choice although this does not appear to be available in some areas, for example the choice of décor in their rooms. Latimer Grange Ltd DS0000064335.V288807.R01.S.doc Version 5.1 Page 13 Meals are generally very good and Service Users consistently made positive comments about the home cooking. The provision and serving of breakfast was seen to be excellent. Diversity was not properly accommodated in respect of a Service Users dietary preference for vegetarian food. Although her diet was respected and provided there was evidence that her preferences and choices were not given the same in depth consideration as Service Users eating the normal full diet. Latimer Grange Ltd DS0000064335.V288807.R01.S.doc Version 5.1 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 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 adequate. This judgement has been made using available evidence including a visit to this service. Service Users are listened to and protected from abuse. EVIDENCE: Complaints are taken seriously and properly investigated. A letter received by the home from a relative commended the homes response to an issue of concern raised with the Registered Persons. The complaints record however has not been kept consistently and therefore evidence of this quality was not available. Service Users indicated that they were confident to raise any concerns directly with the Registered Manager or Registered Owner. Service Users are protected from abuse by a strongly caring culture among staff but staff need to be formally trained and aware of the homes procedures to ensure the Protection of Vulnerable Adults. Latimer Grange Ltd DS0000064335.V288807.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19,26 Quality in this outcome is good. This judgement has been made using available evidence including a visit to this service. The home is well maintained, homely and clean. EVIDENCE: Generally the home was seen to be very clean, well decorated and well maintained. Service Users had no criticism of the decoration, cleaning or maintenance of the home. There was one outstanding maintenance issue at the time of the inspection that cannot be addressed until the weather is warmer. As the full maintenance record of issues requiring attention was not available at the time of the inspection it was not possible to check the progress of this problem (a malfunction in the plumbing). Advice was given that the use of flannel towels in communal bathrooms and toilets may compromise infection control for people with Dementia conditions. Latimer Grange Ltd DS0000064335.V288807.R01.S.doc Version 5.1 Page 16 The Inspector was informed of the high standards of hygiene in toilet areas to protect Service Users i.e. that towels and flannels are washed throughout the day whenever they are used. Disinfectant wipes are also used throughout the home to wipe surfaces whenever necessary. Latimer Grange Ltd DS0000064335.V288807.R01.S.doc Version 5.1 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 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 is adequate. This judgement has been made using available evidence including a visit to this service. Service Users are generally well supported by caring well-trained staff. EVIDENCE: Service Users told the Inspector that staff were “lovely”, “very good”, “helpful” and “caring” They also gave examples of how staff were approachable and responsive. Staff were observed to deal capably with difficult situations and to be sensitive to Service Users spoken and unspoken needs. Some people felt that there were times when the service from staff wasn’t quite as good as usual and put this down to a shortfall of staff numbers. However the rota showed that numbers are generally maintained at the same levels, although there may be shortfalls in experience, training, supervision and leadership on some shifts and this needs to be looked at by the Registered Manager. Staff records showed good processes for recruitment and a recently recruited staff member felt that he had been properly supported through the recruitment procedure. Latimer Grange Ltd DS0000064335.V288807.R01.S.doc Version 5.1 Page 18 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, 35, 38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Management of the home continues to be improved and is judged at this inspection to be good. EVIDENCE: Service Users, staff and visiting professionals have all noticed the improvements in the management of the home and find the Registered Manager approachable and effective. The Registered Manager shows that she takes her responsibilities seriously and is keen to further her own training. Service Users feel that all staff at the home including the Registered Manager have their interests at heart and strive to improve the quality of their lives wherever possible. Latimer Grange Ltd DS0000064335.V288807.R01.S.doc Version 5.1 Page 19 The Registered Manager has recently attended a full 5 day course on Health and Safety and is promoting all aspects of this in the home. Where Service Users monies are kept safe for them by staff, records are maintained and receipts kept. Latimer Grange Ltd DS0000064335.V288807.R01.S.doc Version 5.1 Page 20 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 X HEALTH AND PERSONAL CARE Standard No Score 7 3 8 1 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 2 15 2 COMPLAINTS AND PROTECTION Standard No Score 16 2 17 X 18 2 2 X X X X X X 3 STAFFING Standard No Score 27 2 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 x 3 X X 3 Latimer Grange Ltd DS0000064335.V288807.R01.S.doc Version 5.1 Page 21 Are there any outstanding requirements from the last inspection? 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 2 3 4 5 6 Refer to Standard OP8 OP14 OP15 OP16 OP18 OP19 Good Practice Recommendations Healthcare records must be properly maintained to demonstrate compliance with Regulation 12 and schedule 3 A review should be undertaken to explore where Service Users areas of choice can be extended. Service Users who choose a vegetarian diet should be offered the same consideration as those who enjoy the normal menu. A record of complaints made to the home should include details of every complaint, investigation and any action taken. All staff should have a clear understanding of the Protection of Vulnerable Adults, and relevant procedures within the home. The record of maintenance should be available for use by staff at all times for reporting issues and logging when they are resolved. DS0000064335.V288807.R01.S.doc Version 5.1 Page 22 Latimer Grange Ltd 7 OP27 Staff levels and teams should be reviewed to ensure adequacy on all shifts. Latimer Grange Ltd DS0000064335.V288807.R01.S.doc Version 5.1 Page 23 Commission for Social Care Inspection Northamptonshire Area Office 1st Floor Newland House Campbell Square Northampton NN1 3EB 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 Latimer Grange Ltd DS0000064335.V288807.R01.S.doc Version 5.1 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. 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!