Inspection on 16/05/06 for Le Grand Nursing Home

This inspection was carried out on 16th May 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 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

Le Grand Nursing Home 01/08/07

Le Grand Nursing Home 12/01/06

Le Grand Nursing Home 18/08/05

Le Grand Nursing Home 09/02/05

Le Grand Nursing Home 12/10/04

Le Grand Nursing Home 08/03/04

Similar services:

Ruskin Lodge

Bushell House

Langrigg House

Parkside

Dystlegh Grange

Thornton Lodge

Chirnside House

Keer Sands Residential Home

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

CARE HOMES FOR OLDER PEOPLE Le Grand Nursing Home Le Grand Nursing Home Preston Old Road Freckleton Preston Lancashire PR4 1HD Lead Inspector Ms Jenny Hughes Unannounced Inspection 16th May 2006 10:00 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 Le Grand Nursing Home DS0000006054.V286090.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. Le Grand Nursing Home DS0000006054.V286090.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Le Grand Nursing Home Address Le Grand Nursing Home Preston Old Road Freckleton Preston Lancashire PR4 1HD 01772 679300 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) Dr Maganlal Khimchand Vachhani Mrs Nootalkumari M Vachhani Care Home 28 Category(ies) of Old age, not falling within any other category registration, with number (28) of places Le Grand Nursing Home DS0000006054.V286090.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. To accommodate one named person under 65 years of age within a maximum of 28 people. To accommodate one name person under 65 years of age for 2 weeks respite care within a 12 month period. 12th January 2006 Date of last inspection Brief Description of the Service: Le-Grand Care Home with Nursing is located in Freckleton and offers care and nursing to 28 service users aged 65 years and over; the home has a condition of registration for two named service users under the age of 65 years. Accommodation is provided in a purpose built, single storey environment. All bedrooms meet the National Minimum Standards size requirements and have en-suite facilities. Each room is furnished to a satisfactory standard and personal possessions are welcomed with each service user. There are three lounges and a dining room. There is adequate parking for visitors. A bus route is close by as is the village with all its facilities and services such as shops and post office. Dr and Mrs Maganlal Khimchand Vachhani own the home. There is a Statement of Purpose and Service Users Guide available; this is a set of written information that tells you about the care service that is offered, who the manager and staff are and what the resident can expect if he or she decides to live at the home. As at 10th April 2006, the fee scale ranges from £366 to £520.50, with additional charges for chiropodist and hairdresser visits, and any extra newspapers and toiletries requested. Le Grand Nursing Home DS0000006054.V286090.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced inspection visit to the home, in that the owners were not aware that it was to take place. The length of the visit was for 6 hours. Before the visit took place, the owners were asked to complete a preinspection questionnaire, and surveys were received from residents and their relatives, and visiting professionals. During the inspection visit, staff records and resident care records were viewed, alongside the policies and procedures of the home. The owners, residents, qualified staff and care staff were spoken to, and their responses are reflected in the body of this report. A tour of the home was made, viewing lounges, dining room, bedrooms and bathrooms. Everyone was friendly and cooperative during the visit. What the service does well: Le Grand is a very welcoming and homely place for people to live. The decoration and furnishings are of a good standard, making the environment a comfortable and relaxing place to be. The three lounges give choice for residents on where they prefer to sit, and the airy dining room with its pine furniture and matching table linen makes for a pleasant mealtime atmosphere. The gardens are well maintained, with seating areas for the better weather. The home has some long-term staff, who lead by example with good practices and professional attitudes. All of the residents spoken to by the inspector said that the staff were very nice, friendly, and kind. Care plans for residents are clear for staff to understand how to best look after each individual, and personal routines are respected. “You can do what you want really”, commented one resident, “Why shouldn’t you?” Meals are home-cooked, varied, with well-balanced choices. They are well presented, with meal times being pleasant and unrushed. Residents said that Le Grand Nursing Home DS0000006054.V286090.R01.S.doc Version 5.1 Page 6 they enjoyed the meals, and there was a good choice. A relative commented “The food is of a high standard, and cleanliness is good”. Residents said that they often went on outings, and enjoyed them very much. “I am very satisfied with the owners and all of the staff”, said one relative, “I have never had any cause for complaint”. 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. Le Grand Nursing Home DS0000006054.V286090.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 Le Grand Nursing Home DS0000006054.V286090.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 The quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The information the home gives to people about the services available, and the way it gathers information about people who want to live there, means that proper choices can be made about the suitability of the home. EVIDENCE: Individual records are kept for each of the residents, and there is a set procedure for admitting someone to the home. A checklist is used to make sure nothing is missed. A pre-admission assessment is used by management to check that staff can give suitable care to each person, before the manager agrees that the home is the right place for the person to live. Detailed information about the care needed by the residents was seen on three randomly selected files. Le Grand Nursing Home DS0000006054.V286090.R01.S.doc Version 5.1 Page 9 A resident confirmed that she was asked about her care before she arrived at the home: “They asked me what food I didn’t like, and talked about what help I needed when I came here. My family helped sort things though”. Another added, “They asked me what help I needed and still make sure I’m always OK”. The owners and senior staff said that trial periods were offered so that people could have time to decide whether they were happy to stay at the home, and also so that the home could make sure they could provide the right care. GP’s responses to a survey said that the home always communicates clearly and works in partnership with them, and they were satisfied with the overall care provided to residents. Le Grand Nursing Home DS0000006054.V286090.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 and 10 The quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The health and personal care needs for everyone living at Le Grand is well organised, meaning people benefit from individualised care and support. EVIDENCE: Individual care plans are available, identifying the areas of need for each person, and with clear instructions for staff for what they must do to meet that need. The management regularly reviews the way things are recorded, and tries to improve the information and instructions to staff to make improvements to the lives of the residents. Reviews of the care plans of the three files viewed had taken place, to make sure the information about the resident’s care needs was up to date. Resident’s said that “they always ring for the doctor if someone’s not very well”, and a GP called into the home during the visit. “They make sure my Le Grand Nursing Home DS0000006054.V286090.R01.S.doc Version 5.1 Page 11 hearing aid’s working alright. I don’t know who they ring up, but they get it sorted for me”, commented another resident. The staff can look after people who have special needs, for example someone who has very poor sight. They do this by making sure there are clear instructions for staff on things like not changing the position of furniture, and making sure they always tell the resident where things are. Staff were seen to use touch and direct speech with ease to make the resident feel part of the happenings in the home. This way the resident can retain some independence and feel included and equal to other residents in the home. Residents can choose to go where they wish in the home. There are three lounges, so one resident, who said she prefers to sit quietly, sat alone in one lounge, while several others sat with a radio on in another. Another resident enjoyed walking around the home “for some exercise”. Residents commented that visitors called often, and they could use one of the lounges to chat, or go to their own room for privacy. Medication was stored in a lockable trolley. Following advice at the last inspection, the management have changed the system used to both record and administer medication, using Boots pharmacy guidance. The records seen were up to date, and the next inspection will view the new system in place. Only trained staff administer medication. Le Grand Nursing Home DS0000006054.V286090.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 and 15. The quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents daily lives and social activities are well catered for, and all people benefit from living in a home that works hard to ensure that people are provided with opportunities to live lives that are fulfilled. EVIDENCE: The individual care plans include information on each person’s life history, their religious needs, and which hobbies and activities they prefer. Staff address any diverse and individual needs in order to make sure each person is cared for equally, and feel as much at home as possible. As a resident commented,” I’ve been here a while now – I can’t see you know, but the girls tell me what’s going on. I like to have this music on as well. Here comes the tea – I can have coffee if I want. They know exactly what I need you know”. Activities in the home try to stimulate residents to join in, and staff were seen during the visit spending time sitting with and chatting to residents, reading Le Grand Nursing Home DS0000006054.V286090.R01.S.doc Version 5.1 Page 13 short stories to a group of residents who were laughing and listening, and having some quiet time with a resident while giving her a manicure. The staff said that they also played bingo, board games, and enjoyed music and videos. “I like my radio on”, added a resident. Residents and staff showed examples of pictures they had made in a craft session. Information on the notice board in the entrance hall detailed trips arranged, the latest being a trip to a large garden centre. The transport is able to take wheelchairs, so no one is left out. One resident confirmed that everyone who went enjoyed the trips out “ We went to Lowther Gardens. Oh yes and Fairhaven Lake where we had an ice cream. It was very nice”. Not all of the residents want to join in, as one resident commented “ I just like to be quiet in my room. They still always ask if I’m alright or want anything”. Visitors call into the home through the day, all recorded in the visitor’s book by the front door. Several of the residents spoken to commented on the regular visits made to them by their family and friends, and all of the responses on the surveys state that staff are always welcoming to family and friends. The menus are on a four-week cycle, and on the day of the visit residents could choose from gammon and pineapple or cheese and onion pie for their main meal. “I like the meals here, and there’s a choice if you don’t like something. You just tell them. They come round and ask you what you want anyway.” said a resident. Staff served meals in the pleasant dining room, helping tactfully when needed. One resident enjoyed her meals in her own room “I don’t go in the dining room”, she commented, “I like to stay in here. At my age I think I can choose where I want to eat don’t you?” Le Grand Nursing Home DS0000006054.V286090.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 and 18 The quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents are confident their concerns will be listened to and acted upon. Staff have an understanding of Adult Protection issues, which protect residents from abuse. EVIDENCE: There is a complaints procedure in place, with a complaints book to record any complaints, which may come to the manager’s attention. The home’s complaints book has no records of complaints. Several residents spoken to said they would tell the staff if they were not happy with something. As one resident commented, “Of course I would tell the staff if I wasn’t happy. We’re not daft here you know!” Several ‘thank-you’ cards and letters from family and friends were seen on the office notice board. There is advocacy information available for anyone who is without relatives and who might need someone to speak on their behalf. “I’ve been here for a few years now and I’ve got no complaints” confirmed a resident. “It’s all very good”, added another. Le Grand Nursing Home DS0000006054.V286090.R01.S.doc Version 5.1 Page 15 Staff spoken to knew about the Adult Protection procedure, and what to do if they had any concerns. They said they would always act if they thought a resident was at risk. Also if it was a member of staff causing concern they would inform the manager. All staff attend abuse awareness training. Le Grand Nursing Home DS0000006054.V286090.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19 and 26 The 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 well-maintained environment, which provides aids and equipment to meet the care needs of the residents. It is a very pleasant, safe, and homely place to live. EVIDENCE: The home is set in its own well-maintained grounds, with a protected garden area with a lawn, flowerbeds and a well stocked bird table. Residents said they enjoy sitting outside in the better weather. The owners discussed plans to make a ‘Dutch Wall’, where people using wheelchairs would be able to enjoy a spot of gardening if they wished. Domestic staff were in the process of the daily routine cleaning of the home at the time of the visit, and all of the rooms were clean, fresh and tidy on Le Grand Nursing Home DS0000006054.V286090.R01.S.doc Version 5.1 Page 17 viewing. A large fresh flower arrangement in the entrance hall gave an attractive welcome into the home. The bedrooms, all ensuite, were nicely furnished and decorated, and were full of resident’s personal belongings, such as photographs and pictures, ornaments and flowers. “My room’s nice – I can see the birds out of my window. My son brought me that plant”, said a resident, showing her gift. “I’ve got a nice room”, said another resident, “Have you seen my pictures? I watch telly in here as well. You don’t always want to sit with everybody else do you?” There is ongoing maintenance to keep the standard of the environment at a good level, and recent purchases of new towels, pictures, and soft furnishings help to do this. Grab rails, assisted baths, lifting and bathing hoists, and raised toilet seats all go towards helping the mobility of people around the home. The laundry room was clean and tidy, with an organised system being used to protect against cross infection, and to make sure there is no misplaced clothing. Le Grand Nursing Home DS0000006054.V286090.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27 and 30 The quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is properly staffed, which means that the residents are supported by sufficient numbers of well trained and appropriately qualified staff. EVIDENCE: Staff files showed that the necessary recruitment checks had been carried out to ensure the protection of residents. References and Criminal Records Bureau checks were available, and notes of the interview were made. All new staff have induction training, and are given a staff handbook, which gives guidance and information on their terms and conditions, and working practices in the home. A staff rota of trained nurses, care staff, and domestic staff, clearly showed who was on duty at any time. A previous inspection identified low staffing levels, but recent recruitment of staff has addressed this, and there were satisfactory numbers of staff on duty at the home. Many of the staff have worked at the home for a few years, “I’ve worked here this long so it must be alright!” commented one staff member “It’s a friendly place to work. We try to make it as homely as possible for the residents.” Le Grand Nursing Home DS0000006054.V286090.R01.S.doc Version 5.1 Page 19 “There’s plenty of training, and you feel supported here. Everyone discusses things to make sure they are done right,” said another. “It’s a nice place to work. We get regular updates on things like moving and handling, fire awareness and health and safety. We have staff meetings, and formal handovers between shifts to make sure all the information is passed on,” added another staff member. A training matrix was seen showing all the training attended by staff, such as tissue viability, nutrition and dementia awareness. National Vocational Qualifications have been achieved by 44 of the care staff. Le Grand Nursing Home DS0000006054.V286090.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35 and 38 The quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The owners and senior staff work to improve services and to protect the health and safety of residents. However, there is no registered manager to lead and support the staff as a role model, and to develop high quality services. EVIDENCE: The home does not have a registered manager at present. Until one is appointed, the day-to-day running of the home is carried out by a named member of staff who is a Registered Nurse. The owners of the home are also present at the home most of the time. The owners must appoint a suitably qualified person to manage the home and to register with the Commission for Social Care Inspection. Le Grand Nursing Home DS0000006054.V286090.R01.S.doc Version 5.1 Page 21 Staff were happy with the leadership in the home, finding it very open and positive. The owners had realised that they needed more information from people using the home about anything they could improve on, and so a regular meeting for relatives has recently been started, the first one proving popular. The owners and the staff are present to discuss any issues with the relatives, either as a group or confidentially, to try to improve the service they provide if necessary. The owners regularly have informal chats with the residents, and were seen doing this at the visit. The residents said that the owners always spoke to everyone and listened to what they had to say. The home is not responsible for handling any residents’ finances, and they either manage them themselves, or family help in this area. Supervision of staff in the form of regular one to one meetings take place, with full records made. These are targeted to each staff member’s individual needs, and identify training needs and confirm correct working practices. The home has achieved the Investors In People Award, showing that staff are effectively developed through good training, support and guidance. Procedures in the home are regularly reviewed and updated if needed, and the management team are open to suggestions on ways to improve systems. The owners confirmed in their pre-inspection information that all maintenance services on any equipment in the home were up to date. Le Grand Nursing Home DS0000006054.V286090.R01.S.doc Version 5.1 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 X 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 X 29 X 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 X 3 X 3 X X 3 Le Grand Nursing Home DS0000006054.V286090.R01.S.doc Version 5.1 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. 1. Standard OP31 Regulation 9 Requirement The service must employ a suitably qualified and experienced manager who is registered with the CSCI 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. Refer to Standard Good Practice Recommendations Le Grand Nursing Home DS0000006054.V286090.R01.S.doc Version 5.1 Page 24 Commission for Social Care Inspection North Lancashire Area Office 2nd Floor, Unit 1, Tustin Court Port Way Preston PR2 2YQ 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 Le Grand Nursing Home DS0000006054.V286090.R01.S.doc Version 5.1 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. 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. 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