Inspection on 28/06/05 for Littleport Grange

This inspection was carried out on 28th June 2005.

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

Littleport Grange 16/06/09

Littleport Grange 16/06/08

Littleport Grange 18/12/07

Littleport Grange 13/09/07

Littleport Grange 15/01/07

Littleport Grange 07/02/06

Littleport Grange 17/01/05

Littleport Grange 07/06/04

Littleport Grange 24/03/04

Similar services:

Claremont House

Oak Ridge

Sun Court Nursing Home

Ashville House

Bilney Hall

Hill Barn

Mabbs Hall Nursing Home

Henrietta House

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

CARE HOMES FOR OLDER PEOPLE Littleport Grange Grange Lane, Ely Road Littleport, Ely Cambridgeshire CB6 1HW Lead Inspector Alison Hilton Unannounced 28 June 2005 @ 08:05 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 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. Littleport Grange I53 I03 24311 LITTLEPORT GRANGE V234578 280605 STAGE 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Littleport Grange Address Grange Lane, Ely Road, Littleport, Ely, Cambridgeshire, CB6 1HW Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) 01353 861329 01353 862878 Dove Care Homes Limited Catherine Ann Mary Doswell Care Home with Nursing 75 Category(ies) of Old age, not falling within any other category OP registration, with number (75), Physical disability over 65 years of age PD of places (E) (75) Littleport Grange I53 I03 24311 LITTLEPORT GRANGE V234578 280605 STAGE 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: NONE Date of last inspection 17/01/05 Brief Description of the Service: Littleport Grange is registered as a care home with nursing for up to 75 older people. Accommodation is provided in a large detached property set in attractive and well maintained grounds on the edge of the town of Littleport. There are local amenities within walking distance and the city of Ely is a short drive away. The house is on three floors made accessible by two lifts and stairs. There are a number of lounges and dining rooms available to residents. Although Littleport Grange is registered with 75 beds some double rooms have been made into singles , which means there are 71 places available. There are 57 single and seven double bedrooms, most with en-suite facilities. There are three single rooms that do not have this facility and they share a bathroom. There are registered nurses on duty at all times as well as day care and night care assistants, administrators, cooks, housekeepers, bedmakers, laundry workers, maintenance man, gardener and full time activities co-ordinator. Littleport Grange I53 I03 24311 LITTLEPORT GRANGE V234578 280605 STAGE 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was unannounced and took place on Tuesday 28th June 2005 between 08:05 and 15:50 hrs. There were 54 residents in the home and none in hospital. The manager (matron) was present during the inspection. 11 Residents, 2 visitors and 7 staff were spoken to, general files were seen and personnel and resident files were also inspected. What the service does well: What has improved since the last inspection? 1) There has been a major improvement in care plans and risk assessments to ensure the care provided to residents is appropriate. The information is clear and well laid out and staff have regular times during the month to complete reviews. 2) Pressure sore care is now well documented and clearly states the actions taken and when a pressure sore has healed. 3) Littleport Grange have completed a satisfaction survey of all residents and practice has been improved as a result, although on the day of inspection the action plan could not be found. 4) The home has provided a plastic marquee in the garden to enable residents to go outside when the weather is windy but dry and warm. 5) All eligible care staff are registered on the NVQ Level 2 course. 6) Records on the medication charts in relation to the date on which new medication is started and codes used for non-administration of medication are now consistent and clear. Littleport Grange I53 I03 24311 LITTLEPORT GRANGE V234578 280605 STAGE 4.doc Version 1.30 Page 6 7) The manager encourages nurses, ancillary and care staff to attend courses in areas they have an interest so that they can pass on up to date information to other staff. 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. Littleport Grange I53 I03 24311 LITTLEPORT GRANGE V234578 280605 STAGE 4.doc Version 1.30 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 Standards Statutory Requirements Identified During the Inspection Littleport Grange I53 I03 24311 LITTLEPORT GRANGE V234578 280605 STAGE 4.doc Version 1.30 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 standard(s) 1,2,3,4,5 and 6 Pre-admission assessments were found on files seen during the inspection and these together with visits made by the manager and senior nurse provide the necessary information to ensure a prospective resident could have their needs met by the home. Residents and their visitors said they had had the opportunity to visit the home before coming to live at Littleport Grange so that they could see what it was like. EVIDENCE: In discussions with residents and relatives it was clear that most had been admitted from hospital and it was their relative or friend who had decided on Littleport Grange as a suitable home. The manager stated that the home encourages hospital wards to bring prospective residents to the home or allow their relatives to do so wherever possible. The visit would be for the day so that a meal was eaten at the home and the activities provided and facilities available could be seen and experienced as far as possible. Littleport Grange I53 I03 24311 LITTLEPORT GRANGE V234578 280605 STAGE 4.doc Version 1.30 Page 9 On the two files seen there was evidence of a pre-admission assessment provided by the hospital and the manager stated that in most cases these were informative reports. The manager and senior nurse visit prospective residents where possible and this provides more information as to whether the home is suitable and able to provide the necessary care. The home does not provide intermediate care, but does have one bed for interim care. Interim care is provided to someone who for example is waiting in hospital for specialist items such as grab rails to be put into their home. They do not need a hospital bed and can be accommodated in a residential home where their needs can be met, until such time as their home is ready. Littleport Grange I53 I03 24311 LITTLEPORT GRANGE V234578 280605 STAGE 4.doc Version 1.30 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 standard(s) 7,8,10 and 11 There has been a major improvement in the care plans on residents files and these now provide all the necessary information to enable staff to care for residents in a safe and positive way. EVIDENCE: The plans of care now completed by the staff with residents on admission are a great improvement from the last inspection. All the necessary information was in evidence and regular reviews had been completed. Care plans include agreements for the use of bed rails and these are signed by the resident (where possible) or their representative. The wound care register was seen and found to contain comprehensive notes and full up to date information, which is an improvement since the last inspection. Details of residents who have MRSA are evident but discreet. The manager stated that all residents known to have MRSA are barrier nursed. Specific needs, in relation to special mattresses for those with a tissue viability issue for example, are clearly stated. Littleport Grange I53 I03 24311 LITTLEPORT GRANGE V234578 280605 STAGE 4.doc Version 1.30 Page 11 Visits by or to the GP, District Nurse, chiropodist, optician and dentist are recorded. On the day of inspection staff were seen to treat residents with respect and always knocked before entering a room. Records in relation to medication have improved since the last inspection. The MAR sheets for the two residents being tracked were seen, together with the Controlled Drugs Register and all was in order. The home has an area in the care plan to discuss arrangements to be made in the event of a resident’s death. On one file this had been completed. The other resident has only just moved into the home and the manager stated this would be discussed at a later date. Littleport Grange I53 I03 24311 LITTLEPORT GRANGE V234578 280605 STAGE 4.doc Version 1.30 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 standard(s) 12,13,14 and 15 The home continues to have exceptional provision in relation to the activities co-ordinator. She is active in providing appropriate activities and encouraging residents to participate. Residents spoken to expressed their appreciation. EVIDENCE: Residents spoken to on the day of inspection said their friends and families visited whenever they liked. Visitors spoken to said they found the home friendly and were provided with tea and biscuits during their visits. Some also stayed at the home during mealtimes and thought the food was of a good standard. One resident with little appetite said that the cook was always trying to find foods she may fancy and that nothing was too much trouble. There are always choices at all meals and on the day of inspection lunch was chicken casserole, sausages with onion with creamed or new potatoes and vegetables. There were also salads or omelettes available. The sweets were apple crumble or pear halves with custard or cream. Residents said they could eat in their rooms if they wished but many said they enjoyed eating in one of the dining rooms with others. One said that in the recent nice weather she had tea outside. The home employs a full time activities co-ordinator. Residents said they had recently had outings to Ely and the coast. They also said the activities coLittleport Grange I53 I03 24311 LITTLEPORT GRANGE V234578 280605 STAGE 4.doc Version 1.30 Page 13 ordinator arranged various entertainment and bingo sessions. On the day of inspection the home had a company who sells clothes and shoes come in to allow residents to choose their own items. Littleport Grange I53 I03 24311 LITTLEPORT GRANGE V234578 280605 STAGE 4.doc Version 1.30 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 standard(s) 16 and 18 The complaints procedure continues to be displayed in the home so that residents and visitors can see the process to be undertaken. Residents said that they would speak to carers if they had a problem. Visitors said they would speak to the manager (matron) if they were unhappy with any aspect of care provision in the home. Both parties felt the manager and staff would listen and act on their concerns. EVIDENCE: The home has a complaints procedure in place. There has been one complaint since January 2005 and this was dealt with in line with the procedure. The manager was clear that she has an open door policy and that minor issues can be discussed immediately and dealt with so that there is no escalation into a major issue. It was clear during the inspection that staff and relatives have a good relationship and that the manager and other staff in the office have a very good rapport with all visitors. Staff are completing the Protection of Vulnerable Adults training but there are only two places available on each course. It was suggested that the manager might be able to get the trainer to come to the home because of the large numbers of staff involved. The home does not handle the finances for any resident. Littleport Grange I53 I03 24311 LITTLEPORT GRANGE V234578 280605 STAGE 4.doc Version 1.30 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 standard(s) 19,20,21,22,23,24,25 and 26 The garden provides a variety of areas to sit and has access from the home. Residents rooms contained some of the necessary specialist equipment such as mattresses, wheelchairs and hoists, whilst bathrooms contained specialist baths and showers to enable residents to be safe and comfortable. The manager is aware that two shower rooms need some work on the tiling to maintain pleasant and clean surroundings for residents. EVIDENCE: The home continues to provide suitable accommodation with several dining rooms and sitting rooms for all service users. The main seating area is light and airy. The décor throughout the building is mainly well maintained and clean. In some areas there were indications that wheelchairs had scraped the paint off skirting boards. In one room it appeared that drinks had been spilled over the walls and these should have been wiped off. Outside room 23 the handrail was slightly damaged. Two shower rooms require some attention to Littleport Grange I53 I03 24311 LITTLEPORT GRANGE V234578 280605 STAGE 4.doc Version 1.30 Page 16 the tiling and the manager said that the maintenance man already has this task in hand. The residents rooms seen during the inspection were seen to contain personal items of furniture, pictures, ornaments and photographs. The rooms were clean and homely. There was also equipment such as wheelchairs and hoists in rooms where there was a need. The home appeared clean, hygienic and was free from offensive odour in the areas and rooms seen during the inspection. Separate staff are employed in the laundry. The home has separate sluicing facilities and washing machines that meet disinfection standards. Staff in the laundry said that they were attending a course in infection control and decontamination. The large grounds were tidy on the day of inspection with a range of flowers in bloom and trees to provide some shade. The gardens are accessible to all residents through the front door or patio doors. There is seating in the garden for those who wish to use it, and also a plastic marquee which allows the garden to be used on less sunny days. There is also an aviary which provides some interest for the residents. In addition to the general sitting rooms there are several other areas such as the entrance hall where service users can spend time. The home continues to provide adequate washing and toilet facilities as there are fewer residents at the moment. There are 2 Parker baths and nine showers. Most bedrooms have en-suite facilities. One shower room was out of use on the day of inspection. Littleport Grange I53 I03 24311 LITTLEPORT GRANGE V234578 280605 STAGE 4.doc Version 1.30 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 considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27,28,29 and 30 The two staff files seen during the inspection contained the necessary paperwork and police checks to maintain the safety of residents as detailed in their recruitment policy. EVIDENCE: On the day of inspection there were 54 residents with 9 care staff and 3 Registered Nurses on duty. There were also housekeeping (including bed makers and cleaners), kitchen staff, office staff, gardener, maintenance man and activities co-ordinator on duty. According to the Department of Health guidelines the home has the staff complement necessary to carry out the care of the current resident group. The manager stated that all eligible staff were registered and completing NVQ Level 2. Two staff already have this qualification. One staff member is completing NVQ Level 3. Laundry, housekeeping and kitchen staff are completing infection control and decontamination training. Two housekeepers are completing NVQ Level 2 Housekeeping, and two kitchen staff are completing a relevant NVQ Level 2 for their work. Two staff files were seen during the inspection and found to contain all the necessary paperwork. Littleport Grange I53 I03 24311 LITTLEPORT GRANGE V234578 280605 STAGE 4.doc Version 1.30 Page 18 Staff spoken to during the inspection stated they had completed the statutory courses and felt the manager would be open to any request for other relevant training. Littleport Grange I53 I03 24311 LITTLEPORT GRANGE V234578 280605 STAGE 4.doc Version 1.30 Page 19 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31,32,33,34,35,36,37 and 38 Formal supervision is taking place to ensure the welfare of residents through information about policies, procedures and best practice guidance. The manager uses internal audits and resident surveys to ensure the home is run in the best interests of the residents. EVIDENCE: The manager is registered with the commission and is a qualified nurse and has a management qualification confirmed by TOPSS as being equivalent to NVQ 4. The manager stated she continues to have an open door policy for staff, residents and their relatives. This was evident on the day of inspection and when in conversation with relatives visiting the home. Those spoken to during Littleport Grange I53 I03 24311 LITTLEPORT GRANGE V234578 280605 STAGE 4.doc Version 1.30 Page 20 the inspection said the manager was approachable. Residents, their visitors and staff agreed that the home is run in an open way. The manager is approachable and staff particularly felt that there was an open door policy where they could approach anyone in the office at any time, ensuring the needs of residents were met. The home does not handle any resident’s finances. Supervision of staff does take place both formally and informally. Informal chats re individual issues in relation to residents for example are not always documented. Formal supervision is documented but it is recommended that the notes be signed by the supervisor and supervisee to ensure that both parties agree on what was discussed and the outcomes. The manager stated that internal audits had been completed on areas such as the admission procedure, daily life and activities and meals and mealtimes for example. These were seen and contained the methodology, details of files looked at, outcomes and ways forward. The manager also completed user satisfaction surveys. The activities coordinator assisted residents who wanted help. The office administrator collated the outcome of the survey and the home used the information to improve practice. For example there was an issue regarding fresh fruit. The home now has fresh fruit which is taken round by the activities co-ordinator each day to ensure everyone has a choice and any assistance necessary. The manager was also aware that the company has sent out satisfaction questionnaires to the families of residents and use the information to compile a report that goes into the brochure provided on the home. Dove Care is the registered provider and its Head Office hold details of the homes financial position. The home does keep a monthly cost flow chart to show the budget for the home, but the main business plans are kept at Dove Care. Littleport Grange I53 I03 24311 LITTLEPORT GRANGE V234578 280605 STAGE 4.doc Version 1.30 Page 21 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score 3 3 3 3 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 4 13 3 14 3 15 3 COMPLAINTS AND PROTECTION 3 3 3 3 3 3 3 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x 3 3 3 3 3 3 3 3 3 Littleport Grange I53 I03 24311 LITTLEPORT GRANGE V234578 280605 STAGE 4.doc Version 1.30 Page 22 NO 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. 1. 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 10 Good Practice Recommendations The registered person should ensure that the call bells are answered in a reasonable time to ensure the well being of residents. (This is in relation to one call taking 15 minutes to be answered on the day of inspection.) The registered person should ensure that supervision doscumentation is signed by the supervisor and supervisee. 2. 36 Littleport Grange I53 I03 24311 LITTLEPORT GRANGE V234578 280605 STAGE 4.doc Version 1.30 Page 23 Commission for Social Care Inspection CPC1, Capital Park Fulbourn Cambridge CB1 5XE 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 Littleport Grange I53 I03 24311 LITTLEPORT GRANGE V234578 280605 STAGE 4.doc Version 1.30 Page 24 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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