Inspection on 14/09/05 for Marsden Grange

This inspection was carried out on 14th September 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

Marsden Grange 19/01/09

Marsden Grange 25/06/07

Marsden Grange 31/01/06

Marsden Grange 04/03/05

Marsden Grange 10/08/04

Marsden Grange 03/12/03

Marsden Grange 17/07/03

Marsden Grange 17/07/02

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

CARE HOMES FOR OLDER PEOPLE Marsden Grange 239 Barkerhouse Road Nelson Lancashire BB9 9NL Lead Inspector Mrs Marie Dickinson Unannounced Inspection 14th September 2005 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 Marsden Grange DS0000009480.V255902.R01.S.doc Version 5.0 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. Marsden Grange DS0000009480.V255902.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Marsden Grange Address 239 Barkerhouse Road Nelson Lancashire BB9 9NL 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) 01282 618226 01282 613382 Mrs Eileen Frances Littlewood Mrs Belinda Jane Finch Care Home 34 Category(ies) of Old age, not falling within any other category registration, with number (34) of places Marsden Grange DS0000009480.V255902.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. The registered provider shall, at all times, employ a suitably qualified manager who is registered with the Commission for Social Care Inspection The home and unit is staffed to the following level: Management - 1 person on duty at all times (Hours required per week: 105). Cook hours required 60. Ancillary Staff: Domestics - 45 hours per week (designated persons) In the main home during the day, in addition to the full time manager two carers to cover the waking hours. (Hours required per week 210) During the night, an experienced carer on waking watch and one person on call on the premises each night. In the unit during the day, two carers on duty at all times. During the night, one carer on waking watch and one person on call in the vicinity. Date of last inspection 4th March 2005 Brief Description of the Service: Marsden Grange is located in Nelson, set back off the main road in its own grounds. There is a bus stop outside the home, on route to the town centre. Accommodation is offered for twenty-four people in single and double rooms in the main house. The upper floor is accessed via stair lifts. There are aids and adaptations provided to assist people to maintain their independence. All rooms have a call system for residents to summon staff assistance. There is a purpose built extension to the rear of the home that accommodates ten people. Bedrooms in this extension are single and have en suite facilities. There is car parking space to the front and rear of the home. Marsden Grange DS0000009480.V255902.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was unannounced, and involved looking at written information and records relating to residents and staff employed in the home. Comments were also received at the Commission from people giving their views about the service. Time was spent talking to the people who live at the home and staff on duty. Observations were made of the care provided in line with Minimum Standards and some residents gave an individual account of their personal experiences of life for them in the home. What the service does well: Before anyone becomes a resident in the home proper assessments are completed and used to decide if living at the home is in the person’s interest. This information was used correctly, making sure residents requirements for care and support by staff was provided. The standard of how this information was recorded in a care plan was very good, and care staff had clear guidance in what each person needed. Staff were described as ‘nice, polite and caring’. Relatives shared this view, and comments received at the Commission stated ‘the friendliness, care and attention are all excellent’. Activities were varied and staff helped residents to take part in what they wanted. Catering arrangements were also of a high standard. Residents were protected by good recruitment of staff and by the training staff were given. Residents living at the home expressed satisfaction about their accommodation. The home was spacious and furnished to a high standard. Training was provided for staff and included topics such first aid, medication and infection control. The standard of training and commitment of the management to support staff was very good. The level of staff trained in a National Vocational Qualification in Care well exceeded the recommended guidelines in standards. Recruitment of staff took into account residents needs and sufficient staff were employed. They were supervised in their work and teamwork was evident. Staff said they enjoyed their work and chosen career. Marsden Grange DS0000009480.V255902.R01.S.doc Version 5.0 Page 6 An excellent standard of hygiene was maintained and observed during inspection. Resident’s health, safety and welfare were considered, and staff worked with safe working practices. This inspection has found the high standards seen during the last inspection had been kept to the same level. 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. Marsden Grange DS0000009480.V255902.R01.S.doc Version 5.0 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 Marsden Grange DS0000009480.V255902.R01.S.doc Version 5.0 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): 2, 3, 5. Assessments of people wanting to live in the home contained sufficient information to plan their care needs. Staff were trained to care for people. Advice was taken from other professionals to make sure all care needs were dealt with in a proper way. Residents were given a contract on admission. EVIDENCE: Records showed that residents had been assessed before they came to live at the home. The assessments were clearly written, showing what support was needed. It was also noted the family and resident had also been involved in the process. It was the homes policy that before anyone is admitted they are given an opportunity to visit and look at the home and meet the staff. Sometimes this is not possible and a representative of the resident is invited to look around on their behalf. A contract had been given to residents on admission. Marsden Grange DS0000009480.V255902.R01.S.doc Version 5.0 Page 9 The range of needs for residents had been considered. New staff members are given training as part of their recruitment as a carer. Staff working in the home also said they had continuing training. Records that were kept showed staff acted upon the changing needs of residents. Other professionals had been consulted for advice. This included amongst others, contact with visiting district nurses. Marsden Grange DS0000009480.V255902.R01.S.doc Version 5.0 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. Care plans were used to help staff to provide the right personal care for residents. The quality of recording care plans was good and showed care needs were properly looked at giving staff guidance when caring for residents. They had been reviewed regularly and residents had been included in these reviews. Residents were satisfied that their needs were met and they considered staff to be respectful to them. EVIDENCE: Care plans referred to residents assessed need. They were thorough and included health, personal and social care needs. The standard of recording was very good and helped staff personalise care and respond to residents needs. There was evidence that residents were involved in regular reviews. The home had a key worker system. Staff had written guidelines on what their role as key worker involved. This is when a carer takes extra responsibility for named residents to make sure their needs are met. Some residents confirmed staff talked to them about their care. They liked their ‘special’ carer and were happy with how they were helped. Entries in daily records showed residents received personal care and additional specialist support where needed. Marsden Grange DS0000009480.V255902.R01.S.doc Version 5.0 Page 11 Residents said staff in the home were mindful of their privacy, for instance they kept the bathroom and toilet doors locked when they were helping them. They also said staff would knock on bedroom doors and wait to be invited in. This was also observed during inspection. The resident’s healthcare and mental health care needs were also identified and staff confirmed how these needs were met. These included visits from a chiropodist, district nurse and their doctor when necessary. Pressure care was promoted and pressure-relieving aids were used where needed. Risk taking was evident as being part of everyday life and showed residents were involved in decisions on how to manage risks that affected them. Risk assessments were very good and outlined what action staff must take to minimise the risk for residents. Relatives written responses to the Commission confirmed they were kept informed of matters that involved their relative. Good practice was observed in confidentiality of information. Residents spoke highly of staff they described as ‘lovely people who treated them with respect’. Marsden Grange DS0000009480.V255902.R01.S.doc Version 5.0 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. Resident’s lifestyle was to their expectations and they felt satisfied with their care in the home. Activities provided were varied and resident’s relatives and friends who visited were made welcome. Catering arrangements were of a very high standard. EVIDENCE: Activities for residents were varied. A member of staff was employed for this purpose, and staff said they had time to help with this. Residents said they went out. Some people went to Church with staff on Sundays. Other people said they enjoyed the visiting organist and the birthday celebrations they had. Other activities included hymn-along, film afternoon, palatine club on Tuesday mornings and armchair exercises. Residents said routines in the home suited them. They could please themselves when they get up or when they went to bed and staff were available should they need them. As one resident stated ‘I can please myself what I do, and staff are always willing to help me. I don’t have to account for staying in bed’. Several residents enjoyed feeding the birds in the garden and the tame birds in the home. Marsden Grange DS0000009480.V255902.R01.S.doc Version 5.0 Page 13 Residents talked about their family visiting. Staff were thoughtful offering drinks and were friendly. Comments sent to the Commission confirmed this. Relatives sometimes had meals. Residents said the food was up to their expectations. They discussed menus and preferences both one to one with staff and at meetings. The groceries and fresh produce provided was more than sufficient. Residents were given choices at meals and records showed alternatives were also given. Any special food residents wanted were provided. Staff were also observed offering support to those people who could not manage to eat their meal without assistance. Meal times were flexible. The standard of hygiene observed in the preparation and serving of meals was excellent. Marsden Grange DS0000009480.V255902.R01.S.doc Version 5.0 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, 17, 18. The complaints procedure was clear and accessible for residents and visitors to the home such as relatives. It was clear any concern or suggestion was acted upon and taken seriously. There were policies and procedures in place to ensure a proper response to any suspicion or allegation of abuse. Staff were familiar with this and had received training. EVIDENCE: There was a complaints procedure for residents to use. This was given to residents when they came to live at the home. A number of residents said they had no complaints against the staff, but if they did they would speak to the manager or any other staff member. Relatives also had faith in this procedure. Comments received at the Commission showed this. One comment noted said minor issues are dealt with promptly. There had been no complaints received at the Commission. Abuse procedures including a whistle blowing policy were available and training was given during staff induction. Staff discussed their responsibility to protect residents from abuse and considered it their duty to follow abuse procedures if necessary. A condition of employment for staff in the home prevents them having any financial gain from residents. When people are a permanent resident in the home they are put on the electoral register. Marsden Grange DS0000009480.V255902.R01.S.doc Version 5.0 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, 20, 21, 23, 24, 25, 26 The home was maintained to very good standard, and residents lived in a comfortable and homely environment. An excellent standard of hygiene was also achieved. EVIDENCE: Marsden Grange is situated in a residential area of Nelson. It is a large adapted property set in attractive grounds, which includes parking areas and sitting and walking areas for the residents. There is an extension to the rear of the building known as the Pendle Suite. The home was furnished to a very good standard and well maintained. Comments received at the Commission from a relative stated ‘Pendle Suite is very well appointed and well kept’. Residents said they liked their bedrooms. Some had brought their own furniture with them when they came to live at the home. Bedrooms in the main home were single and three double. All rooms had proper door locks on, but were a type that let staff open the door in an emergency. Residents could Marsden Grange DS0000009480.V255902.R01.S.doc Version 5.0 Page 16 use a stair lift to go upstairs and some said they used this. Bedrooms in the Pendle Suite were single with en suite facilities that included shower and toilet. All of the residents have use of a call bell to summon the staff for assistance. The baths and showers residents used were special to help people who had difficulty getting in and out of the bath. The water temperature was controlled to prevent people from accidental scalding. Laundry facilities were excellent and the standard of hygiene kept throughout the home was exceptional. Residents said they had enjoyed sitting in the garden during the warm weather. One resident said they liked to walk around the pathways and several residents said they enjoyed watching the birds and squirrels that visited to feed off the bird table. They put food out regularly for them. Marsden Grange DS0000009480.V255902.R01.S.doc Version 5.0 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 The level of staffing was good. Recruitment and selection procedures were satisfactory. Residents had confidence in the staff working at the home. Training provided and attended by staff was to a high standard and offered a wide range of topics. Staff received regular supervision. EVIDENCE: The home was staffed properly during the inspection. Rotas showed sufficient staff were employed in the main home and in Pendle Suite to make sure all residents’ needs were met. Residents said they were very happy with the staff in the home. Staff were described as ‘very good’ and ‘they helped them’. Relatives comments received at the Commission indicated staff were ‘friendly’ and ‘welcoming’. Staff files showed recruitment checks to be complete. Satisfactory references and Criminal Record Bureau (CRB) and Protection of Vulnerable Adults (POVA) register check had been applied for, prior to employment. All staff had attended basic training. The percentage of staff having completed a national vocational qualification in care level 2 was near 100 . Staff said they enjoyed training and were supported by the manager to develop their career in care. Arrangements for staff training were very good with a variety of topics covered to help staff work with skill and knowledge. Staff confirmed they received supervision regularly for which records were kept. Marsden Grange DS0000009480.V255902.R01.S.doc Version 5.0 Page 18 On appointment members of staff were issued with a contract of terms and conditions of employment. Staff said they had received a copy of the General Social Care Council’s code of practice and conduct. All members of staff had a job description. Marsden Grange DS0000009480.V255902.R01.S.doc Version 5.0 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 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, 36, 37, 38. The home was well organised and managed efficiently. Guidance and support was given to staff, which contributed towards ensuring the resident’s quality of life experience in the home was positive. Staff and residents expressed confidence in how the home was managed and in the benefit of having good management support. The health, safety and welfare of residents were given priority in day-to-day management, and good practice was observed in safe working procedures. EVIDENCE: The registered manager Mrs Finch manages the home with the support of Mrs Littlewood the owner and a management team of manager and senior carers. Mrs Finch has the right qualifications for management and care. The means of seeking residents and staff views about the home was both formal and informal. Staff and residents said they had regular meetings. Views Marsden Grange DS0000009480.V255902.R01.S.doc Version 5.0 Page 20 of residents and relatives from anonymous questionnaires were also sought. Comments received at the Commission from residents and staff showed that there is an overall satisfaction in the care provision, the manager and owner, the staff and in the accommodation provided. Staff confirmed they received routine formal supervision, and were happy at their work. During supervision they were given an opportunity to discuss issues relating to their work. Records were kept. During inspection residents expressed general satisfaction about the home, and some said ‘although nothing is like your own home, they were very happy living there’. Some residents described living at the home as ‘very good’. Policies and procedures had been reviewed. The guidance given to staff for work routines were good, and staff teamwork was evident. The health, safety and welfare of residents and staff had been considered. Proper safety maintenance checks were carried out and staff were trained in safe working practices. Record keeping was good. Marsden Grange DS0000009480.V255902.R01.S.doc Version 5.0 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 Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 x 3 3 x 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 4 8 3 9 3 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 4 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 3 18 3 3 3 3 3 3 3 3 4 STAFFING Standard No Score 27 3 28 4 29 3 30 4 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 x 3 x 3 3 3 3 Marsden Grange DS0000009480.V255902.R01.S.doc Version 5.0 Page 22 Are there any outstanding requirements from the last inspection? N0 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. Refer to Standard Good Practice Recommendations Marsden Grange DS0000009480.V255902.R01.S.doc Version 5.0 Page 23 Commission for Social Care Inspection East Lancashire Area Office 1st Floor, Unit 4 Petre Road Clayton Business Park Accrington BB5 5JB 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. 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