CARE HOMES FOR OLDER PEOPLE
Marsden Grange 239 Barkerhouse Road Nelson Lancashire BB9 9NL Lead Inspector
Mrs Marie Dickinson Unannounced Inspection 10:00 25 and 27th June 2007
th 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.V335265.R01.S.doc Version 5.2 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.V335265.R01.S.doc Version 5.2 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 40 Category(ies) of Old age, not falling within any other category registration, with number (40) of places Marsden Grange DS0000009480.V335265.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION
Conditions of registration: 1. The home is registered for a maximum of 40 services to include *up to 40 service users in the category of OP (old age not falling within any other category). 31st January 2006 Date of last inspection 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 sixteen 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. Information about the service is available from the home for potential residents in a Statement of purpose and Service User Guide. Weekly charges for personal care and accommodation range between £360:50 and £528:40. Residents are responsible for purchasing optional extras such as hairdressing, and private chiropody. Marsden Grange DS0000009480.V335265.R01.S.doc Version 5.2 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. A key unannounced inspection was conducted in respect of Marsden Grange on the 25th & 27th June 2007. Information about the service was received at the Commission prior to the inspection. The inspection involved getting information from staff records, care records and policies and procedures. It also involved talking to residents, staff on duty, the registered provider, and included a tour of the premises. Twenty-eight responses were returned to the Commission from residents and visitors and one from a visiting General Practitioner who gave their personal view of the services provided. The home was assessed against the National Minimum Standards for Older People. What the service does well:
Before people are admitted to the home their needs were assessed. They were consulted about the level and type of care they required and could visit the home to look for themselves at the facilities offered. Important information needed to support them in every day living was recorded and used to decide if Marsden Grange could provide the right care, staff expertise and facilities needed. This process made sure requirements for care and support by staff could be provided. Contracts given to residents protected their legal rights, informing them of the terms and conditions of residence. Good care planning meant residents had their assessed and changing needs met in a way that was suitable to them. Residents benefited the support of a named worker referred to as a Key worker who took responsibility to make sure care needs for individuals was personalised. Assessments linked well to care plans. These included health, personal and social care needs. The standard of recording was very good giving staff clear instructions on how to support people in their daily lives. Relatives who sent written comments considered their relatives well cared for and comments such as ‘I feel confident that my father is extremely well cared for.’ And ‘ the staff are caring considerate and patient. They are sympathetic to my mothers needs (and as far as I have seen, the needs of other residents). They cope and do well with many difficulties caused by my mothers mental and physical state.’ Care planning took into account people’s rights such as privacy, dignity, independence, rights, choice, and fulfilment. Resident’s views on how well these were met were recorded. Residents considered their rights to be met. Marsden Grange DS0000009480.V335265.R01.S.doc Version 5.2 Page 6 Healthcare needs were also monitored. Medical personnel written comment stated, ‘I have always found that the needs of my patients are being met, and kept the residents in touch with me on a need to basis, whenever concerns arises about my patients health or welfare’. District nurses visiting during the inspection also said ‘there are never any problems in the home. Instructions for residents care were always followed through.’ Continence management was excellent. Medication practice, policies and procedures, and staff training, reduced the risk of errors being made. Social activities were managed very well. An activities coordinator was employed for this purpose and make sure all residents’ needs were considered. Group activities were popular and recently residents had sat out in the garden enjoying the warm spell. Entertainment had been provided with a pianist playing the organ outside while they drank ‘snowballs’ and ate ice cream. One relative wrote ‘they do little extras e.g. A lady walks them around the grounds, cuts nails etc.’ Visiting arrangements were very good which meant residents could stay in contact with their relatives and friends. Catering arrangements were to the resident’s satisfaction and fruit and vegetables and meat were delivered fresh several times a week. The complaints procedure was clear which helped residents/relatives have confidence to raise any concern they may have. There were policies and procedures, and appropriate training for staff in professional conduct and adult protection issues. This meant residents rights, safety, and welfare was promoted. Overall environment standards in the home were excellent which meant residents were provided with a warm, comfortable, clean, safe, environment that suited their needs. Residents said the home was a nice place to live, as one resident said ‘you’ll not find any better’. Comments from residents/relatives included ‘Provides a clean, attractive and homely environment (both inside and outdoors)’. ‘The place is warm and clean’. ‘Rooms, bedding, environment, clean and acceptable on every occasion’. ‘The home is always clean and tidy’. Recruitment and selection of staff was thorough and protected residents. The level of staffing maintained, training provided, and supervision of staff was excellent which meant residents were cared for by competent qualified staff. Residents described staff as ‘very good’ and ‘the girls are really good you know’, ‘the staff are excellent’. A General Practitioners opinion of the staff was ‘I have never found the care staff wanting in skills or experience as far as my patients are concerned’. The home was well organised and managed efficiently. Residents and staff benefited from regular meetings and were informed of any changes planned. This ensured it was run in the best interests of residents. Guidance and support was given to staff, which contributed towards the resident’s quality of
Marsden Grange DS0000009480.V335265.R01.S.doc Version 5.2 Page 7 life experience in the home being a good experience. Relatives had confidence in the way the home was managed. Written comments such as ‘‘The proprietor and manager are constantly on hand and make a point of knowing the residents individual needs’. ‘From what I have seen they treat all residents with good care and respect.’ 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. The summary of this inspection report can be made available in other formats on request. Marsden Grange DS0000009480.V335265.R01.S.doc Version 5.2 Page 8 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.V335265.R01.S.doc Version 5.2 Page 9 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. JUDGEMENT – we looked at outcomes for the following standard(s): 2,3,4,5 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. Information and opportunities to visit the home were given to people that helped them decide if the facilities and services could meet needs and preferences. Contracts issued, informed them about the terms and conditions of living at the home. Assessments were completed properly which helped plan personalised care. EVIDENCE: Records showed that new residents in the home had their needs assessed before they were admitted. The assessments showed essential information was recorded to provide staff with sufficient information about the resident’s circumstances and level of support required to give the right care. 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
Marsden Grange DS0000009480.V335265.R01.S.doc Version 5.2 Page 10 not possible and a representative of the resident is invited to look around on their behalf. One relative wrote, ‘thank you so much for showing my mum around Marsden grange. Mum particularly liked all the different seating areas and the lovely gardens, a room for her overlooking the garden would be wonderful. You were so kind to her during the visit.’ Comments sent to the Commission from residents confirmed that they were issued with contracts that outlined the cost of staying at the home and terms and conditions of residency. The range of needs of residents had been considered. Staffing levels were good and staff training programme-included full induction and essential training for example, moving and handling, and protecting vulnerable adults. Training staff was ongoing and part of staffs development in providing quality care. Records kept, showed staff acted upon the changing needs of residents. Assessments were ongoing and other professionals had been consulted for advice. This included amongst others, contact with visiting district nurses. Marsden Grange DS0000009480.V335265.R01.S.doc Version 5.2 Page 11 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. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,9,10. Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Good care planning meant residents had their assessed and changing needs met in a way that was suitable to them and took into account their rights to privacy and dignity Thorough risk assessments and management strategies potentially reduced the risk of harm to residents. Medication practice, policies and procedures and staff training reduced the risk of any errors being made. EVIDENCE: Comments from relatives sent to the Commission included ‘I feel confident that my father is extremely well cared for. During the ten weeks since he moved in his health has improved greatly.’ A visiting General Practitioner commented ‘I have always found that the needs of my patients are being met, and kept the residents in touch with me on a need to basis, whenever concerns arises about my patients health or welfare’. Relatives were generally happy they were kept up to date with important issues affecting their friend/relative and considered the home gave the care they expected or agreed. Comments included for
Marsden Grange DS0000009480.V335265.R01.S.doc Version 5.2 Page 12 example ‘Mrs Littlewood goes out of her way to keep me informed’ and ‘Mum was in a different home before moving to Marsden Grange. The help and support she now gets is wonderful and far beyond that in her former home.’ Also ‘When I visit they tell me of any problems’. ‘‘Communication is excellent and the home supports my relative, even to the extent of visiting when he was in hospital recently.’ People also felt the care staff had the right skills and experience to look after people properly and met their diverse needs. Comments included ‘ the staff are caring considerate and patient. They are sympathetic to my mothers needs (and as far as I have seen, the needs of other residents). They cope and do well with many difficulties caused by my mothers mental and physical state.’ Assessments linked well to care plans. They were thorough and included health, personal and social care needs. The standard of recording was very good and staff had clear instructions on how to support people in their daily lives. Particular attention staff must give to residents when providing care was recorded, for example ‘observe discreetly’. Staff worked to a key working system, which meant they had particular responsibilities for a number of residents. There was evidence residents were involved in care planning and reviews of residents needs was ongoing. Residents said they liked the staff and described them as ‘good girls’ and ‘all very good’, and were happy with how they were helped. Entries made in daily records showed how residents received personal care. Six basic principles of care, privacy, dignity, independence, choice, rights, and fulfilment, were discussed with residents and used to see how well these needs were being met. Their views were recorded for example ‘Privacy ‘……….. thinks his privacy and dignity is respected and says that staff always close the bathroom and toilet door when he is using them.’ And ‘ ……. feels that he is able to be independent, with Marsden Grange staff encouraging him to do things for himself’. One written comment from a relative stated ‘My father has been able to regain some independence since living at Marsden Grange. This is due entirely to the fact that the staff enable and encourage him at all times.’ The resident’s healthcare and mental health care needs were also identified. These included regular routine screening such as eyesight tests, visits from a chiropodist, district nurse, and their doctor when necessary. Pressure care was promoted and pressure-relieving aids were used where needed. Continence management was excellent. One General Practitioner to the home wrote ‘I have never found the care staff wanting in skills or experience as far as my patients are concerned,’ District nurses visiting during inspection said ‘there Marsden Grange DS0000009480.V335265.R01.S.doc Version 5.2 Page 13 are never any problems in the home. Instructions for residents care were always followed through. People’s right to take risks was respected. Risk assessments were very good and outlined what action staff must take to minimise the risk for residents. These assessments included self-medication management. The home operated a monitored dosage system for the administration of medication. This was audited by the supplying pharmacist. An appropriate recording system was in place to record the receipt, administration and disposal of medication. A record of medicines received into the home had been maintained and medication had been returned to the pharmacy for disposal. Records of medication administered were up to date. Information sent to the Commission by the provider showed that staff were trained in medication procedures. Those residents who could managed their own medication. Good practice was observed in confidentiality of information. Records were kept secure in the office. Residents spoke highly of staff. Comments included I just ask the staff and they will help me. I like it here.’ And ‘The staff are excellent’. Marsden Grange DS0000009480.V335265.R01.S.doc Version 5.2 Page 14 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,14,15. Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. The level of staffing and choice of activities made available enabled the residents have their social, cultural, religious and recreational interests and needs met. Visiting arrangements were very good which meant residents could stay in contact with their relatives and friends. Catering arrangements were to the resident’s satisfaction. EVIDENCE: The residents’ preferences in respect of social activities had been sufficiently recorded as part of their assessment. These included for example ‘. Enjoys company. Enjoys listening to the radio and television. Particularly likes listening to sport. Enjoys walking and spending time in the garden. Loves the wine tasting events’. Care planning showed how these needs were catered for and if staff support was needed, for example, walking in the garden, staff to walk with resident. ‘Preferred life style was also recorded for example what time a person would like to get up. Marsden Grange DS0000009480.V335265.R01.S.doc Version 5.2 Page 15 Activities for residents were organised and efforts to offer a personal touch was made. An activity coordinator was employed for this purpose. A record was kept of what each person did, such as 16/06/07, ‘Had a good week. Weather been good. We had a clothes party which they enjoyed. Barry the pianist played outside for all the residents, had a lovely afternoon. Had ‘snowballs’ and ice cream.’ Whilst residents were aware of their limitations written comments were made such as ‘I am unable to take part in any physical activity, but enjoy the musical concerts etc.’ Relatives were mainly pleased with activities on offer. One relative wrote ‘they do little extras e.g. A lady walks them around the grounds, cuts nails etc. They have people coming in to entertain them and keep them happy’. Comments in general showed an overall satisfaction. Staff said the residents enjoyed festive celebrations and birthday parties and were interested in what was generally going on in the home. Residents were supported to continue with their chosen religion. One relative wrote ‘I have nothing to suggest that any inappropriate discrimination takes place’. Residents could go to a place of worship in the community or attend a service in the home. Representatives from local churches will visit the home on a regular basis for prayers and communion. Care records showed for example, ‘had communion this morning’. The residents were able to receive visitors at any time and were able to entertain their guests in private. There was evidence seen in care records that relatives regularly visited the home. Written comment cards supported this. They also thought the home did well in ‘communicating well with relatives, provides excellent entertainment and provides excellent nutrition.’ From observations staff were seen to be considerate and made visitors feel welcome. Residents bedrooms were personalised. They were able to bring in personal belongings and arrange their rooms how they wished. Dining arrangements meant residents had a choice of where to eat. Dining tables were set attractively and care was made in how food was served. Small lap trays were provided for morning and afternoon tea/coffee and biscuits. Comments about the food such as ‘it’s good’ and ‘no complaints’ were made. Information sent to the commission showed the range of choices of meals. Records showed alternatives were also given. Any special food residents wanted were provided. Meal times were flexible. Particular attention was made to food hygiene. Residents could have what they wanted and every effort was made to accommodate individual needs. Meat was purchased from a local butcher and provisions, fresh fruit and vegetables delivered three times a week. Marsden Grange DS0000009480.V335265.R01.S.doc Version 5.2 Page 16 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. JUDGEMENT – we looked at outcomes for the following standard(s): 16,17,18. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The complaints procedure was clear which helped residents/relatives have confidence to raise any concern they may have. There were policies and procedures, and appropriate training for staff in professional conduct and adult protection issues. This meant residents rights, safety, and welfare was promoted. EVIDENCE: Information received at the Commission from residents and relatives showed they knew how to make a complaint. Residents also knew who to speak to if they had any concerns. A copy of the complaints procedure was given to current and prospective residents. The procedure gave clear directions on whom to make a complaint to, and the timescales for the process. Records show complaints/concerns were dealt with promptly and satisfactorily. Residents rights were discussed when care planning and issues such as voting was recorded. An electoral register is completed every year. Residents were cared for under the guidance of a code of conduct and ethics of care. Staff terms and conditions outlines duties and responsibilities of staff such as ‘to take into account of the customs values and beleifs of residents.’ Marsden Grange DS0000009480.V335265.R01.S.doc Version 5.2 Page 17 The home had an appropriate internal procedure for staff to follow should they suspect or witness an incident of abuse. Abuse procedures and whistle blowing had been covered during staff induction training, and continues to be considered a high priority with staff. Staff knew 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. Marsden Grange DS0000009480.V335265.R01.S.doc Version 5.2 Page 18 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. JUDGEMENT – we looked at outcomes for the following standard(s): 19,20,21,24,26. Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Overall standards in the home were excellent which meant residents were provided with a warm, comfortable, clean, safe, environment that suited their needs. 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. The extension on Pendle suite had gone very well and the residents benefited an additional lounge.
Marsden Grange DS0000009480.V335265.R01.S.doc Version 5.2 Page 19 Written comments from residents in relation to the home included, ‘always immaculate’ and ‘the fixtures and fittings are of good quality’ and the carpets are vacuumed every day.’ Relative’s comments included ‘Cleanliness is paramount throughout the home’. ‘Provides excellent care and a spotless home’. ‘Provides a clean, attractive and homely environment (both inside and outdoors)’. ‘The place is warm and clean’. ‘Rooms, bedding, environment, clean and acceptable on every occasion’. ‘The home is always clean and tidy’. Residents who joined in discussions said they were very pleased with the home. Everything was kept nice and clean. They particularly enjoyed sitting in the garden during the warm weather. There is an outside toilet to use for their convenience. Several residents said they often had a walk around the garden, and one resident said ‘you would be amazed at the wildlife that visits the bird table’. The grounds were safe, pleasant, and regularly attended by a gardener. Garden furniture was provided. All the bedrooms in the Pendle suite were single with en suite toilet and shower. Bedrooms were furnished to a high standard and residents had personalised them with items they had brought from home. One resident said ‘it’s beautiful here’. Bedrooms in the main home were equally attractive and shared rooms benefited couples and friends. Laundry facilities were excellent and the standard of hygiene kept throughout the home was exceptional. One visitor during inspection said, ‘no matter what time I visit, everywhere is clean and I have never smelt any bad odour in the home.’ Marsden Grange DS0000009480.V335265.R01.S.doc Version 5.2 Page 20 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. JUDGEMENT – we looked at outcomes for the following standard(s): 27,28,29,30. Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Good staffing levels meant there was sufficient staff on duty to meet the needs of residents. The recruitment and selection procedures were thorough and protected residents. Staff received training and supervision, which meant they had the skills and knowledge to care for residents. EVIDENCE: Information sent to the Commission prior to this inspection showed the home had a full compliment of staff to cover all essential duties in providing care, and maintaining essential standards in the home such as care and hygiene. Rotas showed sufficient staff were employed in the main home and in Pendle Suite. Written comments from most residents showed most thought staff were available when needed and listened to what they said. Relative’s written comments regarding care staff having the right skills and experience to look after people properly included ‘ ‘I understand that staff have undertaken NVQ and that managers are appropriately qualified. ‘The carers are well briefed and trained. They are polite to visitors and residents’. ‘The staff are caring, considerate, and patient. They are sympathetic to my mothers needs (and as far as I have seen, to the needs of other residents). They cope and deal with many difficulties caused by my mothers mental and physical
Marsden Grange DS0000009480.V335265.R01.S.doc Version 5.2 Page 21 state’. A General Practitioners comment stated ‘I have never found the care staff wanting in skills or experience as far as my patients are concerned’. All staff had proper induction training. This was given over a period of time and included essential training such as moving and handling, food hygiene, fire safety, first aid, adult protection and were instructed in health and safety. Residents spoken to during inspection said they were very happy with the staff in the home. Staff were described as ‘very good’ and ‘the girls are really good you know’, ‘the staff are excellent’. 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. On appointment members of staff were issued with a contract of terms and conditions of employment. They were given a copy of the General Social Care Council’s code of practice and conduct, a copy of the homes code of conduct and a job description. All staff had received training. The percentage of staff having completed a national vocational qualification in care level 2 and above was above the recommended 50 . External trainers praised the home for the training provided for staff and the interest staff showed during training sessions. Staff confirmed they received supervision regularly, for which records were kept. Marsden Grange DS0000009480.V335265.R01.S.doc Version 5.2 Page 22 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. JUDGEMENT – we looked at outcomes for the following standard(s): 31,33,35,36,37,38. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home was well organised and managed efficiently. This ensured it was run in the best interests of residents. Guidance and support was given to staff, which contributed towards the resident’s quality of life experience in the home being a good experience. EVIDENCE: The registered manager has many years experience in managing a care home. Information received at the Commission show the registered provider also is active in managing the home. Six senior care staff and office staff, support them in their management duties, having delegated responsibilities in key
Marsden Grange DS0000009480.V335265.R01.S.doc Version 5.2 Page 23 areas such as administration, day, evening, and night shifts, activities/day care and the kitchen. The management approach in the home allowed for residents to have opportunities to tell management and staff how they would like the home to be run, the care they receive and facilities they enjoy. Basic human rights were discussed individually with residents to make sure they lived a valued life in the home. Information was used to promote best practice for staff in respecting these rights. Residents meetings were held and residents wrote an agenda for discussions. They were kept informed about important matters that could affect them. They also decided on activities and entertainment and gave their views on how their life experience in the home matched with their expectations. Written comments from relatives in relation to what the home does well included, ‘The proprietor and manager are constantly on hand and make a point of knowing the residents individual needs’. from what I have seen they treat all residents with good care and respect. They expect all staff to treat residents as if they were their relatives and all care is extremely good and kind and respectful. I have the utmost respect for the management and staff at Marsden Grange’. And ‘provides excellent care and a spotless home’. And ‘communicates well with relatives’. Views about the home were both formal and informal with residents and staff meetings. Residents and relatives present during inspection were pleased about all aspects about living in the home. The home has investors in people award. Throughout the inspection there was evidence in equal opportunities for all. Residents and staff had their say and were listened to. Staff had the opportunity to discuss work issues with the owners and manager on a day-to-day basis, in supervision, and during their meetings. Training was provided for all staff groups. Relationships between staff and those living in the home were observed as positive. Staff confirmed they were supervised, and had an appraisal. Staff supervision records showed for example personal development, review of workload, and targets met. Staff said they felt supported in their work, and supervision was organised and beneficial. Staff meet together daily and have ‘shift meetings’ to discuss residents and other issues relevant to their work for the day and night. Routines for staff in the home were established, and good teamwork was evident. Comments included ‘that’s the good thing about here, we all work together as one team.’ Correct insurance cover was in place to meet any loss or legal liabilities. The home encouraged residents/relatives to manage their own financial affairs. Record keeping was very good, and confidential records were stored securely. Marsden Grange DS0000009480.V335265.R01.S.doc Version 5.2 Page 24 Staff were made aware of the requirements of the Data Protection Act, and compliance was included in their terms and conditions of employment. The health, safety, and welfare of residents and staff had been considered. The home had a good range of policies and procedures and practice aimed at keeping everyone safe. Staff were given essential health and safety training in topics such as first aid and fire prevention. Information contained in the pre – inspection questionnaire indicated that essential services such as gas and electricity were regularly serviced. Safe working practices in the home were evident. Residents had regular fire drills and each person was risk assessed to make sure they were kept safe in the event of a fire. Marsden Grange DS0000009480.V335265.R01.S.doc Version 5.2 Page 25 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 3 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 4 8 3 9 3 10 4 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 4 13 3 14 3 15 4 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 3 18 3 4 4 4 X X 4 X 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 4 X 3 3 3 4 Marsden Grange DS0000009480.V335265.R01.S.doc Version 5.2 Page 26 Are there any outstanding requirements from the last inspection? N/A 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.V335265.R01.S.doc Version 5.2 Page 27 Commission for Social Care Inspection Lancashire Area Office Unit 1 Tustin Court Portway Preston PR2 2YQ National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 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 Marsden Grange DS0000009480.V335265.R01.S.doc Version 5.2 Page 28 - 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!
