Inspection on 31/01/06 for Marsden Grange

This inspection was carried out on 31st January 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Excellent. 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 14/09/05

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 31st January 2006 11am 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.V272154.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.V272154.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.V272154.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 14th September 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.V272154.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection was carried out on the 31st January 2006. It is the second required statutory inspection carried out this year. The inspection involved getting information from staff records, care records and policies and procedures. It also involved talking to residents, attending a residents meeting, talking to staff on duty and a tour of the premises. The registered manager was on duty and Mrs Littlewood the owner visited. The home was assessed against the National Minimum Standards for Older People. Not all standards were assessed and this report should be read with the inspection report dated 14th September 2005 for the reader to have a complete overview of the home. What the service does well: Information was made available for people interested in the services and facilities of the home. People considering living at the home could stay for a trial period. Before anyone becomes a resident in the home permanently 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 ‘attentive’, ‘lovely and kind’. Relatives also shared this view. Activities were varied and gave residents opportunities to take part in community life such as going to Church. Catering arrangements were also of a high standard. Residents were protected by good recruitment of staff and by the training staff were given. The numbers of staff employed helped make sure residents lived a lifestyle that suited them. Residents living at the home expressed satisfaction about their accommodation. The home was spacious and furnished to a high standard. An excellent standard of hygiene was maintained and observed during inspection. 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.V272154.R01.S.doc Version 5.0 Page 6 Training was provided for staff and included topics such as 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 the National Minimum Standards. Residents and staff were given opportunities to have their say in how they think the home is run and if there can be improvements made. Their views were considered important. Residents were consulted about important issues that may affect them. Resident’s health, safety and welfare were considered, and staff worked with safe working practices. This inspection has found the high standards achieved 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.V272154.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.V272154.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): 1,2,3,4,5 Sufficient information about the home was made available for people that helped them decide if the home was suitable to meet their needs. Assessments of people wanting to live in the home contained enough information to plan how care needs were to be met. Trial stays were offered. 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: One resident recently admitted said he was sure the home was right for him. His wife was resident and he had been a frequent visitor. Information about the home was available to read. Records showed that new residents in the home had the benefit of care management assessment in addition to the homes own assessment of needs. Information essential to provide the right care was recorded in detail and from Marsden Grange DS0000009480.V272154.R01.S.doc Version 5.0 Page 9 these assessments an individual plan of care was written and agreed with everyone concerned. 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. 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.V272154.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 with residents. Residents were satisfied that their needs were met and they considered staff to be respectful to them. EVIDENCE: Care plans referred to residents assessed needs. They were thorough and included health, personal and social care needs. The standard of recording was very good and helped staff to personalise care as each resident wanted. Residents said they ‘talked about their care’ with staff. They liked the staff who were described as ‘attentive’, and were happy with how they were helped. Residents care needs were reviewed regularly with them. Entries in daily records showed residents received personal care and additional specialist support where needed. Marsden Grange DS0000009480.V272154.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. 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. Continence management was excellent. 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 visiting confirmed they were kept informed of matters that involved their relative. Two visitors visiting a relative said ‘they were delighted with the care given’. Good practice was observed in confidentiality of information. Records were kept secure in the office. Residents spoke highly of staff they described as ‘lovely people who treated them with respect’. ‘They did a remarkable job’. Marsden Grange DS0000009480.V272154.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: During inspection residents held a meeting. Activities was a topic on their agenda which they presented to the manager. 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, and were waiting for better weather to enjoy the walks around the garden. Some people went to Church with staff on Sundays. Other people said they enjoyed the visiting organist and the birthday celebrations they had. There had been three birthdays recently. Everyone said they had a good Christmas. They enjoyed the hymn-along, film afternoon, 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. One resident said she was happy with how she lived. She enjoyed reading newspapers especially the small articles and staff made sure Marsden Grange DS0000009480.V272154.R01.S.doc Version 5.0 Page 13 she had a newspaper every day. She said staff ‘were very good and knew what she wanted’. Several residents said the grounds were lovely and nice to walk around ‘weather permitting’. There were visitors in the home during inspection. They said they were made welcome by staff. Residents said the food was up to their expectations. They took the opportunity during the inspection to discuss menus and preferences. Residents were given choices at meals and records showed alternatives were also given. Any special food residents wanted were provided. One resident said ‘she is a good cook, and comes in and discusses meals’. Meal times were flexible. Dining arrangements meant residents had a choice of where to eat. Small lap trays were provided that were set attractively, and care was made in how food was served. In addition to this some residents were given hot drinks on small drinks trays. Residents could have what they wanted. Every effort is made to accommodate individual needs. Marsden Grange DS0000009480.V272154.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): 16,18 The complaints procedure was clear and easy for residents and visitors to the home such as relatives to follow. 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: Residents showed confidence in discussing issues with management at the meeting they had during inspection. There was a complaints procedure for residents to use. This was given to residents when they came to live at the home. Residents said they had no complaints against the staff. Anything they wanted to discuss was taken seriously and dealt with. Relatives visiting said they had no complaints and were aware of the complaints procedure they could follow if they needed. 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. A condition of employment for staff in the home prevents them having any financial gain from residents. Marsden Grange DS0000009480.V272154.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): 19,26 The home was maintained to very good standard, and residents lived in a comfortable and homely environment. An excellent standard of hygiene was 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. Residents said they enjoy sitting in the garden during the warm weather. There is an outside toilet to use for their convenience. Several enjoyed walking around the path of Pendle suite. Birds and squirrels visited to feed off the bird table. Residents put food out regularly for them. Marsden Grange DS0000009480.V272154.R01.S.doc Version 5.0 Page 16 The home was furnished to a very good standard and well maintained. Residents described the home as ‘such a nice place’ and ‘more than comfortable’. There are plans to extend the Pendle suite. This was discussed with the residents at their meeting during inspection. Residents liked the idea of an office being included in the plans. Laundry facilities were excellent and the standard of hygiene kept throughout the home was exceptional. Marsden Grange DS0000009480.V272154.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. Residents said there was always enough staff about to help them day and night. All staff had a proper induction training that includes essential training such as moving and handling and were instructed in health and safety. Residents said they were very happy with the staff in the home. Staff were described as ‘very good’ and ‘they helped them’. 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 and a job description. Marsden Grange DS0000009480.V272154.R01.S.doc Version 5.0 Page 18 All staff had attended basic training. The percentage of staff having completed a national vocational qualification in care level 2 and above was near 100 . Staff confirmed they received supervision regularly, for which records were kept. Marsden Grange DS0000009480.V272154.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): 32,33,34,36,38 The home was managed efficiently and in the interest of the residents. Proper accounting and financial procedures protected residents. Staff and residents expressed confidence in how the home was managed. Guidance and support was given to staff. 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: Residents were outspoken about issues they wanted to discuss at their meeting during inspection. They had an agenda which they had written. Residents said they always had their say about how the home was run. Everything was discussed with them at their meetings. They were kept informed about important matters that affected them, such as the proposed extension. They also decided on activities and entertainment and gave their Marsden Grange DS0000009480.V272154.R01.S.doc Version 5.0 Page 20 views on how their life experience in the home matched with their expectations. Their meetings were regular. Staff also had regular meetings and supervision. They had opportunities to discuss their care practice and training needs. Staff were happy in how they were supported in their work. The guidance given to staff for work routines were good, and staff teamwork was evident. The insurance documentation for the home was up to date. Business and financial management was good with a continuing investment being made in maintaining such high standards. Residents expressed satisfaction about the way the home was run. They felt the management and staff were ‘approachable’ ‘nice’ and ‘caring, and the home was ‘very nice’. The health, safety and welfare of residents and staff had been considered. Proper safety maintenance checks were carried out and staff were all trained in safe working practices. Marsden Grange DS0000009480.V272154.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 3 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 3 13 3 14 3 15 4 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X X X X 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 X 3 3 3 X 3 X 3 Marsden Grange DS0000009480.V272154.R01.S.doc Version 5.0 Page 22 Are there any outstanding requirements from the last inspection? NO STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 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.V272154.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. Extracts may not be used or reproduced without the express permission of CSCI Marsden Grange DS0000009480.V272154.R01.S.doc Version 5.0 Page 24 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!