Inspection on 23/08/06 for Metfield Grange

This inspection was carried out on 23rd August 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Metfield Grange 10/05/07

Metfield Grange 13/03/06

Metfield Grange 21/09/05

Metfield Grange 20/09/04

Metfield Grange 05/05/04

Similar services:

Chirnside House

Keer Sands Residential Home

Ruskin Lodge

Bushell House

Langrigg House

Parkside

Dystlegh Grange

Thornton Lodge

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

CARE HOMES FOR OLDER PEOPLE Metfield Grange 59 Hartwood Road Southport Merseyside PR9 9AW Lead Inspector Mrs Elaine Stoddart Unannounced Inspection 23rd August 2006 09.45 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 Metfield Grange DS0000005335.V295803.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. Metfield Grange DS0000005335.V295803.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Metfield Grange Address 59 Hartwood Road Southport Merseyside PR9 9AW 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) 01704 538691 Mrs Belinda Wallace Mr D R E Wallace Mrs Belinda Wallace Mr D R E Wallace Care Home 13 Category(ies) of Old age, not falling within any other category registration, with number (13) of places Metfield Grange DS0000005335.V295803.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. Service users to include up to 13 OP Date of last inspection 13th March 2006 Brief Description of the Service: Metfield Grange is a small, friendly, family run residential home, which provides personal care and support for 13 elderly people. Both Mr and Mrs Wallace are registered as Managers/Owners and live on the premises. Both are involved in managing the day to day running of the home, working hands on with both the residents and staff, providing supervision, support and direction. Nursing care is provided by the nursing care service, when required. The home is located within a quiet residential area, within easy reach of the town centre of Southport. A local bus route provides access to all the amenities of the coastal resort. These include a large shopping area, cinema, theatre, parks and lake. The accommodation comprises of 3 double rooms and 7 single rooms. There is a stair lift, which provides access to the first floor. There is a communal lounge and a dining room located on the ground floor. All areas are provided with emergency call points. Access is provided to front and rear landscaped gardens. The cost for the service ranges from £273.50 to £323.00 per week. Metfield Grange DS0000005335.V295803.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The site visit took place over one day. It was an unannounced visit and conducted as part of the regulatory requirement for care homes to be inspected at least twice a year. A tour of the building was conducted. A selection of care staff and home records were also viewed. During the inspection 3 residents were case tracked (their care files were examined and their views of the home were obtained). This process was not carried out to the detriment of other residents who also took part in the inspection process. The managers, 2 staff members, 4 of the 11 residents and 1 relative were spoken with and their views obtained of the home. Survey forms ‘Have your say about….’ were also given to residents to complete. Comments received from the surveys and discussions were positive and are incorporated within this inspection report. What the service does well: Metfield Grange has a very pleasant relaxed, homely atmosphere. The managers live on the premises with their family. The routine of the home is based very much around residents’ wishes and relatives are encouraged to become involved and visit when they like. Activities provided to meet the needs of the residents who were observed enjoying a game of bingo during the afternoon of the visit with the staff. Other activities include BBQ’s, brownie concerts, massage, communion, coffee mornings and entertainers. Resident’s birthdays and special occasions are celebrated. One resident had recently had a birthday party. The care is delivered by staff who are enthusiastic, motivated and there is a stable team who have worked at the home for many years. The home continues to be fully occupied and twelve service users were accommodated at the time of the inspection. One double room has single occupancy. Assessments of need are completed prior to admission to ensure the home can meet the residents’ needs and care plans are reviewed monthly. Metfield Grange DS0000005335.V295803.R01.S.doc Version 5.2 Page 6 An ongoing maintenance programme is in place, which ensures that repairs and redecoration are completed. The home is very well maintained, colour schemes attractive to provide a pleasant, homely environment. All areas were observed to be clean. A staff-training programme is in place and staff are kept up to date with the statutory training required. Additional training is provided to ensure the staff are equipped with the skills to carry out their roles. These include medication and abuse. The staff are encouraged to obtain National Vocational Qualifications (NVQ). 5 of the 9 care staff are qualified in NVQ Level 2 and above. The manager, Mr Wallace and the deputy manager are qualified in NVQ Level 4. There have been no complaints made since the last inspection. What has improved since the last inspection? The home has met the requirements made at the last inspection. Risk assessments are now in place for those residents who use the stair lift and all staff are recruited following the necessary procedures to protect the residents. Staff files have been updated to include more detailed information. An ongoing maintenance programme is in place and since the last inspection decoration has taken place in two of the bedrooms and one carpet replaced in a residents bedroom. The home has produced a new statement of purpose and service user guide, which outlines the service provided and detailed information about the home and the staff employed. The home has conducted a quality review survey in February 2006 to obtain the views from residents, relatives and other professionals involved in their care. The home has now collated the responses and has developed an action plan to address the comments made and make improvements suggested including the provision of new menus. Comments include – “I am very impressed with all aspects of care within Metfield grange (Community Psychiatric Nurse). “Marvellous home. We are well cared for” (Resident) Metfield Grange DS0000005335.V295803.R01.S.doc Version 5.2 Page 7 “Metfield have proved very accommodating. The staff are friendly and supportive” (Social Worker) “I wish all homes’ atmosphere and friendliness was a s good” (Chiropodist) “All the staff here are always kind and helpful” (Relative) New policies and procedures are in place and have been distributed to staff for their information and signatures of acknowledgement. Activity plans in place are completed daily to demonstrate those residents and visitors who attended. All staff have completed abuse training and have received a copy of the new ‘safeguarding adults’ procedures and have signed to acknowledge their understanding of these. All residents who use the stair lift have been risk assessed. 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. Metfield Grange DS0000005335.V295803.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 Metfield Grange DS0000005335.V295803.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1,2,3 The quality in this outcome area is good. This judgement has been made using available evidence and visit to this service. The manager to ensure that the home can meet the needs of the residents carries out Pre admission assessments. All residents have information on the service provided and statements of terms and conditions. EVIDENCE: All residents have an individual care file. Assessment documentation for three residents was seen and had been completed and contained information on the care needs required. A new service user guide and statement of purpose is now in place, which provides information on the service and has been distributed to all residents. Metfield Grange DS0000005335.V295803.R01.S.doc Version 5.2 Page 10 Observation and discussion with residents, a relative, staff and the managers confirmed the home is meeting the resident’s needs as outlined in their plan of care. Positive comments were received from a visiting relative and residents spoken with. “Mum is provided for exceptionally well” (Relative) “Lovely place” (Resident) Metfield Grange DS0000005335.V295803.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,9,10. The quality in this outcome area is good. This judgement has been made using available evidence and visit to this service. Residents health, personal and social care needs are addressed in care plans and care needs are met effectively. Residents are treated with dignity and respect at all times. Medicines are administered according to the home’s policy and procedure. EVIDENCE: Three care plans viewed where found to contain up to date information on the residents needs. All care plans are reviewed monthly to monitor changing needs and the action required to meet those needs. Residents moving and handling needs are reviewed every three months to ensure safe practice. Observation throughout the inspection demonstrated the caring approach and relaxed atmosphere present. Residents interviewed confirmed that they are happy with the care provided. “Marvellous home. We are well cared for ”(Resident). “All staff are very helpful and friendly” (Relative). Metfield Grange DS0000005335.V295803.R01.S.doc Version 5.2 Page 12 Residents spoken with confirmed the staff treat them with dignity and respect at all times. Staff were observed to knock prior to entering private rooms and spoke to residents in a friendly, approachable manner. There was a pleasant, comfortable and homely atmosphere throughout the visit. A medication policy and procedure is in place and available to staff for reference. All medication is securely stored and signed for on administration. All staff have received medication training to update them on the procedures in April 2006. The health care needs of residents are reassessed monthly to ensure they receive the appropriate services. One resident’s fluid and food intake is being monitored closely as requested by the GP. The home is maintaining daily records of this information. Metfield Grange DS0000005335.V295803.R01.S.doc Version 5.2 Page 13 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 The quality in this outcome area is good. This judgement has been made using available evidence and visit to this service. There is a sociable, relaxed and pleasant atmosphere in the home and residents interviewed were happy with the daily routines. Social activities are provided and visitors are made welcome. Wholesome appealing meals are provided in pleasant surroundings. EVIDENCE: A pleasant, relaxed, homely and comfortable atmosphere was present during the visit. Residents chatted freely with each other, the care staff on duty and the managers in the lounge. Relatives were seen to be made welcome and call in daily. One visiting relative said, “The staff are very helpful and friendly”. Residents are provided with activities, which include bingo, karaoke nights, BBQ’s, brownie concerts, entertainers, hand and foot massages and gentle exercise sessions. Relatives are encouraged to join in and a record is kept of all who participated. Some residents are able to go out shopping with their relatives, attend local clubs or are taken to the shops by the staff. Metfield Grange DS0000005335.V295803.R01.S.doc Version 5.2 Page 14 A recent survey has been completed to obtain feedback from relatives and residents provided positive comments regarding the activities in place and some ideas for improvements, which the managers are to address within their action plan and consult with the residents on ‘what they want for new activities’. “Maybe a quiz”, (Resident). The home provides a wholesome, varied diet and caters for residents with dietary requirements such as diabetes. All residents are consulted daily on the choices available, however a menu should be displayed to inform the residents of the choices available. The recent survey conducted resulted in the request for ‘new items’ being introduced into the menus. This is being addressed by the home in consultation with the residents. Snacks and drinks are available throughout the day when requested. Metfield Grange DS0000005335.V295803.R01.S.doc Version 5.2 Page 15 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 quality in this outcome area is good. This judgement has been made using available evidence and visit to this service. Abuse and complaint policies and procedures are in place to protect the residents. EVIDENCE: The new statement of purpose and service user guide outlines the complaints procedure and is made available to all residents. There have been no complaints made since the last inspection. Residents and a relative interviewed confirmed they know how to make a complaint and commented they wouldn’t have any problems speaking to the managers or staff is they wished to make a complaint. The managers are in daily contact with the residents and visitors and any comments received are resolved appropriately. Policies and procedures are in place and are made available to staff for reference and staff sign their acknowledgement of their understanding of these. All staff have been trained in abuse and have received a copy of Liverpool and Sefton’s ‘safeguarding adults’ procedure. Staff spoken with confirmed their understanding of the procedures. Records are made of all financial transactions, receipts obtained and regularly audited. Metfield Grange DS0000005335.V295803.R01.S.doc Version 5.2 Page 16 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19,20,21,23,24,25,26 The quality in this outcome area is good. This judgement has been made using available evidence and visit to this service. The home offers very comfortable ‘homely’, safe accommodation and all areas are well maintained. This contributes to a good quality of life for the residents. EVIDENCE: A tour of the premises demonstrated the home continues to provide a high quality, well-maintained, comfortable, homely and clean environment for the residents. The grounds are kept tidy, safe and attractive and used by the residents in the summer months for BBQ’s. The front and rear gardens are accessible, with the exception of two steps at the front entrance. Since the last inspection improvements have included – a new carpet in a bedroom and a number of rooms decorated. Metfield Grange DS0000005335.V295803.R01.S.doc Version 5.2 Page 17 A large, comfortably furnished, smoke free lounge area is used daily by the residents to sit and chat, take part in activities or watch TV. The residents were observed to be relaxed and comfortable and chatted freely with staff, visitors and each other. A number of residents rooms viewed were found to be comfortable and clean and contained their own personal possessions. Residents provided positive comments on the accommodation. “Lovely place” (Resident) “I have everything I need here” (Resident) A stair lift provides access to the first floor and risk assessments are in place for residents who use this facility. Bathrooms would benefit from updating to improve the standard. This is incorporated within the recommendations of this report. Metfield Grange DS0000005335.V295803.R01.S.doc Version 5.2 Page 18 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27,28,29,30 The quality in this outcome area is good. This judgement has been made using available evidence and visit to this service. The staff are suitably trained to carry out their roles effectively. The home’s recruitment and selection procedures and records are robust to protect the residents. EVIDENCE: Residents and relatives spoken with and comments received from surveys conducted provided positive comments regarding the staff employed, the management of the home and the care provided. “The Staff are supportive and friendly” (Social Worker – Survey) “All the staff are very helpful and friendly” (Relative) “We are well cared for” (Resident) The staff interviewed showed enthusiasm and commitment to providing care and support to the residents. Some have worked at the home for many years and there is a low staff turnover, which enables continuity of care for the residents. Metfield Grange DS0000005335.V295803.R01.S.doc Version 5.2 Page 19 Since the last inspection the home has made progress in organising the staff files to ensure the correct information is available. Two files viewed for new employees showed staff are recruited following the correct procedures to ensure the safety of the residents. This involves a POVA (Protection of Vulnerable Adults Check) first check, a satisfactory CRB (Criminal Record Bureau) check and two written references. A new interview format has been developed for new employees. A training programme is in place and all statutory training, such as manual handling and first aid is has been brought up to date. Staff are encouraged to take NVQ qualifications five of the nine care staff are qualify in at least NVQ Level 2. There is sufficient staff on duty to meet the needs of the residents. 2 care staff, 1 volunteer, 1 deputy manager and both managers were on duty during the visit. Metfield Grange DS0000005335.V295803.R01.S.doc Version 5.2 Page 20 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31,32,33,35,36,38 The quality in this outcome area is good. This judgement has been made using available evidence and visit to this service. The home is safe and well managed in the best interest of the residents. Care staff are appropriately supervised. EVIDENCE: Both Mr and Mrs Wallace are the registered managers and are in day-to-day contact with the staff, residents and visitors as they live on the premises. A pleasant, homely atmosphere is present and the residents, staff and visitors spoken with confirmed this. “I enjoy working in a small, friendly home with a happy, caring atmosphere” (Staff) “I love it here” (Resident) Metfield Grange DS0000005335.V295803.R01.S.doc Version 5.2 Page 21 “Mum is very well looked after. I have no worries compared with when she was in hospital. She is very much better off in Metfield Grange” (Relative) As it is a small home and the owners live on the premises they are regularly available to discuss anything with the relatives and residents. Both residents and a relative interviewed said they would discuss any issues with the managers should they have any. Mr Wallace and the deputy manager are both qualified in NVQ Level 4. A formal supervision and appraisal process is in place to support the staff and 2 staff files viewed and staff spoken to confirmed this. The home has conducted a recent quality review survey to obtain the views from residents, relatives and other professionals involved in their care. Surveys viewed showed the feedback was positive and suggestions made for improvements are to be addressed by the home’s manager. See section ‘What has improved’ for comments made. Records are made of all residents’ financial transactions; receipts obtained and are regularly audited by the deputy manager. Accident and injuries are recorded for both staff and residents and risk assessments are maintained to help prevent falls. All certificates for services were viewed i.e. Gas, and found to be up to date. Hot water and fridge and freezer temperatures are regularly recorded. A full and up to date training programme is in place to equip them with the skills to carry out their duties. This includes – moving and handling, health and safety, fire safety, food hygiene and infection control and other training i.e. Abuse. Fire records showed that regular checks on the alarms and emergency lighting systems take place. Metfield Grange DS0000005335.V295803.R01.S.doc Version 5.2 Page 22 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 3 3 3 X X X HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 3 3 X 3 3 3 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 4 4 X 3 3 X 3 Metfield Grange DS0000005335.V295803.R01.S.doc Version 5.2 Page 23 Are there any outstanding requirements from the last inspection? No STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 2 Refer to Standard OP19 OP15 Good Practice Recommendations The home should consider upgrading the bathrooms to improve the standard. The home should display daily menus with choices available. Metfield Grange DS0000005335.V295803.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Knowsley Local Office 2nd Floor, South Wing Burlington House Crosby Road North Liverpool L22 0LG 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 Metfield Grange DS0000005335.V295803.R01.S.doc Version 5.2 Page 25 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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