Inspection on 10/08/05 for Ogwell Grange Care Home

This inspection was carried out on 10th August 2005.

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

The inspector found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Ogwell Grange Care Home 01/03/07

Ogwell Grange Care Home 16/02/06

Ogwell Grange Care Home 17/01/05

Ogwell Grange Care Home 08/06/04

Similar services:

Fairfields Country Rest Home

Poldhu

Queensmount

Trevaylor Manor

Didsbury Court Rest Home

Belma

Hunters Care Centre

Manor Lodge

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

CARE HOMES FOR OLDER PEOPLE Ogwell Grange Care Home Rectory Road East Ogwell Newton Abbot TQ12 6AH Lead Inspector Douglas Endean Announced 10 August 2005 th The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Ogwell Grange Care Home D54-D07 S32352 Ogwell Grange V232749 100805 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Ogwell Grange Care Home Address Rectory Road, East Ogwell, Newton Abbot, Devon, TQ12 6AH Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) 01626 354576 01803 400321 suttonr@btconnect.com Ogwell Grange Ltd Sylvia Betty Kay Care Home 20 Category(ies) of Dementia - over 65 years of age (20), Old age, registration, with number not falling within any other category (20) of places Ogwell Grange Care Home D54-D07 S32352 Ogwell Grange V232749 100805 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 17/01/05 Brief Description of the Service: Ogwell Grange is registered as a Care Home that offers personal care for up to 20 (twenty) people who are of retirement age, some of whom may have a memory problem. It is in the village of East Ogwell that is a short distance from the market town of Newton Abbot in South Devon. The home is a listed building and was an old rectory that has been used as a residential care home since late 1994. Ogwell Grange is a large, detached, stone built construction within its own grounds that offer countryside views from many of the rooms. The grounds are easily accessed by the independently mobile, disable or wheel chair user, and are well maintained. The home is full of character in its design and furnishings. It offers a large lounge and a large separate dining room that is also used for the varied activities that take place at the home. There are 14 (fourteen) single rooms and 3 (three) double rooms all with en-suite facilities. The home has been adapted over the years to meet the needs of the Service Users who live there. This includes the provision of a small shaft lift that goes from the ground to the first floor and a stair lift to the mid landing serving the mezzanine floor. The care is led by the Registered Manager who motivates her well-trained team of social care staff to provide good standards of personal care. Ogwell Grange Care Home D54-D07 S32352 Ogwell Grange V232749 100805 Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was announced inspection that commenced at 10.00 hours, and concluded after four hours. The inspector took time to speak to all of the twenty clients and also a couple who were spending the day at the home. He was also provided with a completed pre-inspection questionnaire and has received feed back forms from five clients and five relatives. A very complimentary letter was also received from one relative. During the inspection he toured the home including the kitchen. The Registered Person, Registered Manager, Head of Maintenance were all conversed with during the inspection as well as three care staff members. The homes maintenance records were looked at, three clients files and five staff files were read. What the service does well: What has improved since the last inspection? What they could do better: The home is achieving good levels of satisfaction in client care, and recognition for this by the relatives and friends of clients. The records being kept are satisfactory and sufficient and the environment is exceptional. The inspector has no advice at this time on what the home can do better than it presently does and was reassured during the inspection that the clients will offer that advice to the homes Management should they feel it is needed. Ogwell Grange Care Home D54-D07 S32352 Ogwell Grange V232749 100805 Stage 4.doc Version 1.40 Page 6 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. Ogwell Grange Care Home D54-D07 S32352 Ogwell Grange V232749 100805 Stage 4.doc Version 1.40 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Standards Statutory Requirements Identified During the Inspection Ogwell Grange Care Home D54-D07 S32352 Ogwell Grange V232749 100805 Stage 4.doc Version 1.40 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 3, standard 6 is not applicable. The pre-admission assessment gathers sufficient information to enable the Registered Manager to make an informed decision about the appropriateness of each referral for admission. EVIDENCE: The inspector read three clients case files as a random sample to establish the standard of record keeping at the home. It was found that the staff continues to produce records that hold more than sufficient information on the clients from the point of referral. There were assessments from care management and hospitals discharge information that helped to inform the care planning procedure. The Registered Manager also produces a pre-admission assessment for each new client that holds information on such things as mobility, mood, memory, and general health issues. There were care plans in each file that were seen to have been produced from the initial and ongoing assessment of each client. Ogwell Grange Care Home D54-D07 S32352 Ogwell Grange V232749 100805 Stage 4.doc Version 1.40 Page 9 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 7, 8, 9 and 10. The staff delivers planned care in a dignified and respectful way to the clients who participate in the arrangement. The level of communication and activity with the clients has resulted in an atmosphere of mutual respect in the home. EVIDENCE: The home has well designed care plans that include social care assessment and planning. The care of each client is actually reviewed on a weekly basis as part of the homes review of services and quality assurance management meeting with the Registered Person. The three care plans seen by the inspector were well constructed and did record areas of need and how the home intended to address them. The care plans were also split to cover day and night time issues. Subjects covered by the care plans include communication, mobility, nutrition and mood. To further inform the care planning process the staff gathers a social history from as many informants as possible, the client and their family and friends, so that they can be individualised around the experiences and character of the client. An example of this would be communication and how the staff are to approach each client for effective communication to take place. Ogwell Grange Care Home D54-D07 S32352 Ogwell Grange V232749 100805 Stage 4.doc Version 1.40 Page 10 There are good relationships between the home and the General Practitioner, District Nursing services and Community Mental Health team for the Elderly. The home also have regular contact with other professionals such as the chiropodist, optician and dentist who will visit the home to attend to the clients who cannot manage to attend appointments outside the home. Evidence of visits and treatments were seen in the client’s files. Key staff have been trained, by an external source from a major pharmacy group, in the correct management of medication including administration and evidence was provided to the inspector that this training has taken place. The storage arrangements for medication are adequate. The record sheets all have photo’s of clients for identification purposes. During the inspection the inspector observed the interactions between the staff and the clients. There was respect on both sides when communicating with each other and all care was delivered in a dignified way such as in the privacy of the client’s own bedrooms. The relationship’s between the staff and the clients was observed by the inspector to be more than just care being delivered and care being received, there appeared to be a bond that came from the respect for each other. Ogwell Grange Care Home D54-D07 S32352 Ogwell Grange V232749 100805 Stage 4.doc Version 1.40 Page 11 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12 and 13. The staff, of all grades, approach the activities of caring in a way that maintains the dignity of the clients and nurtures a relationship of mutual respect. EVIDENCE: The normal routine of delivering care is undertaken with the clients permission and in a manner that maintains their dignity. This is managed well and is entwined around the many activities that occur at the home so that no one is excluded because of their physical care needs. The clients do exercise choice in every aspect of their life at the home including the food they eat, the cloths they wear and the activities they are involved in. The inspector was made fully aware of this by the twenty clients that he spent time talking too during the course of the inspection. The staff at the home are regularly involved in a wide variety of activities with the clients both in the home and in the community such as afternoon tea at the Grand Hotel in Torquay, flower arranging in the home, musical events for entertainment in the home and at the theatre, church services, visits to places of interest by car and boat. There are written records of all the activities that are undertaken, photographic evidence on notice boards and the inspector listened to verbal evidence given by the clients who show great enthusiasm in doing and talking about the activities they take part in. Ogwell Grange Care Home D54-D07 S32352 Ogwell Grange V232749 100805 Stage 4.doc Version 1.40 Page 12 The families and friends of clients are also participants in many of the activities at the home and externally with the clients as was occurring during the inspection with clients going out shopping with relatives. There is a board in the main reception hall that displayed all times and dates of planned activities. The home does not handle the financial affairs of any of the clients. They do however assist in clients to purchase items such as toiletries from small amounts of pocket money held for safekeeping and there was clear records accounting for this money backed up by receipts. Client’s bedrooms are tastefully decorated with their own possessions. The home produce meals from local produce that meets with the clients wishes and nutritional assessments. Positive comments were made by the clients about the choice and quality of the food that is presented to them. Meals are served in the dining room, or the client’s own room if requested. The inspector has observed meal times at the home including the main meal during this inspection and feels that it is a social event enjoyed by the participants with help given in a sensitive discreet way where this is needed. The necessity for adequate fluids is promoted by the manager to all the staff and it was clear that staff understand that this is important as “drinks rounds” were seen to be regular during the inspection. Ogwell Grange Care Home D54-D07 S32352 Ogwell Grange V232749 100805 Stage 4.doc Version 1.40 Page 13 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 16 and 18. The homes recruitment and retention arrangements for staff provide a reliable and consistent workforce. The complaints procedure is clear and the clients did know who to initially raise complaints with. EVIDENCE: There is a complaints procedure on display in the main reception area of the home that includes time scales and the contact details of the Commission for Social Care Inspection. The clients knew who they should first speak to if they had a concern or complaint to make. The home has addressed the issue of Vulnerable Adults training in several ways. They have the Local Authorities “Alerters Guide” that staff read and the Local Authorities training video that accompanies the guide. In addition to this staff are involved in training in the home and external to the home that has also covered the subject such as National Vocational Qualification training at levels 2,3, and 4 plus Dementia care training. Over 80 of staff have an NVQ at level 2 or above. The manager also has level 4 in care and management. Prospective staff are vetted by way of references and Criminal Records Bureau checks to establish their suitability for working in the care home. The records five staff were read by the inspector as a sample of these records. Each were complete including a record of the Criminal Records Bureau check and information that identifies the staff member such as copies of passports, drivers licence, etc. There is a low turnover of staff at this home. Ogwell Grange Care Home D54-D07 S32352 Ogwell Grange V232749 100805 Stage 4.doc Version 1.40 Page 14 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 19 and 26. The Registered Person and Registered Manager have provided an attractive and safe environment for the clients to live in and the staff to work in. EVIDENCE: The home is located within reasonable travelling distance from the market town of Newton Abbot. The home is extremely attractive being a listed building constructed in stone and having been a rectory that has retained its appearance and character through good management of the building maintenance. The grounds are equally attractive and accessible to the clients even if they are in wheel chairs. Inside the home the communal rooms are large and attractively furnished and decorated, as are each of the clients rooms. There is a shaft lift that clients can use to reach the first floor and also a chair lift to the first landing and the mezzanine level. The maintenance records were shown to the inspector as evidence of regular work being undertaken to meet such legislation as the Health and Safety at Ogwell Grange Care Home D54-D07 S32352 Ogwell Grange V232749 100805 Stage 4.doc Version 1.40 Page 15 Work Act 1974. Fire system maintenance, hoists and general maintenance records were seen and were up to date. During the tour of the home all areas were noted to be clean, in good decorative order, odour free and not cluttered. The home has a laundry that is housed in a separate building next to the main home and equip with machines to deal with personal clothing. The laundry has been refurbished in recent years to take into account the need for washable walls and impermeable floor covering for the control of infection. Bed linen is contracted out. Separate machines are used for personal clothing and clothing that has been soiled in some way. There are policies on infection control and there is evidence that staff have received training on the same subject. Ogwell Grange Care Home D54-D07 S32352 Ogwell Grange V232749 100805 Stage 4.doc Version 1.40 Page 16 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27, 28, 29 and 30. Staff recruitment arrangements provide a good degree of protection to the clients as does the homes emphasis on having a trained workforce. EVIDENCE: The inspector saw duty rotas that were evidence of the regular planned staffing of the home. The care staff levels were satisfactory and the clients provided information that the proved inspectors decision on this matter was correct. The clients commented that their needs, care and social, were satisfied by the staff on duty. In addition to the care staff the home employs staff for maintenance, catering and domestic duties. There is a mix of age, experience and skills of staff who are on duty through out the day. Additional staff are on duty when the situation warrants it. One member of staff is not yet 18 years old and is supervised during her span of duty and she does not provide intermit personal care. The home has a continuous training program that includes NVQ, Fire, manual handling, infection control, medication management, etc. Evidence of this training was seen in staff files and certificates on display in the home. Staff recruitment arrangements are satisfactory. The sample of staff files seen by the inspector did have the information required of them including an application form, two references, result of the Criminal Records Bureau check, and proof of identity. Ogwell Grange Care Home D54-D07 S32352 Ogwell Grange V232749 100805 Stage 4.doc Version 1.40 Page 17 New staff receive copies of the General Social Care Council code of conduct and practice. Ogwell Grange Care Home D54-D07 S32352 Ogwell Grange V232749 100805 Stage 4.doc Version 1.40 Page 18 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 33, 35 and 38. The quality assurance methods adopted by the home are not time consuming but do provide valuable on going information to the Registered Person and care team the result of their efforts in achieving their goals. EVIDENCE: The home has good quality assurance systems in place that included obtaining the views of clients and visitors to the home. There is a weekly management team meeting, this covers care, maintenance, Health and Safety and staffing issues. Records of the meetings were made and are available for inspection. The inspector has sat in on these meetings on several occasions and found them to be well conducted and very informative. The home also uses daily and weekly staff meetings as opportunities to obtain the views of staff and feed back information to them. The home does not manage the personal affairs of any client. They may hold small amounts of pocket money and did provide the inspector with clear accounting where this has been the case supporting the records with receipts. Ogwell Grange Care Home D54-D07 S32352 Ogwell Grange V232749 100805 Stage 4.doc Version 1.40 Page 19 Records of fire training and fire system maintenance were seen, including regular checks on the smoke alarms. There was current information regarding house wiring tests, lift and hoist maintenance, maintenance of heating system pumps and evidence that a new boiler was fitted during the inspection. The home has all past accident book available for review. The current one was looked at for patterns in accidents and the Manager was able to answer enquiries about accidents that the inspector made. Ogwell Grange Care Home D54-D07 S32352 Ogwell Grange V232749 100805 Stage 4.doc Version 1.40 Page 20 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score x x 3 x x N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 4 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 4 13 4 14 4 15 4 COMPLAINTS AND PROTECTION 3 x x x x x x 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x 3 x x 3 x 3 x x x Ogwell Grange Care Home D54-D07 S32352 Ogwell Grange V232749 100805 Stage 4.doc Version 1.40 Page 21 YES Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard Good Practice Recommendations Ogwell Grange Care Home D54-D07 S32352 Ogwell Grange V232749 100805 Stage 4.doc Version 1.40 Page 22 Commission for Social Care Inspection Unit D1 Linhay Business Park Ashburton TQ13 7UP National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. 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