Inspection on 06/03/06 for Oldbury Grange Nursing And Residential Home

This inspection was carried out on 6th March 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. 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

Oldbury Grange Nursing And... 10/02/10

Oldbury Grange Nursing And... 22/04/08

Oldbury Grange Nursing And... 26/05/06

Oldbury Grange Nursing And... 24/06/05

Oldbury Grange Nursing And... 07/10/04

Oldbury Grange Nursing And... 21/04/04

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

CARE HOMES FOR OLDER PEOPLE Oldbury Grange Nursing And Residential Home Oldbury Road Oldbury Bridgnorth Shropshire WV16 5HA Lead Inspector Joy Hoelzel Unannounced Inspection 6th March 2006 10:45 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 Oldbury Grange Nursing And Residential Home DS0000022259.V275908.R01.S.doc Version 5.1 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. Oldbury Grange Nursing And Residential Home DS0000022259.V275908.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Oldbury Grange Nursing And Residential Home Address Oldbury Road Oldbury Bridgnorth Shropshire WV16 5HA 01746 766616 01746 768741 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) Shropshire Private Care Limited Caroline Susan Weston Care Home 55 Category(ies) of Dementia (10), Old age, not falling within any registration, with number other category (45) of places Oldbury Grange Nursing And Residential Home DS0000022259.V275908.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. The home must comply with the Staffing Notice issued by the Shropshire Area Health Authority dated 30 June 1999. The home may accommodate a maximum of 55 service users. The home may accommodate a maximum of 10 persons with dementia, the remainder being persons who are over 65 years of age whose needs do not fall into any other category. 24th June 2005 Date of last inspection Brief Description of the Service: Oldbury Grange is a care home providing accommodation, personal and nursing care for up to fifty five older people. It is a privately owned establishment and is situated in the Oldbury area of Bridgnorth. Nursing care services are provided in the single storey wing of the building with the original building used to accommodate the other service users. There is a mix of single and double occupancy bedrooms of which some have an en suite facility. The communal sitting and dining areas are comfortable and homely. The passenger lift allows easy access to the first floor of the building. The gardens are well maintained and safe for service users to enjoy. Oldbury Grange Nursing And Residential Home DS0000022259.V275908.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The unannounced inspection took place over six hours on Monday 6th March 2006 and is the second of the statutory inspections for 2005/06. Fifty three people were resident at the time of inspection, the manager, deputy, enrolled nurse, seven care staff were on duty in addition to ancillary staff. Staffs were observed to be attending to the needs of the service users in an appropriate and dignified manner. This inspection focused on the ‘key’ standards that were not inspected at the previous visit in June 2006. Relevant documents were inspected, discussions were held with service users and staff and a tour of the premises was conducted. What the service does well: What has improved since the last inspection? All three requirements made following the inspection in June 2005 have been complied with. Alterations and improvements are being made to two of the bathrooms. Oldbury Grange Nursing And Residential Home DS0000022259.V275908.R01.S.doc Version 5.1 Page 6 There has been a change of manager since the previous inspection; changes are being made to staff working practices to improve the service provision. 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. Oldbury Grange Nursing And Residential Home DS0000022259.V275908.R01.S.doc Version 5.1 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 Oldbury Grange Nursing And Residential Home DS0000022259.V275908.R01.S.doc Version 5.1 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): OP 6 EVIDENCE: This set of standards was not inspected in depth on this occasion. However, the statement of purpose and service users guide was available on request and used by the acting manager for reference. The home does not provide an intermediate care service. Oldbury Grange Nursing And Residential Home DS0000022259.V275908.R01.S.doc Version 5.1 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 the following standard(s): OP9 The home’s arrangements for the recording, handling, safekeeping, safe administration, and disposal of medicines are adequate, some minor amendments would further enhance the safety for service users. EVIDENCE: The home operates a twenty eight day regime for the administration of medication using a monitored dosage system with the additional use of bottles and boxes. The two areas of the building both have a medication trolley and staffs in the designated areas are responsible for the medication procedures. There were some gaps in the Medication Administration Record where the medication had been given but not signed for. The acting manager explained that this omission had probably occurred when an agency staff had been on duty. Stock medication stored in the cupboards was seen to be at a minimum. Tubes and tubs of external medications had not been dated at the time of opening and two packets of proctosedyl suppositories had been stored in the satellite kitchen fridge. The person in charge of the unit removed these immediately. Oldbury Grange Nursing And Residential Home DS0000022259.V275908.R01.S.doc Version 5.1 Page 10 The air temperature of the rooms where the medication is being stored is not being monitored on a regular basis to ensure that the correct temperature is being maintained for the safe storage of medication. Some members of staff had undertaken training in the use of the monitored dosage system in June 2005. Oldbury Grange Nursing And Residential Home DS0000022259.V275908.R01.S.doc Version 5.1 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 the following standard(s): OP 14, 15 The home provides a good quality and unique lifestyle for the people in residence Service users are offered a varied, well balanced diet, which takes into account individual likes and dislikes along with seasonal changes EVIDENCE: Service users discussed their daily routines and stated that they are able to go to bed when they wish and could have a lay in if they so desired. During the tour of the premises is was very evident that service users are encouraged to have their own personal possessions with them and the bedrooms contained pictures, ornaments and belongings. The home operates a four weekly rotational menu offering a well-balanced and nutritional diet. Service users were in the process of having their midday meal and stated that the food is ‘lovely’, and ‘ always plenty to eat’. Care staffs were observed to be assisting the more frail people with their meal in a relaxed and unhurried way. The acting manager described the recent changes to the staff regime in the kitchen to provide the home with kitchen personnel for a longer period of time during the day; she stated that she thought that the new system was working well. One member of staff stated that in his opinion it was an improvement. Oldbury Grange Nursing And Residential Home DS0000022259.V275908.R01.S.doc Version 5.1 Page 12 Oldbury Grange Nursing And Residential Home DS0000022259.V275908.R01.S.doc Version 5.1 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 the following standard(s): OP 16,18 Concerns or complaints are dealt with promptly and professionally; robust procedures are in place for dealing with adult protection issues. EVIDENCE: The home has a complaints procedure, a copy of which is displayed on the notice board and included in the statement of purpose and service users guide. The procedure at present does not contain the current contact details of Commission for Social Care Inspection. One complaint was referred to Commission for Social Care Inspection for investigation in December 2005, the complaint was upheld and the home was required to make improvements to the safety of the environment. The responsible individual deals with any complaints and concerns raised at the home using the home’s procedures. Two complaints are currently being investigated with one being referred to the protection of vulnerable adults team. Both have yet to reach a satisfactory conclusion. The responsible individual and acting manager demonstrated a sound knowledge in this area. Oldbury Grange Nursing And Residential Home DS0000022259.V275908.R01.S.doc Version 5.1 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 the following standard(s): OP 19, 21, 22, 24, 25, 26 The standard of the environment is good providing service users with a comfortable environment to live in. EVIDENCE: The home provides a comfortable and homely environment for the people in residence. Service users spoken with all commented positively about the standard of accommodation. A married couple had been at the home for many years and stated that they are very settled and happy, and felt fortunate that they are able to be in the same home together. They are planning a celebration for their fiftieth wedding anniversary later on in the year. Door wedges continue to be used for keeping open fire doors. Routine maintenance continues to be carried out when required and since the inspection in June 2005, two bathrooms are being revamped and redecorated. One is nearing completion with a few minor snagging items to be attended to and work is continuing on the other bathroom. The observation windows in the 4 bedroom doors have been replaced and now afford complete privacy to the people within the rooms. Oldbury Grange Nursing And Residential Home DS0000022259.V275908.R01.S.doc Version 5.1 Page 15 The carpet in the four toilets has yet to be replaced with a more suitable covering to allow for effective cleaning of the areas. Two bedrooms had a slight malodour; this was discussed with the acting manager during the tour of the building. The acting manager has been proactive in attempting to overcome this problem and has recently contacted the GP and continence advisor. Staff were observed to be assisting service users with transferring between different areas in wheelchairs without footrests. The wheelchairs are in urgent need of a good clean and general maintenance. Some bedroom doors do not have a suitable locking facility without this, service users do not have true choice of whether they wish to lock their bedroom door or not. The temperature of the hot water outlets accessible to service users were randomly tested and were found to be within the required levels of around 43 degrees centigrade. The laundry is well equipped; the laundress confirmed that the equipment is in working order and demonstrated a good knowledge of the process of dealing with soiled and infected laundry. Appropriate hand washing facilities have been provided in all areas. Oldbury Grange Nursing And Residential Home DS0000022259.V275908.R01.S.doc Version 5.1 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 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): OP 27, 28, 29, The home maintains an adequate complement of staff to ensure that service users needs are being met. EVIDENCE: The home is divided into two distinct areas, nursing and residential, with each unit having a deputy manager and staffed with dedicated staff. The nursing unit is nurse led supported with 3- 4 care staff during the day and one care staff at night. The residential unit maintains three care staff for the twenty four hour period. Domestic and catering staffs are additional and the home has employed a person to arrange social activities. The acting manager stated that a first level nurse has the responsibility for the training and development for staff in the core and specialist topic areas. A training matrix has been developed but was not available at this inspection. The responsible nurse was off duty at the time. Three staff personnel files were randomly selected for inspection. All three contained references, proof of identity and criminal record bureau disclosures. Oldbury Grange Nursing And Residential Home DS0000022259.V275908.R01.S.doc Version 5.1 Page 17 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): OP 31, 33, 35, 36, 38 The management team have a clear vision for the home, and are continually developing systems for improving the service on offer. EVIDENCE: Since the inspection in June 2005 the registered manager has left the home, a member of the existing staff has taken over the role of acting manager. The application for her to become the registered manager is progressing. The acting manager is a first level nurse and has the skills and experience to manage the home on a day-to-day basis. She is currently working 28 hours a week and is supported with deputies in the nursing and residential units. The acting manager demonstrated a good knowledge of the current service users group and the conditions and difficulties associated with ageing. Oldbury Grange Nursing And Residential Home DS0000022259.V275908.R01.S.doc Version 5.1 Page 18 Quality assurance monitoring continues with regular staff and service users meetings arranged through out the year. Satisfaction questionnaires are distributed to service users and their representatives; the findings are audited and then discussed at the meetings. The monthly visits by the responsible individual continue with reports forwarded to the acting manager and Commission for Social Care Inspection The acting manager is currently reviewing the policies and procedures used at the home. The home does not hold any personal monies on behalf of the service users, all sundry expenditure i.e. hairdressing, toiletries, newspapers, is invoiced to the service users representative for payment. The acting manager is aware that it is a requirement for staff to be adequately supervised and is currently preparing the documentation to implement regular sessions with staff. Risk assessments are carried out for the safe working practices, however the portable electrical appliance annual test is overdue and a stated previously in this report the wheelchairs need a thorough overhaul. The fire alarm, emergency lighting and hot water temperatures are monitored on a regular basis. Oldbury Grange Nursing And Residential Home DS0000022259.V275908.R01.S.doc Version 5.1 Page 19 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 X X X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 X 8 X 9 2 10 X 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 X 13 X 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 2 17 X 18 3 2 X 3 2 X 2 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 X 3 X 3 2 X 2 Oldbury Grange Nursing And Residential Home DS0000022259.V275908.R01.S.doc Version 5.1 Page 20 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. 1 Standard OP9 Regulation 13(2) 17(1a) Sch.3(k) Requirement Timescale for action 31/03/06 2 OP9 13(2) 3 OP16 22(7)(a) All medicines administered/non administered must be recorded immediately after the transaction with either a signature or a defined abbreviation in order to eliminate gaps in the administration record. A dedicated fridge must be used 31/03/06 for the storage of medication where they are required to be stored at a low temperature. The complaints procedure must 30/06/06 include the contact details of Commission for Social Care Inspection The use of wedges for keeping open fire doors must cease, where there is a need or a personal for a fire door to be kept open, and then the appropriate closure must be fitted linked to the fire alarm to close when the alarm is activated. Regular maintenance checks are needed for the safe use of the wheelchairs. DS0000022259.V275908.R01.S.doc 4 OP19 23(4)(a) 30/06/06 5 OP22 16(2)(c) 31/03/06 Oldbury Grange Nursing And Residential Home Version 5.1 Page 21 6 OP23 23(2)(c) 7 8 OP24 OP26 16(1) 12(4) 123(3) 9 OP38 EWR 1989 13(3c) Footrests must be on the wheelchairs and used. A risk assessment must be undertaken when there is an assessed need for the foot rests to be removed. All private accommodation doors must be fitted with a suitable door locking facility. The carpets in the floor toilets must be replaced with a more suitable easily cleanable floor covering. All portable electrical appliances must have an annual safety test. 31/03/06 30/09/06 30/06/06 31/03/06 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 OP9 OP9 Good Practice Recommendations It is recommended that the date of opening is placed on the container of tubes and tubs of external preparations and discarded after 3 months and 28 days respectively. It is recommended that the air temperature of the rooms used for storing medications be monitored to ensure that the temperature does not exceed 26 degrees centigrade in line with the requirements for the safe storage of medications. Oldbury Grange Nursing And Residential Home DS0000022259.V275908.R01.S.doc Version 5.1 Page 22 Commission for Social Care Inspection Wolverhampton Area Office 2nd Floor St. Davids Court Union Street Wolverhampton WV1 3JE 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 Oldbury Grange Nursing And Residential Home DS0000022259.V275908.R01.S.doc Version 5.1 Page 23 - 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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