Please wait

Please note that the information on this website is now out of date. It is planned that we will update and relaunch, but for now is of historical interest only and we suggest you visit cqc.org.uk

Inspection on 15/07/05 for Pirton Grange Nursing Home

Also see our care home review for Pirton Grange Nursing Home for more information

This inspection was carried out on 15th July 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.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

The manager, directors and staff work hard to improve and maintain the standards within the home. This is reflected in the number of standards being met. Residents were most complimentary about the staff, and the facilities available to them at the home. The service makes sure that residents` health care needs are met and activities are provided. Food provided according to the residents is excellent with a good choice. Residents are encouraged to make comments about the service provided.

What has improved since the last inspection?

Decoration and furnishings had been upgraded since the last inspection; this has further enhanced the homes appearance. A resident confirmed he was pleased with the redecoration in the lounge. The residents care records have improved since the last inspection.Staff training and supervision records have improved. Policies and procedures have been updated to include appropriate information to comply with the national minimal standards.

What the care home could do better:

Care records should be reviewed more frequently.

CARE HOME ADULTS 18-65 PIRTON GRANGE The Grange Pirton Worcestershire WR8 9EF Lead Inspector Christine Potter Unannounced 15th July 2005 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 Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationary 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. PIRTON GRANGE E52 S4133 Pirton Grange V237367 200705.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Pirton Grange Address The Grange Pirton Wadborough Worcestershire WR8 9EF 01905 821544 01905 821257 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) Pirton Grange Limited Ms C Yeates CRH 34 Physical disabilities 34 Physical disabilities - over 65 34 Category(ies) of PD registration, with number PD(E) of places PIRTON GRANGE E52 S4133 Pirton Grange V237367 200705.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: The home is primarily for people with a physical disability, but may also accommodate people with an associated mental disorder. Date of last inspection 30 September 2004 Brief Description of the Service: Pirton Grange is a period building providing accommodation to a total of 34 residents on the three floors within the home. A passenger lift and a staircase access the floors to the building.The home is situated in the village of Pirton, approximately five miles south of Worcester. It is registered to provide twentyfour hour nurse-led care for residents, and is staffed by registered nurses and care assistants throughout the twenty-four hour period. PIRTON GRANGE E52 S4133 Pirton Grange V237367 200705.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The unannounced inspection took place over part of one day totalling six hours. The inspection focused on the requirements from the last inspection, tour of the environment, care documentation, staff, health and safety records. On the day of the inspection, the home was accommodating 34 residents. During the inspection three residents and three staff were spoken to. What the service does well: What has improved since the last inspection? Decoration and furnishings had been upgraded since the last inspection; this has further enhanced the homes appearance. A resident confirmed he was pleased with the redecoration in the lounge. The residents care records have improved since the last inspection. PIRTON GRANGE E52 S4133 Pirton Grange V237367 200705.doc Version 1.40 Page 6 Staff training and supervision records have improved. Policies and procedures have been updated to include appropriate information to comply with the national minimal standards. 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. PIRTON GRANGE E52 S4133 Pirton Grange V237367 200705.doc Version 1.40 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Standards Statutory Requirements Identified During the Inspection PIRTON GRANGE E52 S4133 Pirton Grange V237367 200705.doc Version 1.40 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users’ know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) These standards were not reviewed at this inspection. EVIDENCE: These standards were not reviewed at this inspection. The home had updated its Statement of Purpose and Service User’s Guide following the requirements from the last inspection. PIRTON GRANGE E52 S4133 Pirton Grange V237367 200705.doc Version 1.40 Page 9 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate, in all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 6,7,8,9,10 The home ensures that residents are consulted regularly on their changing needs and are supported to take risks. EVIDENCE: Since the last inspection the care records have been further developed. The care records clearly showed that residents and their representatives were being routinely consulted about the care provided. Documentation available showed that risk assessments were taking place, and action was being taken to minimise risk once it had been identified, while promoting, as far as possible, the independence of each resident. The home needs to ensure that all care records are reviewed and updated every month. Care records included details about residents’ social activities, outings undertaken, clubs they were attending, and family contacts. Two residents spoken to during the inspection confirmed that they undertook social interests and weekend visits home. Regular meetings were taking place between staff and residents. The residents were usually consulted individually and then their ideas put forward at staff PIRTON GRANGE E52 S4133 Pirton Grange V237367 200705.doc Version 1.40 Page 10 meetings. Documents were examined that showed how residents had been consulted on food provision. Care records are stored securely in the nurses’ office. Since the last inspection the home has included information in the Statement of Purpose and Service Users’ Guide about accessing information. PIRTON GRANGE E52 S4133 Pirton Grange V237367 200705.doc Version 1.40 Page 11 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 11,12,13,14,15,16 & 17. Dietary needs of residents are well catered for with a balanced and varied selection of food available that meets residents’ tastes and choices. Social activities are varied to meet the individual’s needs. EVIDENCE: The home employs specific staff responsible for activities and therapies. A reflexologist provides treatment for the residents at no additional cost. Activities for residents include visits to; local public houses, the cinema, a hydro- pool in Malvern and shopping trips. A resident confirmed he went to the local pub every week and was looking forward to his next visit that coincided with the day of the visit. Residents care records give details of social activities and the residents’ likes and dislikes. Menus were inspected and found to be balanced and interesting, and mealtime arrangements are also flexible enough to accommodate individual preferences. Catering staff demonstrated a detailed knowledge and understanding of PIRTON GRANGE E52 S4133 Pirton Grange V237367 200705.doc Version 1.40 Page 12 individual residents’ dietary preferences and requirements. A food audit had recently been completed by the residents and the findings were available. The nutritional and dietary needs of people who required a softened diet were being appropriately met. The menu for the day was displayed for the residents to assist them in choosing a meal. Appropriate records were being maintained by the catering staff and these were available and up to date at the time of the visit. A new cooker has been provided since the last inspection. Care records show that the home completes a nutritional risk assessment for all the residents, and the weight records for the residents were fairly stable. PIRTON GRANGE E52 S4133 Pirton Grange V237367 200705.doc Version 1.40 Page 13 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 18,19 Significant progress has been made on improving arrangements to ensure that the health care needs of residents are identified and met. EVIDENCE: Individual plans of care are available, and progress has been made to ensure that all aspects of health, personal and social care needs are identified and planned for. Plans were detailed, but simple enough to enable care staff to follow the program of care. Significant events in the home had been recorded, daily entries into case records had been made and entries available gave an indication of the actual care given. Staff were seen providing care in a sensitive way to the residents. PIRTON GRANGE E52 S4133 Pirton Grange V237367 200705.doc Version 1.40 Page 14 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 22&23 Complaints are handled objectively. A vulnerable adults procedure ensures a proper response to any suspicion or allegation of abuse. EVIDENCE: Since the last inspection the home has updated the complaints policy, this has been included in the home’s Statement of Purpose and Service User’s Guide. Complaint records reviewed showed the home was following the complaint policy and a clear outcome was recorded. Protection of Vulnerable adult training has been provided for staff to further assist them in reporting and recognising any possible abuse. The home has updated its whistle blowing policy and all staff have signed to confirm they have read the policy. The manager confirmed that two staff had been referred to the Protection of Vulnerable Adults list since the last inspection so was fully aware of the procedure and the need to check all new staff against the POVA (Protection of Vulnerable Adults) list. PIRTON GRANGE E52 S4133 Pirton Grange V237367 200705.doc Version 1.40 Page 15 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 24,26,27,28,29 & 30. Residents are provided with a warm and comfortable home that is well maintained and meets their assessed needs. EVIDENCE: The home provides a safe comfortable and well-maintained environment, which also has a homely atmosphere. All the rooms have been personalised by the resident’s choice. The home provides two lounges, a small dining room, and a shaft lift to assist residents to access all areas of the home. Several parts of the home have been redecorated; this has further enhanced the homes appearance. Further plans to redecorate the middle floor are in hand. A new shower unit has been provided since the last visit and plans to provide a specialist bath are being discussed. Given the dependency of the residents some baths are not suitable for their assessed needs. The home stands in large well maintained grounds, and a seating area is available for the residents to use when the weather permits. A resident who requires the assistance of an electric wheelchair stated that he had no problems accessing any area of the home or grounds. PIRTON GRANGE E52 S4133 Pirton Grange V237367 200705.doc Version 1.40 Page 16 All residents spoken to on the day of inspection confirmed that they were pleased with the environmental standards within the home. The legionella risk assessment remains outstanding from the last inspection. The maintenance person confirmed that all appropriate precautions were being undertaken and the results from these tests are available. It is required that the home has a specific legionella risk assessment completed by a competent person with appropriate qualifications for Pirton Grange. A window restraint was observed to be broken during the inspection this was reported to the maintenance person to address at the time of the visit. All areas of the home were observed to be clean and tidy, the management of odours was commended. PIRTON GRANGE E52 S4133 Pirton Grange V237367 200705.doc Version 1.40 Page 17 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31,32,34,35 & 36 Staffing levels and competencies are suitable to ensure that residents’ needs are identified and effectively met. EVIDENCE: There were suitable nursing and care staff on duty to provide care and support for the 34 residents. The home has a stable team of staff and use very little agency staff to make up the numbers. In addition to nursing and care staff, there was administration, activity therapists and ancillary staff on duty to support the service provision. Training has been provided to the staff and is ongoing. Training was identified as a result of the needs of the residents; to ensure care delivered was appropriate to meet those assessed needs. Residents complimented the staff and their dedication to their work. The home is well on its way to achieving 50 of staff having NVQ levels two and three by the end of 2005. PIRTON GRANGE E52 S4133 Pirton Grange V237367 200705.doc Version 1.40 Page 18 The recruitment procedure was being followed appropriately by the home. A formal staff supervision program has been commenced for all grades of staff, and the manager confirmed this has been most helpful. PIRTON GRANGE E52 S4133 Pirton Grange V237367 200705.doc Version 1.40 Page 19 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. 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 are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 37, 38,39,40,42 & 43. There is clear leadership, guidance and direction to staff to ensure residents receive consistent care, resulting in practices that promote and safeguard the health, safety and welfare of the people using the service. EVIDENCE: Since the last inspection the proposed manager has been approved by the CSCI to be the registered manager. She is competent and appropriately qualified and experienced to manage the service. Staff and residents spoke very highly of her and she related well with the residents. On taking over the manager’s role she has further developed and enhanced the quality of the service provided. Residents expressed their opinion that the home was being run in their best interests. The home operates a quality assurance system, this needs to be formalised to PIRTON GRANGE E52 S4133 Pirton Grange V237367 200705.doc Version 1.40 Page 20 meet the requirement fully. Records inspected indicated that regular health and safety checks are carried out including fire safety tests. There are systems in place for risk assessments to ensure the safety of the residents and staff at all times. A formal staff supervision program is in place, the need for the manager to have regular supervision was recommended. Regulation 26 reports are completed and forwarded to the CSCI on a regular basis. PIRTON GRANGE E52 S4133 Pirton Grange V237367 200705.doc Version 1.40 Page 21 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 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 CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score x x x x x Standard No 22 23 ENVIRONMENT Score 3 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 3 3 3 3 3 Score Standard No 24 25 26 27 28 29 30 STAFFING Score 3 x 3 3 3 3 2 Standard No 11 12 13 14 15 16 17 3 3 3 3 3 3 3 Standard No 31 32 33 34 35 36 Score 3 3 3 3 3 3 CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 PIRTON GRANGE Score 3 3 x x Standard No 37 38 39 40 41 42 43 Score 3 3 2 3 3 x 3 E52 S4133 Pirton Grange V237367 200705.doc Version 1.40 Page 22 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. 2. Standard 6 30 Regulation 15 13 Requirement The residents care records must be reviewed and updated every month. The home must have a legionella risk assessment personalised to Pirton Grange by an appropriately qualified person. The window restraint must be repaired/replaced in bedroom 9. The home must formalise their quality assurance mechanisms, and audit their results. Timescale for action 31st August 2005 31st August 2005 within 7 days of the inspection. 31st October 2005 3. 4. 30 39 13 24 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 PIRTON GRANGE E52 S4133 Pirton Grange V237367 200705.doc Version 1.40 Page 23 Commission for Social Care Inspection The Coach House John Comyn Drive, Perdiswell House Droitwich Road Worcester WR3 7NW 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 PIRTON GRANGE E52 S4133 Pirton Grange V237367 200705.doc Version 1.40 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!