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Inspection on 19/01/06 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 19th January 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 found no outstanding requirements from the previous inspection report, but made 2 statutory requirements (actions the home must comply with) as a result of this inspection.

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 home provides a committed staff team, and residents appeared comfortable with all the staff. The home provides a friendly atmosphere, and all staff was observed interacting well with the residents. Several residents complimented the choice and quality of food available at the home. Many residents` bedrooms were personalised to reflect their choice and reflect their personality. Residents who were able to express an opinion were complimentary about the home and the staff. Residents are able to pursue their activities with the assistance of the committed staff team.

What has improved since the last inspection?

Since the last inspection the home has provided a new specialist bath to assist staff in meeting the residents hygiene needs. Staff training has been maintained since the last inspection and a record maintained in the home.

What the care home could do better:

The home would benefit from a redecoration and refurbishment program. Some areas of the home are looking tired and well worn. Some carpets were well worn and in need of repair and or replacement. It is recommended that the home further develop their job application forms, more information is required.

CARE HOME ADULTS 18-65 Pirton Grange Nursing Home The Grange Pirton Wadborough Worcestershire WR8 9EF Lead Inspector Chris Potter Unannounced Inspection 19th January 2006 10:00 Pirton Grange Nursing Home DS0000004133.V274134.R01.S.doc Version 5.1 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 Pirton Grange Nursing Home DS0000004133.V274134.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 Adults 18-65. 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. Pirton Grange Nursing Home DS0000004133.V274134.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Pirton Grange Nursing Home Address The Grange Pirton Wadborough Worcestershire WR8 9EF 01905 821544 01905 821257 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) Pirton Grange Limited Catherine Yeates Care Home 34 Category(ies) of Physical disability (34), Physical disability over registration, with number 65 years of age (34) of places Pirton Grange Nursing Home DS0000004133.V274134.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. The home is primarily for people with a physical disability, but may also accommodate people with an associated mental disorder. The home may also accommodate 2 named persons over the age of 65 years whose needs fall within category OP. 15th July 2005 Date of last inspection 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 Nursing Home DS0000004133.V274134.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection was unannounced and was carried out for part of the day on the 31st January 2006. The inspection totalled 5 hours and focused on the requirements from the last inspection. On the day of the inspection the home was accommodating 33 residents. A part tour of the home was undertaken, residents care records were reviewed, health and safety records reviewed and some residents and staff were spoken with to establish their views about the home. Since the last inspection the home has changed owners. This has had no effect on the day-to day running of the home or the resident’s care. What the service does well: What has improved since the last inspection? Since the last inspection the home has provided a new specialist bath to assist staff in meeting the residents hygiene needs. Staff training has been maintained since the last inspection and a record maintained in the home. Pirton Grange Nursing Home DS0000004133.V274134.R01.S.doc Version 5.1 Page 6 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 Nursing Home DS0000004133.V274134.R01.S.doc Version 5.1 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 Outcomes Statutory Requirements Identified During the Inspection Pirton Grange Nursing Home DS0000004133.V274134.R01.S.doc Version 5.1 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 the following standard(s): 2,3,4 and 5 The home provides prospective residents and relatives with appropriate information and advice to assist them in making their choice about the home. The manager assesses all residents prior to admission to ensure the home can meet the assessed needs of the prospective resident. EVIDENCE: The home produces the information in a format suitable for the residents to understand. For many residents the home is chosen for them by their relatives. Individual records are kept for each of the residents, and inspection of the records for three residents had full assessment information recorded. Staff members on duty knew about the care needs of the three residents. The registered manager visits and assesses all prospective residents prior to admission to ensure that the home can safely meet their care needs. The preadmission assessment then forms the basis of the residents care plan. The home offers any prospective resident the opportunity to visit on a trial basis before deciding on a long-term placement at the home. All residents have a contract on admission to the home. Pirton Grange Nursing Home DS0000004133.V274134.R01.S.doc Version 5.1 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 the following standard(s): 6,7,8 and 9 The home ensures that residents are consulted regularly on their changing needs and are supported to take risks. EVIDENCE: Three residents care plans was reviewed at the time of the inspection. 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 independence. Care records included details about residents’ social activities, outings undertaken, clubs they were attending, and family contacts. Residents spoken to confirmed they went out had contact with their families and were encouraged to pursue their hobbies. Regular meetings were taking place between staff and residents and their views were valued. Care records are stored securely in the nurses’ office. Pirton Grange Nursing Home DS0000004133.V274134.R01.S.doc Version 5.1 Page 10 It is recommended that the home develop a head injury protocol and advise all staff to follow the procedure. Pirton Grange Nursing Home DS0000004133.V274134.R01.S.doc Version 5.1 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 the following standard(s): 14,16 and 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: Residents care records give details of social activities and record the residents’ preferences for activities . The home employs specific staff that are 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. The staff are committed to ensure that the residents outings are undertaken and give their time to ensure the residents needs are met. The catering standard was not fully assessed at this inspection. The home provides a varied menu to accommodate the residents likes and dislikes. Feedback from residents generally was complementary about the choice and quality of the food. It was noted in the complaints records that three Pirton Grange Nursing Home DS0000004133.V274134.R01.S.doc Version 5.1 Page 12 complaints were made about the food previously. Following this the menu was changed to address the issues raised by the residents. At the time of the inspection residents were complimentary about the choice and quality of food available for them. Pirton Grange Nursing Home DS0000004133.V274134.R01.S.doc Version 5.1 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 the following standard(s): 18,19,20 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 observed providing care in a sensitive way to the residents. Medication records were generally well managed. The home has a good relationship with the homes General practitioner and the Consultant visits frequently to review the resident’s and the medication they are taking. Pirton Grange Nursing Home DS0000004133.V274134.R01.S.doc Version 5.1 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 the following standard(s): 22 and 23 Complaints are handled objectively. A vulnerable adults procedure ensures a proper response to any suspicion or allegation of abuse. EVIDENCE: The home has a clear simple complaints procedure in place. Since the last inspection the CSCI has received no complaints in respect of the service. The homes complaints records were reviewed and showed that the home was following their complaints procedure. All staff receive regular training on the protection of vulnerable adults. There have been no issues reported since the last visit. Pirton Grange Nursing Home DS0000004133.V274134.R01.S.doc Version 5.1 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 the following standard(s): 24,25,26,27 and 30 Residents are provided with a warm and comfortable home that is well maintained and meets their assessed EVIDENCE: Pirton Grange is an old detached property, which has been converted into a care home. 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. The homes appearance would be further improved by a redecoration program. Some carpets are looking tired and well worn; the lounge carpet was lifting and should be repaired or replaced to reduce the risk of accidents. All the bedrooms have been personalised by the resident to reflect their individual choice. The home provides two lounges, a small dining room, and a shaft lift to assist residents to access all areas of the home Since the last inspection the home has provided a specialist bath to assist staff in meeting the residents needs. Staff confirmed that this had been an advantage to the home. Pirton Grange Nursing Home DS0000004133.V274134.R01.S.doc Version 5.1 Page 16 The home stands in large well maintained grounds, and a seating area is available for the residents to use when the weather permits. The garden is easily accessible for residents in wheelchairs. Since the last inspection the home has completed the legionella risk assessment and this was available at the inspection. The management and organisation of the maintenance and servicing records was commended. All areas of the home were observed to be clean and tidy the management of odours is commended. Pirton Grange Nursing Home DS0000004133.V274134.R01.S.doc Version 5.1 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 32, 34 and 35 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31,32,33,34 and 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 33 residents. The home has a stable committed team of staff and use very little agency staff to make up the numbers. In addition to nursing and care staff, there are administration, activity therapists and ancillary staff on duty to support the service provision. The manager reviews the resident’s dependency levels and given their unpredictable behaviour the home is staffed appropriately. All staff appeared comfortable in their role and confirmed they enjoyed their work. The residents were also complimentary about the staff and their commitment to their work. The home has provided significant investment and emphasis on staff development and training. Training is identified as a result of the residents needs. Three staff files were reviewed at the inspection it is recommended that the home redevelop there job application form. The need for the applicant to Pirton Grange Nursing Home DS0000004133.V274134.R01.S.doc Version 5.1 Page 18 provide more information and evidence about training and qualifications, health history was advised. A staff supervision program is in place that includes a member of staff being shadowed every week, and any training needs are identified. Pirton Grange Nursing Home DS0000004133.V274134.R01.S.doc Version 5.1 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 37, 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 37,38,42 and 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: The manager is competent and appropriately qualified to manage the service. Staff and residents spoke very highly of her and she a good knowledge and understanding about the residents and their needs. 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. Regulation 26 reports are completed and forwarded to the CSCI on a regular basis. Pirton Grange Nursing Home DS0000004133.V274134.R01.S.doc Version 5.1 Page 20 Pirton Grange Nursing Home DS0000004133.V274134.R01.S.doc Version 5.1 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 Standard No Score 1 X 2 3 3 3 4 3 5 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 2 25 3 26 3 27 3 28 X 29 X 30 3 STAFFING Standard No Score 31 4 32 3 33 3 34 3 35 X 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 3 3 X LIFESTYLES Standard No Score 11 X 12 X 13 X 14 3 15 X 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 4 3 X X X 3 3 Pirton Grange Nursing Home DS0000004133.V274134.R01.S.doc Version 5.1 Page 22 No 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 YA24 Regulation 13 Requirement The home must ensure that the carpet in the lounge is repaired or replaced to reduce the risk of accidents. The home must provide an ongoing redecoration program to maintain the homes appearance. Timescale for action 01/03/06 2. YA24 13 01/03/06 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 YA18 YA32 Good Practice Recommendations The home should develop a head injury protocol to ensure all staff follows the same procedure. The home should review their job application form to provide more information about their qualifications. Pirton Grange Nursing Home DS0000004133.V274134.R01.S.doc Version 5.1 Page 23 Commission for Social Care Inspection Worcester Local Office Commission for Social Care Inspection The Coach House John Comyn Drive Perdiswell Park, 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 Nursing Home DS0000004133.V274134.R01.S.doc Version 5.1 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. 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