Inspection on 20/01/06 for Priory Grange Care Home Limited

This inspection was carried out on 20th 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 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

Priory Grange Care Home Limited 21/05/09

Priory Grange Care Home Limited 14/05/08

Priory Grange Care Home Limited 22/05/07

Priory Grange Care Home Limited 13/06/06

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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 Priory Grange Care Home Limited Hessle High Road Hull East Yorkshire HU4 7BA Lead Inspector Simon Morley Unannounced Inspection 20th January 2006 09:00 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 Priory Grange Care Home Limited DS0000064778.V263668.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. Priory Grange Care Home Limited DS0000064778.V263668.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Priory Grange Care Home Limited Address Hessle High Road Hull East Yorkshire HU4 7BA 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) 01482 504222 01482 573966 Priory Grange Care Home Limited Position Vacant Care Home 41 Category(ies) of Dementia - over 65 years of age (41), Old age, registration, with number not falling within any other category (41) of places Priory Grange Care Home Limited DS0000064778.V263668.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 4th October 2005. Brief Description of the Service: Priory Grange is owned by Priory Grange Care Home Limited, a family company that have the one home. It is registered to provide personal care and accommodation for up to 41 people of either gender, over the age of 65, some of who may suffer from dementia. Priory Grange is located in the Hessle area of Hull to the west of the city centre. The home is purpose built with a rear garden and some car parking space. It is a short drive from the centre of Hessle where there is a wide range of shops, pubs and churches. The home provides accommodation in single rooms all with ensuite on two floors. There was a passenger lift connecting the floors. Downstairs there was a large conservatory and dining room, there was also a lounge and dining room on the first floor and a smaller smoking ounge. Priory Grange Care Home Limited DS0000064778.V263668.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection lasted for 7 hours. This included talking to the manager, some of the care staff, residents and their visitors. Care and administration records were also examined. One additional visit was made to the home in October 2005 following the last inspection in June 2005. This was to check progress the home had made to improve the service. This inspection was another check on that progress and to look at some of the national minimum standards not inspected before. What the service does well: What has improved since the last inspection? What they could do better: There must be a full and detailed assessment of a resident’s needs before moving into the home to ensure that the home are able to provide all the care required. This assessment must be used to write a detailed plan of care that tells staff what they need to do for, and is agreed with, each resident. It must be made clearer what the home’s charging policy is and what residents can expect for their money. Priory Grange Care Home Limited DS0000064778.V263668.R01.S.doc Version 5.1 Page 6 They must also be given more opportunities for social stimulation, leisure and recreational activities. Access to the garden must be improved for residents with physical and other impairments who would find it hard to get to. The owners and manager must make sure that the recommend staffing levels are in place so there is enough staff to look after everyone. The recruitment checks of new staff must improve so that only suitable staff are employed to work in the home. The planning of training and supervision and quality of required records must improve. Staff must be trained to do their jobs as well as they can. The owner must check that manager is doing his job properly to help ensure the care provided is always good. The views of residents must be used to make improvements to the service. 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. Priory Grange Care Home Limited DS0000064778.V263668.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 Priory Grange Care Home Limited DS0000064778.V263668.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): 2 and 3. The arrangements for new residents to move into the home need to improve. EVIDENCE: Residents spoken to were happy that their care needs were being met. Staff spoken to were aware of residents’ personal care needs. Visiting relatives were also happy with the care being provided. The new manager said that there had been no new residents since he had started. Some residents had moved into the home before this. Two sets of care records were looked at. The assessments of some one’s needs before they moved in had improved but still did not cover all aspects of health, social and personal care needs. This puts residents at risk of not having their needs met. The manager plans to implement a much improved assessment process to put this right. Priory Grange Care Home Limited DS0000064778.V263668.R01.S.doc Version 5.1 Page 9 The written contract/statement of terms and conditions agreed with residents when they move in was unclear about the charging policy. If fees are paid by social services this is £321 per week, for some one paying themselves the fees are £380 per week for the same level of care. Also when social services are paying, the home ask for a top-up fee from the resident’s family/representative. This varies between £25 and £50. This is not made clear in the information available about the home. It is also not clear exactly what you get for your money and who is responsible for paying it. Priory Grange Care Home Limited DS0000064778.V263668.R01.S.doc Version 5.1 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7 and 9. Some of the arrangements for safeguarding residents’ health, social and personal care need to improve. EVIDENCE: Residents said that staff treat them well and they were happy with their care. This was also the view of relatives and friends that were visiting. Care records looked at did not have detailed care plans that described the actions required by staff to meet residents’ needs. These plans were brief and did not cover all the areas of care that must be included. This is another area of priority that the new manager plans to improve. The arrangements for making sure residents get their medication were good. Some residents had been asked if they want to look after their own medicines, or if they are able or are happy for the home to do this for them. Consent should be obtained from all residents for staff to give them their medication. Priory Grange Care Home Limited DS0000064778.V263668.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): 13, 14 and 15. There were good arrangements for visiting and mealtimes. EVIDENCE: Residents and visitors were happy with the visiting arrangements and it was clear that residents are supported to keep in touch with friends and family. Residents also said that they felt able to make their own choices about how they spend their time. They can have keys to their rooms, get their own post and can have daily newspapers. Staff knock on bedroom doors before they enter and call residents by their preferred name. The home has kept its Heartbeat award for the healthy food it provides. Residents are able to use the two dining rooms or eat in their rooms. Their weight is monitored and any concerns are referred to community health services for support. Residents spoke positively about the quality of food. As part of the new assessment/care planning process the manager intends to improve how dietary needs are assessed and catered for. Priory Grange Care Home Limited DS0000064778.V263668.R01.S.doc Version 5.1 Page 12 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): The key standards were included in the last inspection report. EVIDENCE: Priory Grange Care Home Limited DS0000064778.V263668.R01.S.doc Version 5.1 Page 13 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19 and 26. Priory Grange is well kept, clean, comfortable and smells fresh. EVIDENCE: The home is clean and smells fresh; there are no malodours. There were good procedures for managing clinical waste to help promote a healthy environment. Furniture is comfortable and homely. Residents were pleased with the home and it’s surroundings. There is an enclosed garden area at the back of the home. Not much is made of this space and access for residents is limited. This was the case at the last inspection and something the owners should have addressed by now. It was reported that work on improving access to the garden is due to start next week. The home is well maintained and maintenance certificates were available. Priory Grange Care Home Limited DS0000064778.V263668.R01.S.doc Version 5.1 Page 14 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 29 and 30. There were good staffing levels but the arrangements for recruitment and training need to improve. EVIDENCE: The number of care hours staff work on the rota added up to 774 a week, the recommended guidance says there must be at least 774. This was based on there being equal numbers of residents with high, medium and low needs levels in terms of the care they need. The manager was advised to obtain a copy of the guidance to confirm the needs levels and required staffing. This is necessary to ensure there is adequate staffing at all times to meet the care needs of residents. The new manager reported that he had re-designed the rota to increase (since the last inspection) the number of care hours each week and to provide a good balance of skills and experience of staff on each shift. The new manager had not appointed any new staff. But some staff had started work at the home since the last inspection. Despite writing to the owners after the last inspection, advising them of what checks to make before new staff were recruited, this advice had not been followed. Recruitment records were looked at for two new staff, it was clear from this that the necessary checks had not been made to ensure they were suitable to work in the home. This puts residents at risk of harm from potentially Priory Grange Care Home Limited DS0000064778.V263668.R01.S.doc Version 5.1 Page 15 unsuitable care staff. One of the owners was present for part of the inspection and claimed she knew nothing about these new staff starting. It was clear from discussion with the new manager that he knew what a thorough recruitment process should be and he gave assurances that this would improve. Training records required updating and a thorough assessment completed of what training staff needed. The new manager had started work on this and booked some training for staff to attend. Priory Grange Care Home Limited DS0000064778.V263668.R01.S.doc Version 5.1 Page 16 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35 and 38. There is good potential for the management and administration of the home to improve. EVIDENCE: There has been no registered manager of the home since April 2005. A new manager started at the beginning of January, and was previously a registered manager of another home. He had a list of priorities for improving the service and it was clear from discussion with him he knew what needed to be done. Part of this is to implement a better quality assurance system that aims at improving the home primarily based on the views of residents. There were accurate and up to date records relating to any personal allowances the home keeps on behalf of residents. Priory Grange Care Home Limited DS0000064778.V263668.R01.S.doc Version 5.1 Page 17 The home was well maintained and the majority of maintenance certificates were available for inspection. Priory Grange Care Home Limited DS0000064778.V263668.R01.S.doc Version 5.1 Page 18 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 2 2 X X X HEALTH AND PERSONAL CARE Standard No Score 7 2 8 X 9 3 10 X 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 X 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 X 17 X 18 X 3 X X X X X X 3 STAFFING Standard No Score 27 2 28 X 29 2 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 2 X 3 X X 3 Priory Grange Care Home Limited DS0000064778.V263668.R01.S.doc Version 5.1 Page 19 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 OP2 Regulation 5 Requirement The written contract/statement of terms and conditions must: clearly inform residents of the home’s charging policy, what is included in their fees, and who is responsible for paying them. The registered person must ensure that every prospective resident has their needs fully assessed covering the areas listed in NMS 3.3 before they move into the home. (Previous targets of 31/08/05 and 31/12/05 not met). The registered person must ensure there is a written plan of care detailing the tasks to be undertaken by staff to meet all the care needs for each resident as detailed in NMS3.3. (Previous targets of 31/08/05 and 31/12/05 not met). Resident’s interests must be recorded and they must be given opportunities for stimulation through leisure and recreational activities in and outside the home, which suit their needs. (Previous targets of 31/08/05 DS0000064778.V263668.R01.S.doc Timescale for action 30/04/06 2 OP3 14 30/04/06 3 OP7 15 30/04/06 4 OP12 12 & 16 30/04/06 Priory Grange Care Home Limited Version 5.1 Page 20 5 OP20 23 6 OP27 18 7 OP29 19 8 OP29 19 9 OP30 18 10 OP33 24 11 OP36 26 and 31/12/05 not met). Access to the garden must be made accessible to wheelchair users, residents with other mobility problems and those who suffer from cognitive impairments. (Previous targets of 31/08/05 and 31/12/05 not met). The registered persons must obtain a copy of the recommended staffing guidance and use this to calculate the required staffing levels which must be in place at all times. Two written references relating to a person must be obtained prior to them starting employment and you must be satisfied on reasonable grounds as to the authenticity of the references. One reference must be from the person’s last social care employer. A CRB disclosure must be obtained prior to some one starting work at the home, in exceptional circumstances a POVA first check can be made pending the CRB disclosure. There must be clearer records of the training staff have completed, when they completed it, when they need a refresher by and other training they need. This must be used to prepare an annual training plan. There must be a good quality monitoring system based on the views of residents that can demonstrate success in achieving the home’s aims and objectives. The registered provider must visit the home in accordance with Regulation 26 of the Care Home Regulations. (Previous targets of 04/11/04, 31/03/05 DS0000064778.V263668.R01.S.doc 30/04/06 30/04/06 30/04/06 30/04/06 30/04/06 30/04/06 30/04/06 Priory Grange Care Home Limited Version 5.1 Page 21 and 31/12/05 not met. 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 OP3 Good Practice Recommendations The written contract / statement of terms and conditions should be reviewed in accordance with the Office of Fair Trading report ‘Unfair terms in care home contracts’. Priory Grange Care Home Limited DS0000064778.V263668.R01.S.doc Version 5.1 Page 22 Commission for Social Care Inspection Hessle Area Office First Floor 3 Hesslewood Country Office Park Ferriby Road Hessle HU13 0QF 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 Priory Grange Care Home Limited DS0000064778.V263668.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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