Inspection on 31/07/07 for Rangemore Nursing Home

This inspection was carried out on 31st July 2007.

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

Rangemore Nursing Home 23/08/06

Rangemore Nursing Home 16/02/06

Rangemore Nursing Home 09/08/05

Rangemore Nursing Home 08/03/05

Rangemore Nursing Home 28/09/04

Similar services:

Chirnside House

Keer Sands Residential Home

Ruskin Lodge

Bushell House

Langrigg House

Parkside

Dystlegh Grange

Thornton Lodge

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

CARE HOMES FOR OLDER PEOPLE Rangemore Nursing Home Chester Road Bucklow Hill Knutsford Cheshire WA16 6RR Lead Inspector Joan Adam Unannounced Inspection 09:30 31st July 2007 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 Rangemore Nursing Home DS0000018779.V334350.R01.S.doc Version 5.2 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. Rangemore Nursing Home DS0000018779.V334350.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Rangemore Nursing Home Address Chester Road Bucklow Hill Knutsford Cheshire WA16 6RR 01565 830396 F/P 01565 830396 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) Mr Richard Dickinson Mrs Joyce Edith Healey Care Home 49 Category(ies) of Dementia (18), Dementia - over 65 years of age registration, with number (18), Old age, not falling within any other of places category (31) Rangemore Nursing Home DS0000018779.V334350.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. This home is registered for a maximum of 49 service users to include:* Up to 31 service users in the category of OP (Old age, not falling within any other category) * Up to 18 service users in the category of DE (Dementia) * Up to 18 service service users in the category of DE(E) (Dementia over 65 years of age) 23rd August 2006 Date of last inspection Brief Description of the Service: Rangemore Nursing Home is situated in the Cheshire countryside, close to the towns of Lymm, Knutsford and Altrincham. There are 2 lounges, a conservatory and a quiet room, referred to as the sun room, as well as 2 separate dining rooms. Bedroom accommodation is provided on two floors with access between floors by passenger lift and stairways. The home provides nursing care for 49 older people, including 12 people with a dementia related illness, accommodated within their own wing. The current charges for the home are £500 to £600 per week. This information has been provided by the home manager. Rangemore Nursing Home DS0000018779.V334350.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. An unannounced visit by one inspector took place on the 31st July 2007 and lasted 6.5 hours. This visit was just one part of the inspection. Before the visit the home manager was also asked to complete a questionnaire to provide up to date information about services in the home. Questionnaires were also made available for residents, families, and health and social care professionals such as doctors, nurses and social workers to find out their views. Eight questionnaires were returned and all the comments were positive. Comments such as “ We are happy with the care our relative is receiving” A social worker who visits the home wrote, “Health care excellent, staff are approachable and co-operative” One GP wrote, ”The home monitors patients well being so that changes are highlighted” Other information received by CSCI since the last key inspection was also reviewed. During the visit, various records and the premises were looked at. A number of residents and relatives were also spoken with and they gave their views about the service. What the service does well: All residents are assessed prior to admission so that the staff know they can meet their needs. Care plans are in place so that the staff know how to care for the residents living at Rangemore. Comments such as “this is a nice place to live”” “the staff look after me well” “ The place is always clean” were made by the residents. The home is staffed with people who are trained to look after older people. Residents are offered choice in their daily lives and the standard of catering is good. Residents are treated as individuals and their privacy and dignity is respected. Rangemore Nursing Home DS0000018779.V334350.R01.S.doc Version 5.2 Page 6 Recruitment procedures, staff training and staff supervision ensure that residents are protected from harm. Residents’ financial interests are also safeguarded. The home is clean and comfortable with a warm and welcoming atmosphere. What has improved since the last inspection? What they could do better: The home should continue to maintain and improve the standard of service offered to the residents. Rangemore Nursing Home DS0000018779.V334350.R01.S.doc Version 5.2 Page 7 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. The summary of this inspection report can be made available in other formats on request. Rangemore Nursing Home DS0000018779.V334350.R01.S.doc Version 5.2 Page 8 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 Rangemore Nursing Home DS0000018779.V334350.R01.S.doc Version 5.2 Page 9 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. JUDGEMENT – we looked at outcomes for the following standard(s): 3 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents are fully assessed prior to admission so that care staff is able to meet their care needs. EVIDENCE: Assessments are carried out by the manager or deputy manager who visits each person who might move into Rangemore in their own home or hospital before they move in to check on what their care needs are. Assessments from social services and/or medical professionals such as specialist doctors are also part of this process, to ensure that all the person’s needs can be met at the home. Rangemore Nursing Home DS0000018779.V334350.R01.S.doc Version 5.2 Page 10 The care file of one resident who had recently moved into the home was looked at. Completed assessment forms, which were thorough, were available in the care file and had been used to draw up the person’s care plan. Rangemore does not provide intermediate care. Rangemore Nursing Home DS0000018779.V334350.R01.S.doc Version 5.2 Page 11 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. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,9,10 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents’ health, personal and social care needs are met by staff who enable them to maintain their privacy and dignity. Medication is well managed so that residents receive the medicines for which they are prescribed. EVIDENCE: Four residents’ plans of care were seen and contained information to enable staff to meet the majority of their needs. They were well written, up to date and reviewed regularly. This ensured that people’s changing needs were always recorded in the plans of care. Rangemore Nursing Home DS0000018779.V334350.R01.S.doc Version 5.2 Page 12 All the files looked at contained risk assessments, moving and handling information, information about contact with medical professionals such as doctors and nurses, nutritional records and a variety of other records to ensure the residents’ wellbeing. There was evidence that staff work closely with health professionals and there are good links with local GPs. One doctor wrote in a CSCI comment card - Rangemore are excellent and competent and act appropriately with sick and frail elderly patients” Good daily records were kept by staff, which showed the care given to the person that day, any problems that might have arisen and the action taken to address this. Care staff were observed to treat the residents with dignity and respect and communicate with them in a variety of appropriate ways. One visitor to the home said, “The staff are very good and always treat the residents well.” People living in the home were very positive about the care and facilities provided to them. Comments such as “Staff are very good - they come when we call and are always polite and courteous’ “I have no complaints, staff are very good and look after me well” “ I am happy living here” There was a medication policy in place and the manager regularly audits the management of medication at the home. Medication at the home is well managed which ensures the residents receive the medications that are prescribed and their safety is maintained. Rangemore Nursing Home DS0000018779.V334350.R01.S.doc Version 5.2 Page 13 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,14,15 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The routines of daily living and activities available are flexible and varied to suit residents’ expectations, preferences and capacities. EVIDENCE: A new activities co-ordinator has recently been employed and the staff spoken with described him as very good. They said residents enjoy the activities he arranges, and he is able to encourage some residents to join in. Some of his time is spent with 1:1 activities and some with small groups. Reminiscence, indoor games, music and crafts are some of the activities which take place.He has recently attended a one day course to enable him to improve the activities on offer. Rangemore Nursing Home DS0000018779.V334350.R01.S.doc Version 5.2 Page 14 The relatives spoken with said that they were could visit the home at any reasonable time and links with the local community were maintained. Personal mail was delivered unopened, or given to relatives if appropriate. Meals can be taken in the dining room or in the privacy of residents’ own rooms. There is a menu that has the flexibility to meet individual needs and choices. Residents spoken with said that the food was good. Rangemore Nursing Home DS0000018779.V334350.R01.S.doc Version 5.2 Page 15 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. JUDGEMENT – we looked at outcomes for the following standard(s): 16,18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents have access to a complaints procedure and are protected from abuse. EVIDENCE: There is a complaints procedure displayed on the notice board so that people living in the home and visiting relatives and friends are aware of how to make a complaint if they so wish. People living in the home said that they were give information on how to make a complaint and that this information is kept in a folder in their room. All of them said that they would feel able to complain if they had a problem. The complaints record file was checked and gave details of two complaints received during the last twelve months. Details of both complaints had been well recorded, complainants had received timely responses and appropriate action had been taken to reach resolutions. One complaint has been made to staff at the home since the last inspection. This was a verbal complaint and the acting manager responded quickly to the concern in writing. However records of the verbal complaint were not made at the time, it is advisable to make such records so that the management of the home are aware of all aspects of the complaint. Rangemore Nursing Home DS0000018779.V334350.R01.S.doc Version 5.2 Page 16 There is a policy on adult protection in place. Members of staff have attended training and so would know what to do should an allegation of abuse or misconduct arise. Rangemore Nursing Home DS0000018779.V334350.R01.S.doc Version 5.2 Page 17 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. JUDGEMENT – we looked at outcomes for the following standard(s): 19,26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home provides a clean and comfortable environment for the people to live in. EVIDENCE: Since the last inspection the dementia care unit has been increased from 12 beds to 18 beds. An area of the ground floor has been refurbished to accommodate this increase with a small kitchenette area in the lounge so that staff can make drinks for the residents on request. A door with a keypad has been installed and radiator covers have been put on all radiators in this area of the home to enable the safety of these residents to be maintained. Rangemore Nursing Home DS0000018779.V334350.R01.S.doc Version 5.2 Page 18 Redecoration at the home is on going and a new bathroom and shower room has been installed to enable the residents to have a choice of a bath or shower. The home was clean and fresh on the day of the site visit. Bedrooms were personalised with residents’ own possessions and treasures. Rangemore Nursing Home DS0000018779.V334350.R01.S.doc Version 5.2 Page 19 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. JUDGEMENT – we looked at outcomes for the following standard(s): 27,28,29,30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Staffing levels and skill mix are sufficient to meet the needs of the residents, Residents are protected by the home’s recruitment practices and staff training. EVIDENCE: The staff group at Rangemore have been continuing with their training, and are working towards reaching the target of 50 trained care staff trained in |NVQ level 2 in care. The home has thirty per cent of carers qualified at present and has nine carers who are undertaking the training at present. All staff of which English is not their first language have been enrolled to undertake an English course at the local college. The staff spoken with said their mandatory training was updated as required and all felt there was sufficient training available. A training matrix is in place and the inspector looked at this. The staff group felt well supported by the management of the home. The staff at the home were able to meet the diverse needs of the residents living there. Rangemore Nursing Home DS0000018779.V334350.R01.S.doc Version 5.2 Page 20 Good policies and procedures are in place for the recruitment of staff. Four staff files were seen and each contained evidence of an interview, two references and the necessary POVA and CRB checks having been obtained before the staff member started working in the home. This provides a level of security and safety for residents. Rangemore Nursing Home DS0000018779.V334350.R01.S.doc Version 5.2 Page 21 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. JUDGEMENT – we looked at outcomes for the following standard(s): 31,33,35,38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The health, safety and welfare of the service users are protected. EVIDENCE: Residents commented that they felt the home was well run and that the manager and staff were very welcoming and friendly. The manager is a registered nurse with many years of management. The deputy manager and general manger have achieved the NVQ level four in management. The owner is at the home on a daily basis and is very “hands on.” The systems for the recording of any monies or valuables held were good. Rangemore Nursing Home DS0000018779.V334350.R01.S.doc Version 5.2 Page 22 Safe working practices include fire safety in which all weekly checks are carried out and recorded, up to date certificates for gas safety, electrical safety, portable appliance testing and tests and servicing for all equipment for moving and handling. These checks ensure that the residents are being protected by the procedures in place. This information was sent to CSCI in the form of a pre-inspection questionnaire before the site visit by the manager of the home. The home has various quality assurances in place to maintain the safety and well being of the residents living at Rangemore. Rangemore Nursing Home DS0000018779.V334350.R01.S.doc Version 5.2 Page 23 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 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X X X X X 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X X 3 Rangemore Nursing Home DS0000018779.V334350.R01.S.doc Version 5.2 Page 24 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. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Rangemore Nursing Home DS0000018779.V334350.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Northwich Local Office Unit D Off Rudheath Way Gadbrook Park Northwich CW9 7LT National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 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 Rangemore Nursing Home DS0000018779.V334350.R01.S.doc Version 5.2 Page 26 - 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!