Inspection on 19/12/05 for Romford Grange Nursing Home

This inspection was carried out on 19th December 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.

Other inspections for this house

Romford Grange Nursing Home 14/11/07

Romford Grange Nursing Home 26/06/06

Romford Grange Nursing Home 28/10/04

Romford Grange Nursing Home 29/04/04

Similar services:

Henry Nihill House

Birchwood

The Infirmary

Orchard House Nursing Home

St Josephs Rest Home

Red Court Nursing Home

Spinney (The)

Queen Elizabeth House

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

CARE HOMES FOR OLDER PEOPLE Romford Grange Nursing Home 144 Collier Row Lane Romford Essex RM5 3DU Lead Inspector Ms Edi O`Farrell Unannounced Inspection 19th December 2005 13:55 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 DS0000015601.V271501.R01.S.doc Version 5.0 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. DS0000015601.V271501.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Romford Grange Nursing Home Address 144 Collier Row Lane Romford Essex RM5 3DU 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) 01708 755 185 01708 754 454 romfordgrange@highfield.care.com Southern Cross Care Homes Limited Maureen O`Connor Care Home 41 Category(ies) of Old age, not falling within any other category registration, with number (41) of places DS0000015601.V271501.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 23rd May 2005 Brief Description of the Service: Romford Grange is a purpose built care home with nursing situated in a residential area of Romford. It is within walking distance of local shops, and on several bus routes into Romford town centre. The home is registered for 41 older people, who need 24-hour nursing and personal care. There are bedrooms on the ground and upper floor, and a passenger lift that is wheelchair accessible. One of the bedrooms on the upper floor has been converted into a sensory room. There is a large, open plan, lounge and dinning area on the ground floor, plus a smaller, similar purpose room, which is also used for meetings. The bedrooms are all single, but do not have ensuite toilets, so each room has a commode. There are bathrooms and toilets on both floors. A small patio area off the main lounge contains raised planted beds, and outdoor seating. Individual care planning is used to identify needs, and how these should be met. A hairdresser and a chiropodist visit on a regular basis. Southern Cross Ltd, which is a large private sector provider operate the home. DS0000015601.V271501.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This, unannounced, inspection took place on a weekday afternoon through to early evening. This was the second statutory visit in the inspection programme for 2005/6. Over the course of the two visits, all core standards have now been assessed. Four Requirements were set at the previous inspection and two of these remain outstanding. The focus of the inspection was on checking the standards not assessed at the last visit. Some information from the previous inspection has been used where standards were not tested during this visit. The care being provided to a new admission was discussed with the service users, a relative, and the manager. Conversations with other service users were mainly about preparations for Christmas, and recent social events held in the home. Staff were asked about supervision practice, and medication administration policies and procedures were discussed with a nurse. Financial records were examined and discussed with the administrator. All who contributed to the inspection are thanked for their input, particularly as it was a busy afternoon for staff, being so close to Christmas. What the service does well: What has improved since the last inspection? What they could do better: DS0000015601.V271501.R01.S.doc Version 5.0 Page 6 Some changes need to be made in the checking and recording of medication, and in the checking of staff application forms. 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. DS0000015601.V271501.R01.S.doc Version 5.0 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 DS0000015601.V271501.R01.S.doc Version 5.0 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): 1 and 2 Service users, and their representatives, have the information they need in order to make an informed choice about moving into the home. The change of ownership of the home, earlier this year, is still not reflected in key documents. EVIDENCE: Ownership of the home changed hands earlier in the year, and at the last inspection was a very recent event. A Requirement was set that key documents, such as the Statement of Purpose, Service User Guide, and contracts needed to be amended. The manager reported that this task had not yet been completed, so the Requirement has been brought forward, with a new timescale. This is Requirement 1. DS0000015601.V271501.R01.S.doc Version 5.0 Page 9 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 9 & 11 Some tightening of the checks on in-coming medication, and recording of medication given, is needed, before it is possible to say that service users are always protected. Wishes in the event of dying and death are being very sensitively discussed with service users, and their families. EVIDENCE: The controlled drug cupboard and one of the medicine trolleys were examined along with the medication administration charts. The findings were discussed with a nurse, and fed back to the manager. In general the home has good policies and procedures, and the nurses follow these correctly. However some changes are needed, such as recording the number of tablets given where a PRN (when necessary) medication is prescribed. This is Requirement 2. In one of the boxes checked there were six more tablets than had been recorded as received at the start of the prescription cycle. As the total number remaining corresponded to the number noted on the box as dispensed minus those recorded as given, this appears to have been a mistake made when checking the drugs in. When medication is checked in any discrepancies noted DS0000015601.V271501.R01.S.doc Version 5.0 Page 10 must be raised with the dispensing pharmacist, and a record kept of the outcome. This is Requirement 3. One service user’s medication administration chart did not have a prescription for a controlled drug, though two bottles of the medication were stored in the controlled drugs cabinet. The home must only stock currently prescribed medication. This is Requirement 4. The above three points were discussed in detail with the manager and a nurse, who took immediate steps to rectify them. Immediate Requirement notices were therefore not issued, but the date for compliance is the date of the inspection. At the last two inspections a Requirement has been set that the wishes of service users at the time of their death be established and recorded. This was discussed in some depth with the manager at the last inspection. On checking care plans during this visit it was very clear that a great deal of time and effort has been given to this task. The care plans seen were very clear as to the wishes and anxieties of both service users, and relatives. The care plans detailed how staff should take the discussions further, in a sensitive manner. They not only recorded religion, but the level to which the service user adhered to the beliefs, such as the administration of the last rites. A score of 4, commendable, has been given in recognition of the sensitive and persistent way that the home has pursued this since the last inspection. DS0000015601.V271501.R01.S.doc Version 5.0 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): None at this inspection These standards were not tested on this visit. However evidence from the last inspection was that service users’ lifestyle meets their expectations and preferences. They maintain contact with family, friends and the local community, as they wish. Service users are helped to exercise choice and control over their lives. They receive a wholesome and balanced diet. EVIDENCE: The above standards were not specifically tested on this visit, as there were no outstanding Requirements in relation to the four Standards. At the time of the last inspection all of the outcomes were assessed as met. These standards will be re-tested at a future inspection. DS0000015601.V271501.R01.S.doc Version 5.0 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): 18 Service users are protected from abuse by management taking swift action where any bad practice is suspected, and by staff being aware of adult protection policy and procedure. EVIDENCE: The home has a very person-centred approach, which is evident in the care planning and delivery system. There is also a very open style of management, and a steady stream of visitors. All concerns are responded to, and investigated as soon as they are raised, with good recording systems, which are fair to both service users and staff. All these are elements of a good service, which affords the greatest level of protection possible. DS0000015601.V271501.R01.S.doc Version 5.0 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): None at this inspection These standards were not tested on this visit. However evidence from the last inspection was that service users live in a safe, well-maintained environment, with comfortable indoor and outdoor communal facilities. There are sufficient lavatories and washing facilities, and specialist equipment is in place to maximise independence. Bedrooms suit service users’ needs. The home is clean and hygienic. EVIDENCE: The above standards were not specifically tested on this visit, as there were no outstanding Requirements in relation to the four Standards. At the time of the last inspection all of the outcomes were assessed as met. These standards will be re-tested at a future inspection. DS0000015601.V271501.R01.S.doc Version 5.0 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): 28 & 29 The home has achieved the requirement to have at least 50 of care staff trained to NVQ level 2 by 31/12/05. Some changes to practice are needed in order to ensure that service users are supported and protected by the home’s recruitment policy and procedure. EVIDENCE: The home is currently fully staffed, with a complement of seven nurses, four senior carers, 12 Carers, bank staff, and activity co-ordinator, housekeeper, administrator, cleaners, and laundry staff. Well over 50 of the care staff have NVQ level 2, and there is a training and development programme in place. Three staff files, of people recruited since the last inspection, were examined. All had CRB checks, and two references. Application forms did not always contain full employment history. It is important that all gaps be explored and recorded. It was also not always possible to confirm that former employers had supplied references, as they did not contain such things as company stamps. This is Requirement 5. DS0000015601.V271501.R01.S.doc Version 5.0 Page 15 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): 34, 35, 36, 37 & 38 Service users are safeguarded by the accounting and financial procedures of the home, including the handling of their monies. Staff are appropriately supervised, and the health, safety, and welfare of service users and staff are protected. Policies and procedures still need to be updated so that service users and staff are clear which company is operating the home. EVIDENCE: Service users’ financial records were examined, and discussed with the administrator, who records all transactions. In most cases relatives deal with finances, but in one case the Local Authority has been appointed by the Court of Protection to do so. Monies held in the safe corresponded with the accounts. DS0000015601.V271501.R01.S.doc Version 5.0 Page 16 The manager has a delegated budget for all aspects of the running of the home. She receives monthly management accounts, which are very detailed. She is involved with the budget setting process via the monthly management meeting. She confirmed that where any equipment was needed, in order for individual need to be met, that the company supply this, based on assessment of need. Care staff confirmed that they receive regular individual supervision. The manager reported that, whilst the new owners have updated some policies and procedures, some of the old companies are still being used. This is Requirement 6 brought forward from the previous inspection with a new timescale. Health and Safety records were checked and all was in order. DS0000015601.V271501.R01.S.doc Version 5.0 Page 17 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 2 2 X X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 X 8 X 9 2 10 X 11 4 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 X 13 X 14 X 15 X COMPLAINTS AND PROTECTION Standard No Score 16 X 17 X 18 3 X X X X X X X X STAFFING Standard No Score 27 X 28 3 29 2 30 X MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score X X X 3 3 3 2 3 DS0000015601.V271501.R01.S.doc Version 5.0 Page 18 Are there any outstanding requirements from the last inspection? YES 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 OP1OP2 Regulation 4, 5 & 6 Requirement The Registered Manager must forward sample copies of the updated statement of Purpose, Service User Guide, and statement of terms and conditions/contract to the Commission, and confirm in writing that each service user, and their representative, where appropriate, have received copies. Previous timescale of 31/08/05 not met. Where PRN medication is prescribed as a variable dose the number of tablets administered must be recorded. When medication is checked in any discrepancies must be discussed with the dispensing pharmacist, and the outcome recorded. The home must only stock currently prescribed medication. The recruitment procedure must be robust, and include exploration for all gaps in employment history, and verification of references. The Responsible Person must DS0000015601.V271501.R01.S.doc Timescale for action 31/03/06 2 OP9 13 (2) 19/12/05 3 OP9 13 (2) 19/12/05 4 5 OP9 OP29 13 (2) 19 19/12/05 31/01/06 6 OP37 12 & 13 31/03/06 Page 19 Version 5.0 ensure that all policies and procedures needed to run the home are those of the new owners. Previous timescale of 31/08/05 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. Refer to Standard Good Practice Recommendations DS0000015601.V271501.R01.S.doc Version 5.0 Page 20 Commission for Social Care Inspection Ilford Area Office Ferguson House 113 Cranbrook Road Ilford IG1 4PU 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 DS0000015601.V271501.R01.S.doc Version 5.0 Page 21 - 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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