Inspection on 14/06/07 for Scremby Grange

This inspection was carried out on 14th June 2007.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is (sorry - unknown). 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

Scremby Grange 16/02/06

Scremby Grange 03/02/05

Scremby Grange 03/09/04

Scremby Grange 10/12/03

Similar services:

Hillside

Applegarth

122 Scorer Street

Jubilee Villa Care Home

Thornham Grove

Beech Lodge

8 Thorndale Road (Homefield College)

Hunter`s Lodge

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

CARE HOME ADULTS 18-65 Scremby Grange Scremby Nr Spilsby Lincolnshire PE23 5RW Lead Inspector Mrs Kathryn Emmons Key Unannounced Inspection 14th June 2007 11:00 Scremby Grange DS0000002414.V329293.R01.S.doc Version 5.2 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 Scremby Grange DS0000002414.V329293.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 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. Scremby Grange DS0000002414.V329293.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Scremby Grange Address Scremby Nr Spilsby Lincolnshire PE23 5RW 01754 890339 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) Linkage Community Trust Ms Bridget Anne Rowe Care Home 14 Category(ies) of Learning disability (14) registration, with number of places Scremby Grange DS0000002414.V329293.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 2 February 2006 Brief Description of the Service: The home is a large period property registered for 14 service users with learning disabilities. It is situated just outside the small village of Scremby on the A158 towards Skegness; It is approximately 3 miles from the market town of Spilsby, and directly on a bus route. The home is surrounded by acres of land and the grounds contain a day service and the offices of Linkage community trust who provide the service. This home is a long stay home as long as assessed needs can be met and there are opportunities to move to more independent living if this is appropriate. The fees range from £508.75 - £1081 per week depending on assessed needs and level of support required. Scremby Grange DS0000002414.V329293.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. A visit to the service took place on June 14 2007. This visit was unannounced and took place over 4 hours. Care received by three residents was looked at in detail. This is a method called case tracking. This included looking at their personal records, a range of general home records and staff records. Residents were also spoken to including those whose care was not looked at in detail. Staff and the manager were spoken with and the care they provided was observed. Ten residents completed comment cards sent to the service by us and the detail in these was also used to provide information about living at the home. We also sent a pre inspection questionnaire to the registered manager to provide information before we did a site visit. We spoke with five residents on the day of the inspection to discuss their views of the home. We also had a telephone conversation with another resident who wasn’t in the home on the day of the visit. We also looked at how the provider makes information about their service, including CSCI reports available to prospective service users. Residents made comments such as ‘the house parents are nice” and “I like it here” and “I am happy living here”. Other comments made by residents and staff can be seen in the main body of the report. What the service does well: Residents live in well furnished and decorated accommodation, which they have been able to make decisions about regarding layout and colour schemes. Staff are safely recruited and receive an in depth induction and ongoing training programme. Residents are further supported by access to a professional network of health care professionals such as psychologists and psychiatrists. A competent manager who both staff and residents say many positive comments about manages the home. Residents have systems in place to ensure that they have control over how the service operates and the registered providers also ensure that through quality assurance systems resident’s views are listened to. Residents have many opportunities to engage in occupation and social activities including choice of where to work or attend education classes. Observations on the day evidence that residents can choose how they spend their spare time. Access to the community is encouraged and on the day of the visit residents were out and about using both public transport and the services own cars. Resident’s verbal feedback to us indicates that they have purposeful lives with an emphasis on them having the choice over how they spend they lives. The Scremby Grange DS0000002414.V329293.R01.S.doc Version 5.2 Page 6 service had a clear ethos through the statement of purpose to encourage residents to fulfil their maximum potential. What has improved since the last inspection? 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. The summary of this inspection report can be made available in other formats on request. Scremby Grange DS0000002414.V329293.R01.S.doc Version 5.2 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 Scremby Grange DS0000002414.V329293.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 2 Quality in this outcome area is Good. This judgement has been made using available evidence including a visit to this service. Residents are satisfied that there individual needs are assessed prior to admission to the service and are met on admission to the home. EVIDENCE: Residents told us that when they chose to live at the service they were given a lot of information to help them make a decision. One resident said they had visited the service before they came to live there. The service statement of purpose and service user guide provide up to date information about the service including who works at the service and what residents can expect from the service. Residents said that when they had moved into the home the “house parents knew how to help me”, and “all knew who I was and who my parents are” This tells us that pre admission information is gathered to fully assess if residents needs can be met at the service. Scremby Grange DS0000002414.V329293.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 6,7 and 9. Quality in this outcome area is Good This judgement has been made using available evidence including a visit to this service. Resident’s rights are upheld and they are given choice over how they spend their lives. Written records provide residents with confidence that their needs are known and are able to be kept safe. EVIDENCE: Residents spoken to were aware of written records, which are, kept regarding their assessed needs and support they require. Two residents were able to tell us about how their care plans had been written and how they had been involved in the information that went into them and further reviews. Staff were clear on the person centred planning, which is the term used for the care plans the service use. Staff were able to talk about the care plans and their involvement in writing and reviewing them. There were written records to show that regular reviews had taken place and that the resident had attended these. Where possible residents sign the plans to show their involvement. Scremby Grange DS0000002414.V329293.R01.S.doc Version 5.2 Page 10 Detailed risk assessments are in place and where a resident was not able to undertake a specific task without support an explanation was recorded. Residents told us that they “can chose what I do and staff help me if it could be dangerous without help”. Staff discussion and written risk assessments show us that staff understand the need to balance residents right to take risks against residents being placed in potential danger. Scremby Grange DS0000002414.V329293.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,15,16 and 17 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Residents have educational and occupation opportunities available to them so they can have a worthwhile and fulfilling lifestyle. Relationships and friendships are supported. Catering needs and preferences are catered for. EVIDENCE: Residents told us and we could see from the records we looked at as part of case tracking that residents are engaged in meaning full activities. Residents are supported to attend a mixture of education sessions which are operated at the own organisations education centre or residents can attend the local community further education centres. Residents also have the opportunity to attend paid work and risk assessments for this were on the files inspected. Residents at the time of the visit were planning another holiday to some log cabins and two residents spoke about a recent holiday they had been on. Social activities are varied and residents can chose how they spend their free Scremby Grange DS0000002414.V329293.R01.S.doc Version 5.2 Page 12 time. Residents gave examples such as going to the cinema, out for meals and going swimming and bowling. At the time of the visit one resident was going clothes shopping and another was going to buy some pet supplies for two new rabbits the service had been given and their own hamsters. Staff were able to identify their responsibilities in relation to residents being able to have relationships and continue to have good relationships with family and friends. One resident told us that he was able to speak with his family every day and the staff helped them to do this. Another resident said his partner was able to visit the home and they were able to spend time together. Residents spoken with said they thoroughly enjoyed the food they prepare and chose. At the time of the visit residents were being supported by care staff to do the weekly shopping. One resident said they had chosen to be on a weight reducing diet and that staff were supporting them with this. Another resident has specialized dietary requirements and these were also being met. Residents were observed being able to help themselves to drinks and we were told that fresh fruit was always available for snacks. Two residents confirmed this. Scremby Grange DS0000002414.V329293.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 18,19 and 20 Quality in this outcome area is excellent This judgement has been made using available evidence including a visit to this service. Residents preferred choice of support is provided. Residents are protected by the services medication polices and procedures. EVIDENCE: Through care plans staff were clear on the level of support each resident needs. Staff were able to say how they meet individual residents needs. Residents told us that they received care how they chose to and that they are able to chose if they receive care from male or female staff. Through care plans seen it was evident that staff worked with residents to move them towards being as independent as possible. Medication records seen were completed correctly and there was a clear audit trail of medications being received into the home and through to being administered and reordered. One service user self medicates their medication with support from staff. This means that they can be more independent and do not require intervention from community nursing staff. Clear guidance sheets Scremby Grange DS0000002414.V329293.R01.S.doc Version 5.2 Page 14 are in place for this particular resident so staff are clear on how the procedure is carried out. Case tracking records showed that residents have access to well man and well women clinics and information regarding this is in symbol format. We also saw “hospital passports” which is information about the resident which will go to hospital with them so nursing staff can know each residents individual needs. The service have access to local GP’s and community nursing staff including Community Psychiatric Nurses(CPN) and physiotherapists. The service also employs its own on call psychiatrist and psychologist. Residents told us that they were sure that if they were unwell “I can always see some one they (staff) will take me to see a doctor”. Scremby Grange DS0000002414.V329293.R01.S.doc Version 5.2 Page 15 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. JUDGEMENT – we looked at outcomes for the following standard(s): 22 and 23. Quality in this outcome area is excellent This judgement has been made using available evidence including a visit to this service. Residents are confident that any concerns or comment they make are responded to in an appropriate and timely way. Safe guarding adults systems protect residents EVIDENCE: Residents told us that they are able to make any concern or comment they have known to the manger or staff. A concerns and comment book is in place and this was seen. All concerns are recorded in the book with the action taken. The service manager, to ensure the complaints procedure has been followed also reviews this. The complaints procedure is included in the service users guide and was also on display. Residents told us “I am safe here and Bridget (Manager) will sort anything out”. Comment cards returned to us all indicated that residents know they could speak to staff or the manager or their family about any concerns they had. Comment cards also indicated that all residents felt that staff always listen to them and actioned what they said. Residents also have access to advocacy services. Staff spoken to knew what to do if a safe guarding adult allegation was made. Staff records showed that relevant training had been given and when staff were given a scenario they were able to answer appropriately. . The services safeguarding adult policy is regularly reviewed and forms part of the services polices and procedures. Scremby Grange DS0000002414.V329293.R01.S.doc Version 5.2 Page 16 Scremby Grange DS0000002414.V329293.R01.S.doc Version 5.2 Page 17 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. JUDGEMENT – we looked at outcomes for the following standard(s): 24 ,25 and 30 Quality in this outcome area is Excellent This judgement has been made using available evidence including a visit to this service. Residents live in clean and comfortable surroundings, which they have, control over. EVIDENCE: Since the last visit building work has started in the grounds of the service to build 4 bungalows. This will enable residents who are moving towards more independent living and those residents who benefit from having more personal space to have an improved quality of life. Comment cards received form residents indicted they thought the home was “always clean and fresh”. A cleaner works in the house for a few hours a day and residents and staff work together to keep the house clean and tidy. Residents said their key worker helps them keep their bedrooms clean and tidy. Four residents gave permission for us to look at their bedrooms. All of Scremby Grange DS0000002414.V329293.R01.S.doc Version 5.2 Page 18 these were different and residents told us they have been able to choose their own colour scheme and bedroom furniture. Residents have a bedroom door key and a front door key. This encourages them to see the service as their own home. Residents are encouraged to make decisions regarding the homes layout and decor. One room is a dedicated quiet lounge and the other lounge has a television and music system. Residents have computer access and are able to have music and televisions in their own rooms. The style of the décor is fresh and modern and one resident told us they “like the lounge because its bright and nice to sit in”. The kitchen was clean and tidy and residents where necessary, are supported to use the kitchen . Chemicals used in the kitchen and laundry are kept in secure cupboards. The grounds the home is set in are extensive and well maintained. The home is on the same site as the organisations education resources centre but assess to the house is limited. Residents open the door and welcome visitors into the house. This also indicates that residents are encouraged to take ownership of the house as their own home. Scremby Grange DS0000002414.V329293.R01.S.doc Version 5.2 Page 19 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. JUDGEMENT – we looked at outcomes for the following standard(s): 32,34,and 35 Quality in this outcome area is Good. This judgement has been made using available evidence including a visit to the service. A safely recruited and skilled care team supports residents. Residents can be confident that staff know how to deliver the support they need in a kind and appropriate manner. EVIDENCE: Comment cards returned from residents all indicated that “always” staff treat them well. When we spoke to residents they spoke highly of the staff and made comments such as “I like the house parents” “the house is good”. Residents told us that staff spoke to them in a “nice way and always having a laugh with us”. Interactions were seen between staff and residents and these were valuing and appropriate. Staff are clear on the best way to effectively communicate with the residents and how to word questions so the residents got the best understanding possible. Staff records showed a thorough recruitment procedure with all relevant checks such as references and Criminal record bureau checks (CRB’s) in place. An in depth induction programme is in place and one staff who is new was working with another staff member shadowing them for a few weeks. Scremby Grange DS0000002414.V329293.R01.S.doc Version 5.2 Page 20 An ongoing training programme is in place and staff spoke about recent mediation training and first aid training. Staff are supported to gain NVQ’s (national vocational training qualifications) and 60 of the staff have already completed these . Staff work a shift pattern which means that they work form 9am then do a sleeping in night shift then another day and then another sleep in shift and finish the following morning. Staff said that this helped give them continuity of care for residents but sometimes towards the end of the shift pattern, depending on how busy the home had been they could be a little tired but thought the shift pattern did benefit residents. Residents said they liked having staff on duty for a few days at a time and it made it easier to remember who was going to be caring for them. There are always at least 3 staff on duty and more if residents require one to one support for some activities. Residents said they thought there were enough staff on duty and that they knew they could call them day or night if they needed help. The manager confirmed that a supervision system has been set up for all of the staff and that supervision is carried out every 2 months. Staff spoken to confirmed this and supervision records were seen. Scremby Grange DS0000002414.V329293.R01.S.doc Version 5.2 Page 21 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. JUDGEMENT – we looked at outcomes for the following standard(s): 37.39 and 42 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Residents live in a well managed service. They are protected by the health and safety polices which are kept up to date. Quality assurance systems enable residents to make their opinions known. EVIDENCE: The home is managed by Bridget Rowe who is the registered manager. Staff spoken to said they have a good relationship with the manager and that she was open and responsive to any questions or comments they had. The duty rotas showed that the manager is not included in the staff numbers to enable her to undertake management tasks. Scremby Grange DS0000002414.V329293.R01.S.doc Version 5.2 Page 22 Residents told us their views on the service and also completed our comment cards. One resident wrote, “I think the house is good”. Residents we spoke to also said, “I like it here” and “Its good here”. Residents said they found the manager “really nice” and “I can talk to Bridget about anything” . One staff member said “she is really supportive”. A quality assurance system is in place so residents and visitors to the home can comment on how the service operates. Resident meetings are used to inform residents what action is being taken with any comments made. The manager is considering extending the quality assurance questionnaires to external stakeholders such as social workers, doctors and visiting nurses so that views from outside of the home can be considered. The registered individual for the organisation provides a written report monthly from their visits and this is included in the quality assurance system. The inspection reports produced by us are on display as part of the statement of purpose pack. The information we were given before we visited the service showed that the service does not look after resident’s monies and they manage their own financial affairs with support from staff. Pre inspection information evidenced that polices and procedures are maintained. Records are in place at the home, which show that servicing of equipment and systems such as the fire safety system, heating system and portable appliance testing are up to date. Scremby Grange DS0000002414.V329293.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 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 x 4 x 5 x INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 4 23 4 ENVIRONMENT Standard No Score 24 4 25 4 26 x 27 x 28 x 29 x 30 4 STAFFING Standard No Score 31 x 32 3 33 3 34 x 35 4 36 x CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 4 4 x 3 x LIFESTYLES Standard No Score 11 x 12 4 13 4 14 x 15 4 16 4 17 4 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 4 4 4 x 4 x 3 x x 4 x Scremby Grange DS0000002414.V329293.R01.S.doc Version 5.2 Page 24 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. 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 Scremby Grange DS0000002414.V329293.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Nottingham Area Office Edgeley House Riverside Business Park Tottle Road Nottingham NG2 1RT 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 Scremby Grange DS0000002414.V329293.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. 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