Inspection on 10/12/07 for Shalden Grange

This inspection was carried out on 10th December 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

Shalden Grange 20/01/09

Shalden Grange 30/05/06

Shalden Grange 16/02/06

Shalden Grange 04/10/05

Shalden Grange 24/11/04

Shalden Grange 23/06/04

Shalden Grange 22/03/04

Similar services:

Fairfields Country Rest Home

Poldhu

Queensmount

Trevaylor Manor

Didsbury Court Rest Home

Belma

Hunters Care Centre

Manor Lodge

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

CARE HOMES FOR OLDER PEOPLE Shalden Grange 1-3 Watkin Road Boscombe Bournemouth Dorset BH5 1HP Lead Inspector Martin Bayne Key Unannounced Inspection 10th December 2007 9:00 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 Shalden Grange DS0000003979.V356416.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. Shalden Grange DS0000003979.V356416.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Shalden Grange Address 1-3 Watkin Road Boscombe Bournemouth Dorset BH5 1HP 01202 301918 01202 300663 shaldengrange@btinternet.com 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 Amrik Singh Benepal Mrs Kuldeep Kaur Benepal Care Home 35 Category(ies) of Old age, not falling within any other category registration, with number (35) of places Shalden Grange DS0000003979.V356416.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. One named service user (as known to CSCI) in the category LD (Learning Disability) may be accommodated. 30th May 2006 Date of last inspection Brief Description of the Service: Shalden Grange is registered to provide accommodation and personal care for 35 older people with frailty of old age. The home is situated in a residential area of Boscombe within half a mile of the shops and also the seafront. The home is made up of two large older properties with a single floor extension between the two. The ground floor connecting extension provides the communal areas with a reception conservatory, main lounge, dining room, kitchen and second conservatory. There are also three resident’s bedrooms with all other bedrooms provided in the older properties at either end of the home. One of the properties has a shaft lift for accessing the floors above ground level. The other property now has a stair lift so residents accommodated here can access the upper floors safely. Shalden Grange DS0000003979.V356416.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. We carried out a key inspection at Shalden Grange on 10th December 2007, the aim of which was to evaluate the home against the key National Minimum Standards for older people. There were no requirements made at the last inspection. Since the time of the last key inspection in May 2006 the then Registered Manager has ceased working at the home and a new manager has been appointed. This person has applied to the Commission to become Registered Manager of the Home. We, (the Commission), looked at the records that the home is required to keep up to date, providing evidence of the care provided at the home. We used the care records for three residents who were admitted to the home since the time of the last inspection to track the home’s compliance with required record keeping. We also toured the premises and spoke individually with nine residents who had congregated in the main living room. We also spoke with three members of staff about their experience of working at the home. The returned and completed Annual Quality Assurance Assessment document was used to help inform the judgements within this inspection. A range of comment cards was left at the home for relatives, care managers and health professionals to complete and the returned responses also assisted in forming judgements about the home. The fees for the home range from £268 – 431 per week. What the service does well: Residents’ needs are assessed prior to their being offered a place at the home. Health and social needs are met through the assessment process of the home. Residents gave good accounts of the way they were treated at the home and they spoke highly of the staff. A good standard of food is provided at the home. The staff are recruited and trained in line with best practice. The home is well managed and run in the interests of the residents. Shalden Grange DS0000003979.V356416.R01.S.doc Version 5.2 Page 6 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. Shalden Grange DS0000003979.V356416.R01.S.doc Version 5.2 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 Shalden Grange DS0000003979.V356416.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 36 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Residents benefit from their needs being assessed before being offered a place at the home, however records should be kept of the assessment and a formal offer of a place made by letter to the person as evidence of how the home meets National Minimum Standards. EVIDENCE: We tracked the personal files for three residents admitted to the home since the time of the last inspection. Two were funded through care management arrangements with the local Council and the other person was privately funded. In the case of the two people funded through care management arrangements, a copy of the care management assessment and care plans had been obtained through the placing social worker. The manager informed that Shalden Grange DS0000003979.V356416.R01.S.doc Version 5.2 Page 9 in all cases, he or the deputy manager would go out and carry out a preadmission assessment with the person referred. Should the home be able to meet the person’s needs, a trial period of twenty-eight days is offered. In the case of the person privately funded, there were no notes kept of the preadmission assessment. It was recommended and agreed that notes would be kept in future of any pre-admission assessment so that there was evidence of the assessment taking place. We asked to see copies of letters that the home should send to a person who is offered a place at the home that informs them that a formal offer is being made as the home has assessed that their needs can be met at the home. We were informed that these letters had not been sent. A requirement was made that for future placements, such letters are sent out as required by the Regulations. The home does not provide an intermediate care service. Shalden Grange DS0000003979.V356416.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 7 8 9 10 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Residents benefit from their health and social needs being assessed but care plans could be improved by being personalised to the setting of the home. Residents also benefit from the medication being administered safely. EVIDENCE: The manager informed us that where Social Services care plans had been supplied, these was being used by the staff to meet the care needs of residents. Where residents were self-funding a plan of care would be developed from the pre-admission assessment together with the resident concerned. The subject of care planning was discussed with the manager. It was required and was agreed that care plans, personalised to the needs of each resident be developed from the care management care plan with the person referred. It is further required that the care plans are reviewed each Shalden Grange DS0000003979.V356416.R01.S.doc Version 5.2 Page 11 month so as to ensure that they are kept up to date. We found on some personal files, examples of summary care plans for the staff that recorded succinctly the care expectations placed upon the staff. It was agreed that these were useful for the staff and should be developed for all residents. Concerning risk assessments, we were shown specific risk assessments that had been carried out for people with specific needs, such as one person who had complex moving and handling needs. It was agreed that in general risk assessments should be written up together within the care plan, so that staff are informed of how to deliver care needs safely. We found that there was a photo on the front of each person’s personal file to enable new staff to identify that person. We also found that where care plans identified some expectation of the staff, such as monitoring skin care or nutrition of a resident, individual monitoring charts were in place to record that these care interventions had been put in place. Within people’s care plans we found examples of how medical needs were being met. Each resident was registered with one of the local GP surgeries and on the day of inspection, the district nurses were visiting the home to meet the nursing needs of residents. We also saw that arrangements were made for meeting chiropody, dentistry and optician needs of residents. In the case of one person tracked though the inspection there was evidence of the home contacting the Community Mental Health Team to meet the psychological needs of that person. We also spoke to a person who had medical problems and was told that the home had made arrangements for these to be treated. The manager informed us that all the staff who administer medication to residents had been trained in safe medication administration. We saw the completed medication administration records for all of the residents and we found that these had been completed with no gaps within the records. We saw some examples of where hand entries had had to be made to the printed sheets. It is recommended that in these cases, a second member of staff checks the record for any inaccuracies and signs to inform that the record has been completed correctly. We also recommended that any allergies be recorded on the medication administration records or ‘None know’ be recorded. We also saw that a sample of staff signatures had been recorded at the front of the medication administration records, thus informing of which staff had been involved in medication administration. We saw the medication cabinet where the unit dosage system was stored. On a cursory look it appeared that medicines were being stored correctly with oral medications kept separate from topical medicines. We were told that there was accountability for the medication cabinet with one person holding he key to the cabinet each shift. Concerning respect and dignity, in general the residents spoken with informed that they were treated well at the home and that there was a friendly, caring staff team. Returned comment cards informed that the staff were caring and that health needs of residents were being met. Shalden Grange DS0000003979.V356416.R01.S.doc Version 5.2 Page 12 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. Residents benefit from the social and recreational needs being met, by being able to maintain contact with friends and families and through being offered a varied and balanced diet. EVIDENCE: The manager informed that the recreational and leisure needs of the residents were being met as these needs are assessed as part of the overall assessment process when a person moves into the home. We saw a notice board in the hallway that informs residents of the activities taking place for the week ahead in the home as well as pictures of previous outings and activities. We saw that there was some activity provided each day of the week. These included Bingo once or twice a week; craft sessions provided by an external staff member once a week, a visiting person who arranges light exercises for residents every three weeks, board and card games, ‘Pat’ the dog and the hairdresser visiting once a week. Shalden Grange DS0000003979.V356416.R01.S.doc Version 5.2 Page 13 We were also informed that a Church of England service is held in the home once a month and that a priest visits a person of Catholic faith once a week. The Salvation Army also visits the home and play music to residents. Residents spoken with informed that they could receive visitors at times that suited them and there were no restrictions concerning visitors. Residents spoken with said that they were able to get up and go to bed when they choose, have meals in the dining room or within their room and that generally they were free to make decisions that affected their lives. Risk assessments are carried out by the staff to ensure that residents are supported to make choices within a risk assessment framework. In general the comments made by residents about the food provided in the home were favourable. Residents can either have a continental breakfast served within their room or can go down to the dining room where a cooked breakfast is served. Each day one of the two chefs goes around to residents with the day’s menu and asks residents what their choices are for the midday meal. At lunchtime residents are able to choose from a choice of two main meals or a vegetarian option. Residents informed that they could also ask for variations to meal choices such as having mashed potato instead of chips. In the evenings residents are able to choose either a hot light meal or soup and a selection of sandwiches. The records of food were seen and the preparation of the home cooked midday meal. There was therefore evidence that the home provides a varied and wholesome diet to residents. Shalden Grange DS0000003979.V356416.R01.S.doc Version 5.2 Page 14 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 benefit from a well-publicised complaints procedure and through the staff being trained in adult protection. EVIDENCE: The complaints procedure is detailed within the Service User Guide, the Terms and Conditions of Residence and also is displayed on the resident’s notice board. Residents and their relatives are therefore made well aware of how to make a complaint. The home has a complaints log, which provided details of how complaints were investigated and what the outcome was. Since the time of the last inspection there have been no complaints made to the management of the home, there has however been one referral to Social Services concerning adult protection. This matter has now been resolved with the Registered Providers through changes to procedures within the home. All of the staff receive training in adult protection and the home has copies of all relevant policies and procedures. Shalden Grange DS0000003979.V356416.R01.S.doc Version 5.2 Page 15 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 suitable, safe and well-maintained environment for the residents. EVIDENCE: We were informed that there are plans being negotiated with the Council for an extension to the home with an increase in numbers of places. Since the time of the last inspection a new stair lift has been provided at one end of the building to assist residents gaining access to upper floors of this part of the building. In general the home was found to be well maintained although some areas would benefit from re-decoration, the plan being for these areas to be Shalden Grange DS0000003979.V356416.R01.S.doc Version 5.2 Page 16 addressed when work is carried out on the new extension. The situation will be monitored at future inspections. A tour of the premises was made during which time some residents’ rooms were seen. There was evidence that residents are able to bring their own possessions to personalise their rooms and adequate furniture was being provided. To the rear of the home is an enclosed garden area that was well maintained. The laundry room was seen and this was equipped with commercial machines capable of meeting the laundry needs of the home. Staff are provided with protective clothing of gloves and aprons and it was noted that there was an alcohol gel dispenser provided at the front of the home. On the day of inspection the home was found to be clean with no unpleasant odours. Shalden Grange DS0000003979.V356416.R01.S.doc Version 5.2 Page 17 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. Residents benefit from there being sufficient staff to meet needs of residents and the staff being well trained. EVIDENCE: The manager informed that staffing levels have increased since the last inspection with 7 care staff now on duty between 8am and 2pm, 4 between 2pm and 10pm and during the night time period 2 awake members of staff. The home provides staffing accommodation at both ends of the building so we were told that there are always more staff that could be called to assist during the night if there was a need. The manager and deputy work during the daytime in addition to the care staff and are also available on-call should they be needed. The manager said that the levels of staffing met the needs of the residents. When speaking to residents 2 people said that they thought the home could do with more staff, however the other 7 said that staffing levels were sufficient. The staff spoken with said that they felt staffing levels were adequate and there was no indication from the comment cards that staffing levels were inadequate. Shalden Grange DS0000003979.V356416.R01.S.doc Version 5.2 Page 18 The home employs domestic staff throughout the week. The home also employs two maintenance staff. Since the last inspection there have been three new members of staff recruited to the team. Their employment records were seen and it was found that all of the checks and records required under Schedule 2 of the Regulations were in place. Concerning staff training, we saw the induction training record for new staff that was compliant with standards set by Skills for Care. The home has achieved a level above 50 of staff trained to NVQ level 2 or above. The manager informed that all staff have core mandatory training in areas such as moving and handling, first aid, fire safety, infection control and health and safety. We were informed that courses were being planned to train staff in the new Mental Capacity Act 2005, challenging behaviour and care of people with dementia. Shalden Grange DS0000003979.V356416.R01.S.doc Version 5.2 Page 19 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. Residents benefit from the home being well managed and run in the interests of the residents. EVIDENCE: In May 2007 the Registered Manager ceased working at the home and a new manager has been appointed who is in the process of applying to be Registered Manager of the home. Residents we spoke with made favourable comments about the new manager and the way that the home was managed. The Registered Providers carry out unannounced visits to the home and speak Shalden Grange DS0000003979.V356416.R01.S.doc Version 5.2 Page 20 with residents and staff to ensure that good standards of care are maintained at the home. Residents meetings are held each month with minutes displayed on the residents’ notice board. As detailed earlier in the report, an Adult Protection investigation was carried out earlier in the year after a resident’s money held by the home went missing. The resident in question has been reimbursed by the Registered Provider and new auditing procedures put in place to ensure that there is better accountability for residents’ money. We checked the records and balance of money held for two residents who choose to have money held for safe keeping by the home. The records were detailed and the balance of money held tallied with the records. Details of checks and servicing of equipment in the home were detailed in the Annual Quality Assurance Assessment. There were no hazards identified during the inspection. Shalden Grange DS0000003979.V356416.R01.S.doc Version 5.2 Page 21 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 2 X X X HEALTH AND PERSONAL CARE Standard No Score 7 2 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 Shalden Grange DS0000003979.V356416.R01.S.doc Version 5.2 Page 22 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. 1. Standard OP7 Regulation 15 Requirement Timescale for action 01/03/08 2. OP3 14 (1) (d) Care plans must be developed for each service user that are kept under review and developed where possible in consultation with the service user. Following a successful 01/02/08 assessment of need, the registered person must confirm in writing to the service user that having regard to the assessment the care home is suitable for the purpose of meeting the service user’s needs in respect to his health and welfare. 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 Written records of pre-admission assessments should be kept to provide evidence that the assessment has taken place. Shalden Grange DS0000003979.V356416.R01.S.doc Version 5.2 Page 23 2. OP9 3. OP9 Where hand entries are made to the medication administration records, these should be checked and signed by a second person to validate that the entry is correct. A record of known allergies should be maintained on the medication administration record. Shalden Grange DS0000003979.V356416.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Poole Office Unit 4 New Fields Business Park Stinsford Road Poole BH17 0NF 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 Shalden Grange DS0000003979.V356416.R01.S.doc Version 5.2 Page 25 - 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!