Inspection on 23/06/08 for Solent Grange

This inspection was carried out on 23rd June 2008.

CSCI found this care home to be providing an Good service.

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

Solent Grange 23/11/09

Solent Grange 28/06/07

Similar services:

St Vincents

The Cotswold Home

Newbeech House

Winton House

Rush Court

Hillyfield Rest Home

The Maypole Nursing Centre

The Briars

Extracts from inspection reports are licensed from CQC, this page was updated on 28/09/2008.

CARE HOMES FOR OLDER PEOPLE Solent Grange Staplers Road Wootton Isle of Wight PO33 4RW Lead Inspector Janet Ktomi Unannounced Inspection 23rd June 2008 09:45 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 Solent Grange DS0000068218.V365559.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. Solent Grange DS0000068218.V365559.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Solent Grange Address Staplers Road Wootton Isle of Wight PO33 4RW 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) 01983 882382 solent@lrh-homes.com www.lrh-homes.com London Residential Healthcare Limited Angela Clarke Care Home 40 Category(ies) of Dementia - over 65 years of age (40), Old age, registration, with number not falling within any other category (40) of places Solent Grange DS0000068218.V365559.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 28th June 2007 Brief Description of the Service: Solent Grange is a registered residential home providing care and accommodation for up to forty older people who may or may not have dementia. Solent Grange is located in an extended older property in a rural location yet within a short bus ride or car journey from the town of Newport. The majority of bedrooms are for single occupation some with en-suite facilities. The home is in the process of completing an extension to provide additional bedrooms, bathrooms and communal areas. The home is owned by London Residential Healthcare Ltd and managed by registered manager Mrs Angela Clarke. The current range of fees is £350.00 - £500.00 dependant on the assessed needs of the person. This information was obtained at the time of the inspection visit. Members of the public may wish to obtain more up-to-date information from the care home. Solent Grange DS0000068218.V365559.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 2 star. This means the people who use this service experience good quality outcomes. This report contains information gained prior to and during an unannounced visit to the home undertaken on the 23rd June 2008. All core standards and a number of additional standards were assessed. The visit to the home was undertaken by one inspector and lasted approximately seven and a half hours commencing at 9.45 am and being completed at 5.00 p.m. The inspector was able to spend time with the registered manager and staff on duty. The inspector was provided with free access to all areas of the home, documentation requested, visitors and people who live at the home. Prior to the inspection visit the registered manager had completed the homes Annual Quality Assurance Questionnaire (AQAA), this was received at the Commission within the required timescales and information from it is included in this report. Information was also gained from the home’s service file containing notifications of incidents in the home. Surveys were sent to the home for distribution prior to the inspection visit, at the time of writing the report none had been received by the inspector. Following the inspection visit the inspector telephoned local health professional’s who regularly visit the home. What the service does well: The home has a comprehensive pre-admission procedure, which ensures that the home only admits people whose needs it can meet. All evidence indicates that the home ensures that people’s health and care needs are met. The home provides a range of activities, both individual and in groups, employing an activities person five days per week. The home employs appropriate numbers of care staff that ensure that people’s needs are met. Staff receive the necessary training including NVQ’s and training specific to the needs of the people living at the home such as dementia and challenging behaviour. Solent Grange DS0000068218.V365559.R01.S.doc Version 5.2 Page 6 The registered manager has the necessary skills and experience to ensure the home is run in the best interests of the people who live there. The registered manager is supported by a deputy and by senior staff in the provider’s organisation. What has improved since the last inspection? What they could do better: It was identified during this inspection visit that one of the upstairs windows did not have a restrictor fitted. This was discussed with the registered manager who investigated and stated that the opening restrictor had broken and that she would ensure that this was immediately repaired. Some other upstairs windows were checked and were fitted with opening restrictors. The registered manager also stated that she would undertake a regular check of opening restrictors and remind staff of the need to report any that become nonfunctioning. Parts of the home are in need of refurbishment and redecorating, the registered manager stated that this is all planned as part of the new extension and upgrading of the facilities in the existing home. A requirement is therefore not made in respect of this as there are already plans to undertake all the necessary work and there was evidence that some work has already commenced. The sign at the entrance to the homes driveway must be replaced by one stating the correct provider details. Solent Grange DS0000068218.V365559.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. Solent Grange DS0000068218.V365559.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 Solent Grange DS0000068218.V365559.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, 4 and 5 People who use the service experience good outcomes in this area. This judgement has been made using available evidence including a visit to this service. All people are assessed prior to moving into the home to determine that their individual needs can be fully met. People, or their representatives, are able to visit the home prior to admission to assess the quality, facilities and suitability of the home. Standard 6 is not applicable, as the home does not provide intermediate care. EVIDENCE: The registered manager explained the homes admission procedure and the pre-admission assessment for two people admitted shortly before the inspection visit were viewed. The inspector discussed admissions with care staff and with relatives of people living at the home who were visiting on the Solent Grange DS0000068218.V365559.R01.S.doc Version 5.2 Page 10 day of the inspection visit. Due to age related memory loss it was not possible to discuss the admission process with the people who live at the home. The registered manager stated that if an initial enquiry from either social services or from a person or their family indicates that the home would be able to meet the persons needs the manager (and where possible the deputy) will arrange to visit the person, either at their home or in hospital. A comprehensive pre-admission assessment is completed including where possible members of the persons family and professionals involved in their care. Care manager assessments were also seen in care plans viewed. The person is provided with information about the home and where practicable is invited to visit the home before making the decision as to whether to move in on an initial trial basis. When the person is unable to visit the home a relative is invited to view the available room and facilities at the home. The home has an assessment tool that covers all the relevant areas necessary for the home to decide if it is able to meet a prospective persons needs. The manager was clear about the level of care needs the home can accommodate. The registered manager stated that she will also visit and if necessary reassess people who have been admitted to hospital before they are discharged back to the home to ensure that their needs can continue to be met. Discussions with relatives who were visiting the home at the time of the unannounced inspection visit confirmed that they had received written information about the home and been able to visit the home prior to their relative moving into the home. They also confirmed that someone from the home had visited their relative prior to admission and that information about the person had been sought. Discussions with care staff confirmed that they felt they had enough information about new people admitted to the home and that they had the training to meet people’s needs. People living at Solent Grange tend to be long term, however the home could provide respite or short stay accommodation if a suitable room were available. The registered manager stated that the same admission procedures would be used for respite or short stay admissions as for long-term admissions. The home does not provide dedicated accommodation for, intermediate care or specialised facilities for rehabilitation. Solent Grange DS0000068218.V365559.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 and 10. People who use the service experience good outcomes in this area. This judgement has been made using available evidence including a visit to this service. People’s health, personal and social care needs are set out in an individual plan of care that clearly states how peoples needs should be met. Medication is correctly stored and administered with full records maintained. People are generally treated with respect and their dignity maintained. EVIDENCE: Four care plans were viewed, two for people admitted to the home in the three months prior to the inspection visit and the other’s for people who have been living at the home for a longer time. The inspector discussed with staff, visitors and people who live at the home how care needs are met. Following the inspection visit the inspector telephoned health professional’s who regularly visit the home. People have a detailed plan of care that related to the persons assessment. The care plans follow an activities of daily living format and are individualised Solent Grange DS0000068218.V365559.R01.S.doc Version 5.2 Page 12 and person centred being written in plain language providing detailed information as to how needs should be met. Plans are reviewed on a monthly basis. Photographs were seen in care plans. Care plans contained relevant risk assessments and management plans including nutrition, falls and any individual risks such as those resulting from age related memory loss and how inappropriate behaviours should be managed. Risk assessments viewed appeared appropriate to the persons needs. The home monitors peoples weight on a monthly basis with records being seen. Care staff spoken with said that communication about residents needs was good, with regular shift handovers, staff meetings and supervision. The inspector was able to talk with the relatives of people who live at the home who stated that they felt their relative always received the care and support (including medical care) they need. They also stated that they were kept informed of any issues or concerns. Health professional’s who regularly visit the home were telephoned following the inspection visit. They stated that they had no concerns about the home and felt that staff had knowledge about the people who live there and that peoples health needs were met. The health professionals also felt that the home consulted them when necessary and followed the advice and guidance given. One added that the home has ‘a low incidence of skin flap injuries indicating good manual handling and low incidents of falls and accidents’. Care plans contained individual manual handling assessments. Manual handling equipment was viewed in the home and care staff stated that they had received manual handling training and this was recorded in care staff training files viewed. A member of staff has completed a manual handling train the trainer course. Visitors and health professions stated that they felt that staff always treated people who live at the home with dignity and respect. Although it was not possible to have an in depth conversations with the people who live at the home those able responded that the staff were nice and observations of staff interactions indicated that people are treated with respect and their right to dignity maintained. The inspector observed one incident when a person’s dignity was not maintained whilst a hoist was being used. This was raised with the registered manager who stated she would ensure that people’s dignity was maintained at all times. Privacy and dignity are included in the homes induction training. The home has three twin bedrooms, only one was being used as a twin room at the time of the inspection visit and contained screens to ensure privacy during personal care tasks. Care staff confirmed that they had sufficient time to meet people’s needs and discussions indicated that they had a good understanding of individual peoples needs and how these should be met. Care staff have received training to meet the specific needs of people. Solent Grange DS0000068218.V365559.R01.S.doc Version 5.2 Page 13 At the time of the inspection visit nobody was self administering his or her medication. The manager stated during the inspection and on the homes AQAA that staff who administer medication have undertaken training with regard to the safe administration of medication. Care staff confirmed that they have undertaken medication training. The home has a medications room. At the time of the inspection visit this was not in use as some alterations were being made to the home and the medications room was waiting to have new floor covering put down. Medication was being stored in two locked medications trolley’s however one was noted not to be secured to the wall in the hallway where it was located. The other was secured to the wall. During the inspection visit the registered manager ordered the system by which the trolley could be secured to the hall wall therefore a requirement is not made as the necessary action to ensure the security of the trolley has been taken. With the exception of liquids the local pharmacist dispenses most medication into blister packs. As part of the dispensing process the pharmacist labels include a photograph of the person whose medication it is. The home uses medication administration record sheets supplied by the pharmacist (also including a photograph). These were viewed and seen to be fully completed. The home has the necessary storage and recording books for controlled medications. Solent Grange DS0000068218.V365559.R01.S.doc Version 5.2 Page 14 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 and 15 People who use the service experience good outcomes in this area. This judgement has been made using available evidence including a visit to this service. The routines for daily living and activities made available are flexible and varied to suit people’s individual needs. Family and friends are able to visit. People receive a balanced diet in pleasing surroundings at times convenient to them. EVIDENCE: The inspector spent time talking with people in the homes lounges, met people who had chosen to remain in their bedrooms, observed part of the lunchtime meal and met with relatives. The inspector was also able to talk with the homes activities organiser. The routines for daily living and activities made available are flexible and varied to suit people’s individual needs. People living in the home are able to spend their time in the home where they wish, people were seen sitting in both of the homes two lounges, the large entrance hallway and also in their bedrooms. People were also seen moving around the home. Due to the Solent Grange DS0000068218.V365559.R01.S.doc Version 5.2 Page 15 building work access to the homes gardens was not possible at the time of the inspection. The registered manager discussed how she hopes that once the main building work is completed people will be able to access the garden again and that the provider intends to have the garden landscaped to provide a safe pleasant place for people to spend time in. Care plans contained individual information such as times people like to get up and go to bed. Most of the people living at Solent Grange have age related memory loss and care plans contained life history information and recorded peoples likes and dislikes. People confirmed to the inspector that they are given choice over their meals. The inspector heard staff telling people what the pudding options were at lunchtime and saw staff completing supper lists during the afternoon consulting people as to what they would prefer. Bedrooms seen contained personal items brought into the home. Care plans and assessments include information about leisure activities, hobbies/interests, catering and religious needs. The home employs an activities organiser who works five days per week. The inspector viewed records maintained by the activities organiser and discussed activities with her. The activities organiser undertakes both group and individual activities and was observed doing both during the day of the unannounced inspection visit. Full records of activities undertaken by each person who lives in the home and their responses to activities are maintained and demonstrated that people are provided with a range of activities. As well as the activities provided by the activities organiser the home has visiting entertainers and the activities organiser is able to take one person per week out on a 1-1 basis for drives and coffee to places of their choosing. Information about religious needs is included in care plans and the registered manager stated that she has contact details and would arrange visits from appropriate ministers/clergy if this were requested/identified as a need. The inspector was able to meet several visitors’ who stated that they are able to visit at any time. The home does not have a private room for visitors however the home does have a dining room that is not used outside of meal times which could offer a degree of privacy for visitors. The registered manager stated that the extension included a range of communal facilities and that the opportunities for a private room for visiting would then be possible. The home has a separate dining room. Many people were seen to have chosen to have their lunchtime meal at the dining tables however others had their meal in the homes lounges or their rooms. Relatives stated that the food always looked good and people living at the home able to respond informed the inspector that they had enjoyed their lunch. The inspector was present for the main lunchtime meal. People were seen to be eating the meal and most plates were emptied. Approximately half an hour after lunch the inspector saw one person sitting in one of the lounges with her cold dinner partly eaten and Solent Grange DS0000068218.V365559.R01.S.doc Version 5.2 Page 16 her pudding placed beside this on the table in front of her. Care staff were present in the area but had not acted to assist or encourage the person. By this time the food was cold an unappetising. The inspector asked staff about this and they stated that they would organise something else for the person. Care staff stated that most people are able to eat independently and there is sufficient time to provide any support required. In the dining room the inspector heard a senior staff member asking another carer to encourage someone to eat and equipment was available to support people who required lipped plates and adapted cutlery. Drinks and snacks are also available throughout the day with people confirming this as well as the inspector observing people being given morning and afternoon hot drinks and biscuits. The need for special diets or supplements is recorded pre-admission. The preadmission form included information about people’s food likes and dislikes. The cook was aware of the dietary needs of people. Discussions with the cook indicated that where possible fresh vegetables are used and fruit is available. Supplies of fruit and vegetables were delivered to the home by a local supplier during the inspection. Solent Grange DS0000068218.V365559.R01.S.doc Version 5.2 Page 17 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 and 18 People who use the service experience good outcomes in this area. This judgement has been made using available evidence including a visit to this service. People and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. People are protected from abuse. EVIDENCE: The home has a clear complaints policy and procedure and a copy is in the statement of purpose/service users guide. Discussions with staff confirmed they were aware of what to do if a person or their relative complained or raised an issue. The manager identified in the homes AQAA that the home had received no complaints in the past year. Relatives spoken with stated that they did not have any concerns but if they did they would raise this with the manager. The registered manager stated that she would follow the complaints policy and procedure and that the providers monitor and follow up on any complaints received. The home has a policy and procedure relating to safeguarding adults and ensuring that people are not at risk of abuse. One of the homes senior staff has completed train the trainer for safeguarding and is able to provide safeguarding training to care staff. Care staff have safeguarding adults training as part of their induction and has also have undertaken specific update training, evidence of which was seen in staff files and confirmed by staff. Discussions with care staff indicated they had an understanding of Solent Grange DS0000068218.V365559.R01.S.doc Version 5.2 Page 18 safeguarding and what they should do if they suspected abuse may have occurred. Notifications of incidents received at the commission and referrals made by the home to the local social services department confirm that staff identify when a safeguarding issues has occurred and know what action to take. The homes policies and procedures in respect of people’s personal finances and recruitment should ensure that people should not be at risk of abuse. Solent Grange DS0000068218.V365559.R01.S.doc Version 5.2 Page 19 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 and 26 People who use the service experience good outcomes in this area. This judgement has been made using available evidence including a visit to this service. People live in a clean, safe, generally well-maintained home that meets their individual and collective needs. Areas of the home are looking tired and worn; however there are plans for a major refurbishment once the extension is completed. EVIDENCE: The inspector viewed the home with a senior member of care staff towards the start of the inspection visit and viewed records related to services such as gas and electric and fire safety equipment. The home is an older house that has been extended to provide the current home. There is a further extension in progress and this will provide approximately fifty additional single en-suite bedrooms with additional Solent Grange DS0000068218.V365559.R01.S.doc Version 5.2 Page 20 communal rooms, bathrooms, WC’s and ancillary rooms such as a new kitchen and offices. As part of the overall plans for the home some bedrooms have been upgraded to include en-suite facilities and there had been a change in the use of some rooms from bathrooms to bedrooms and vice versa. One bedroom has been lost as part of the extension and another is being created from a previous small dining room. The inspector was able to see the work in progress and this is being completed to a high standard. The home has two shaft lifts and all parts of the home are accessible to people with mobility needs. One of the bedroom windows on the first floor did not have an opening restrictor; others checked did have opening restrictors. The registered manager investigated this during the inspection visit and identified that the restrictor had broken and arranged for a new system to be fitted to restrict the opening of the window. Some windows have secondary doubleglazing and were dirty between the panels and should be thoroughly cleaned. The home has three rooms designated as twin rooms although at the time of the inspection visit only one was in use as a twin room. All rooms are reasonably decorated; some are quite large and well personalised. All bedrooms have either en-suite facilities or a wash hand basin in the room. There is off road parking to the front of the home. At the time of the inspection visit people did not have access to outside space due to the building work and dust that this is creating to the previous patio area. The registered manager stated that once the main building work is completed it is planned that a safe outdoors area can again be made available and that ultimately the provider intends to have the garden areas landscaped and made safe and accessible for people who live at the home to enjoy. The registered manager stated that some new lounge chairs, furniture and soft furnishings for the dining room have been selected. The home was clean and tidy throughout and there were no unpleasant odours. At the time of the visit the home was comfortably warm throughout. The visitors and people who live at the home confirmed that the home is always warm and clean. The home employs housekeeping staff. The home has the necessary moving and handling equipment and two baths are fitted with hoists. Due to the building work the laundry is sited in a temporary room with the long-term plan that the laundry will be located in the current kitchen when the kitchen is moved to the new part of the building. The laundry was visited and is appropriate and fit for purpose with machines capable of washing to disinfection standards. Members of staff spoken with confirmed they had received infection control training and had access to all the necessary Solent Grange DS0000068218.V365559.R01.S.doc Version 5.2 Page 21 equipment to prevent any risk of cross infection such as disposable gloves and aprons, supplies of which were seen during the visit to the home. Substances hazardous to health (COSHH) were stored securely. Certificates seen confirmed that the homes services such as gas and electric have been checked and serviced as appropriate. Portable electric appliances are regularly checked. Solent Grange DS0000068218.V365559.R01.S.doc Version 5.2 Page 22 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 and 30. People who use the service experience good outcomes in this area. This judgement has been made using available evidence including a visit to this service. The home employs appropriate numbers of care staff that ensure that the needs of people living at the home are met. Staff receive the necessary training. EVIDENCE: All comments from people who live at the home, visitors and professionals were positive about care staff. Duty rotas were seen during the visit to the home. Duty rotas stated that six care staff and a senior are provided throughout the morning and four care and a senior care during the afternoon/evening and at night two care and a senior carer are provided. The registered manager and deputy manager are also present and supernumerary throughout the weekdays and available on call at weekends. The home also employs a cook, housekeepers, activities person and maintenance staff. During the inspectors visit staff on duty corresponded to those on the duty rota. Care staff stated that they generally have sufficient time to meet people’s needs and throughout the inspection care staff appeared to have time to meet people’s needs. Visitors felt there were generally sufficient staff to meet peoples needs. Solent Grange DS0000068218.V365559.R01.S.doc Version 5.2 Page 23 The manager provided training and qualification information during the inspection and on the AQAA. The home employs twenty-seven care staff of whom twelve have at least an NVQ level 2 with seven additional staff undertaking an NVQ. Five care staff are waiting to commence NVQ training when places are available. Care staff stated that they felt they had the necessary skills to meet people’s needs and were not expected to undertake activities for which they had not been trained. Care staff stated they have lots of training. The inspector viewed training certificates in staff files, which confirmed that care staff have undertaken all mandatory and a range of additional training to meet the specific needs of people who live at the home. This has included mental capacity act, dementia, managing aggression and challenging behaviour. One of the senior staff takes a lead in staff training and has undertaken train the trainer for safeguarding and manual handling and is an NVQ assessor. The recruitment records for three people recruited shortly before the inspection visit were viewed. These contained all the required information and confirmed that all staff are fully checked including references, Criminal Records Bureau and Protection of Vulnerable Adults checks prior to commencing employment at the home. A senior member of staff explained the homes induction procedure that that conforms to the common induction standard, copies of essential policies and procedures and a copy of the General Social Care Code of Conduct. Records of induction for new staff were seen in their training files. A new member of care staff confirmed that the above recruitment procedures and induction had occurred. Solent Grange DS0000068218.V365559.R01.S.doc Version 5.2 Page 24 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, 37 and 38 People who use the service experience good outcomes in this area. This judgement has been made using available evidence including a visit to this service. The registered manager has the necessary skills and experience to ensure that the home is appropriately managed and run in the best interests of the people who live there. People’s financial interests are safeguarded. Records are well maintained. The health, safety and welfare of people and staff are promoted. EVIDENCE: Mrs Angela Clarke has been the homes registered manager for several years. She has the necessary skills and qualifications having the NVQ level 4 in Care and informed the inspector that she has now completed the Registered Managers Award with her evidence portfolio with the external verifier. Solent Grange DS0000068218.V365559.R01.S.doc Version 5.2 Page 25 Throughout the inspection visit the registered manager demonstrated knowledge of the people who live at the home and the mechanisms by which support can be obtained when necessary. Care staff and visitors were clear that they felt able to discuss any issues/concerns with the manager. Following the previous inspection one requirement was made and this has been complied with. The inspector noted that the sign at the entrance to the driveway to the home has not been replaced since the current provider purchased the home approximately eighteen months prior to this inspection. The names of the previous owners must be replaced stating the correct owners. A representative of the provider undertakes visit to the home providing monthly reports for the manager. These were seen during the inspectors visit. The registered manager stated that she is able to access support from the providers management structure when required. The manager has undertaken some formal quality assurance work including questionnaires to people who live at the home, relatives and external professionals. These were seen during the inspection visit. The manager explained that where responses identify issues she aims to clarify these and takes action to address the issues. The home produces a three monthly newsletter for relatives and people who live at the home and the week of the unannounced inspection visit had arranged an event for one evening with relatives invited to visit and be provided with information about the building extension and future plans for the home. It was also planned for a senior member of staff to provide a short talk for relatives about dementia. The homes registered manager completed the AQAA that was received on time. The inspector discussed the AQAA with the registered manager and identified areas where additional information could have been provided. The home does not become the appointee for people who live at the home. Any additional expenses such as for hairdressing or chiropody are invoiced to the person responsible for paying the persons bill. An invoice was seen which had been returned with the money to cover the bill. The invoice clearly showed what extra services were being charged for. Various records were viewed during the inspectors visit. All records were appropriately stored with access only available to people who should have access. During the inspectors visit there was only one concern in respect of health and safety identified this being in relation to the lack of a window restrictor on a first floor bedroom window. The home is generally well maintained and clean, with staff having relevant training to meet people’s needs. The home Solent Grange DS0000068218.V365559.R01.S.doc Version 5.2 Page 26 undertakes weekly checks of the fire detection equipment. Portable Electrical Appliance Tests (PAT), electrical wiring and gas certificates were seen. The local environmental health department has awarded the home five stars (maximum being five stars) for food hygiene. Solent Grange DS0000068218.V365559.R01.S.doc Version 5.2 Page 27 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 3 3 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 3 3 Solent Grange DS0000068218.V365559.R01.S.doc Version 5.2 Page 28 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 Solent Grange DS0000068218.V365559.R01.S.doc Version 5.2 Page 29 Commission for Social Care Inspection Maidstone Office The Oast Hermitage Court Hermitage Lane Maidstone ME16 9NT 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. 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