Inspection on 13/09/06 for Sussex Grange

This inspection was carried out on 13th September 2006.

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

Sussex Grange 20/01/09

Sussex Grange 16/01/06

Sussex Grange 07/09/05

Sussex Grange 18/01/05

Sussex Grange 13/09/04

Similar services:

The Shelley

Springfield House

Sutton Lodge Nursing Home

St Helier`s Residential Hotel

St Joseph`s

Ridgemount

Wingham Court

Old Hastings House

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

CARE HOMES FOR OLDER PEOPLE Sussex Grange 14 Vincent Road Selsey Chichester West Sussex PO20 9DH Lead Inspector Mrs H Church Unannounced Inspection 13th September 2006 09:00 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 Sussex Grange DS0000045863.V306823.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. Sussex Grange DS0000045863.V306823.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Sussex Grange Address 14 Vincent Road Selsey Chichester West Sussex PO20 9DH 01243 606262 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) Sussex Grange Dr T Jameson Care Home 24 Category(ies) of Old age, not falling within any other category registration, with number (24) of places Sussex Grange DS0000045863.V306823.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 16th January 2006 Brief Description of the Service: Sussex Grange is a privately owned care home registered to accommodate up to twenty-four persons in the category of older persons. It is a detached two storey building situated in the village of Selsey, West Sussex. It is within easy reach of Selsey village and all its amenities and facilities. The sea front is within a short walking distance. There are well-maintained gardens to the front, side and rear of the property. The accommodation consists of sixteen single rooms and four double rooms currently being used for single occupancy. All rooms have ensuite facilities. A large lounge and separate dining area provides the communal space with wide doorways giving easy access for wheelchair users. A lift provides access between the ground and first floor. Sussex Grange Limited is the registered provider with Doctor Jameson being the registered manager providing day to day management of the home. Sussex Grange DS0000045863.V306823.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This site visit took place over one day and planned to take part in the morning and over the lunch time period. Two deputy managers who complement each other with their skills and experience now support the manager since the previous deputy left to further her career. Doctor Jameson, the registered manager, assisted the inspector with all of her enquiries throughout the site visit. The inspector noted staff spending quality time with individual residents, either in the lounge or in their rooms. A homely, friendly and relaxed atmosphere prevailed and the inspector was welcomed into all areas of the home. Although late summer, it was a fine day and a number of residents were out in the garden enjoying the sunshine. For the site visit, the inspector examined previous information and the Statement of Purpose and Service Users Guide that informs residents about the service. During the inspection, five residents gave their views as a group to the inspector and a further four residents were seen individually in their rooms. Without exception all comments were enthusiastic about the staff and their life there. One resident, describing her life at Sussex Grange commented, “Everything in the garden is beautiful”. Two members of care staff said they felt very supported by the new management system and carried out their duties in a relaxed and positive manner. The care plans showed that the care provided is appropriate according to the needs of the residents and the right amount of support to maintain independence and ensure resident’s lives continue to improve was given. There were no requirements or recommendations made at this inspection although the inspector did discuss some improvements that could be made to the records. What the service does well: Sussex Grange is a well-established care home providing a friendly, homely arena where residents feel well supported. It is well maintained and all of the rooms exceed the National Minimum Standards and have en-suite facilities. In spite of losing his well-experienced deputy, the manager has maintained a supportive management leadership style to all of his staff to promote and continue to provide a good standard of individual care. Care staff are promoting care with independence and supporting residents to maintain their life style by monitoring risks at all levels. It was clear that outcomes for Sussex Grange DS0000045863.V306823.R01.S.doc Version 5.2 Page 6 residents are very good and the focus of the home centres around resident’s needs and quality of care. 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. Sussex Grange DS0000045863.V306823.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 Sussex Grange DS0000045863.V306823.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1,2,3,4,5. All new residents had been assessed before moving into the home. The staff at the home are meeting the residents identified needs. Relatives were given enough information to help them decide the home would be suitable Quality in this outcome area is good. This judgment has been made from evidence gathered during the inspection, which includes a visit to the service and takes into account the views and experiences of people using the service. EVIDENCE: Four residents, including one new resident were case-tracked. A number of Pre-assessments records were seen and noted to include all the areas required for making a decision. The Statement of Purpose and Service Users Guide are regularly updated and the Commission for Social Care Inspection and residents have all received updated copies. Residents are either self-funding or funded by the local authority. The contract is user friendly and contains all the information required for residents to fully understand each person’s responsibilities. Sussex Grange DS0000045863.V306823.R01.S.doc Version 5.2 Page 9 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,9,10. All residents had an individual care plan set out for staff to follow. The home operates a policy where all medication is managed by care staff. Care staff are meeting the health care needs of the residents in a respectful manner. Quality in this outcome area is good. This judgment has been made from evidence gathered during the inspection, which includes a visit to the service and takes into account the views and experiences of people using the service. EVIDENCE: Four care plans and assessments were examined and were seen to include the health, care and social needs of the resident. Risk assessments and nutritional assessments formed part of the care plans but some of the initial records were undated and periphery records did not contain all of the information required to form a comprehensive nutritional assessment of need. However it was clear that the recent appointments of two deputies to assist the manager would rectify these minor omissions. Sussex Grange DS0000045863.V306823.R01.S.doc Version 5.2 Page 10 The home’s medication procedures showed safe practice with the handling, administration, storage and disposal of medicines. MAR charts were accurate with no gaps noted in recording of administration of medicines. Links are made between residents needs and determine the care provided. Staff have been assessed as competent to undertake the medication procedure and monitor the risks for any resident electing to manage their own medication. A recent pharmacy inspection confirmed the need for disclaimers to be made for residents who self medicate any part of their medication. The manager is providing a clear assessment of the residents abilities to self medicate but the resident has not signed any agreement to remain responsible for the storage and administration of these. The manager has agreed to implement these. Care plans are currently being reviewed to reflect the changing needs of residents and the risks to their health, safety and welfare, including falls and pressure areas. Risk assessments were present but the inspector recommended that these could be extended to include the personal abilities and life style of the residents. The inspector noted the care plans contained updated information to inform staff of the current situation. The manager and deputies meet weekly to discuss any new needs noted during the care of each resident. The staff on duty were well informed about the care needed for the four residents case tracked and were providing care appropriately. Where the community health care team are involved, staff were referring and following instructions appropriately. Where specialist equipment had been identified, this had been provided. Sussex Grange DS0000045863.V306823.R01.S.doc Version 5.2 Page 11 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,14,15. Activities are suitable for current residents, visiting is positively encouraged and residents are served meals that are nutritious and appetising. Quality in this outcome area is good. This judgment has been made from evidence gathered during the inspection, which includes a visit to the service and takes into account the views and experiences of people using the service. EVIDENCE: There are twenty residents living in the home at present and care staffing hours are sufficient giving care staff opportunity to spend individual time with the residents. According to five of the residents, visitors are always made welcome. The visitor’s book confirmed this. A programme of activities was observed as being in situ many residents confirmed this was provided. Currently, activities are based on resident’s wishes and abilities with any new activities being provided from residents’ requests. Activities range from individual to group activities and range from physical to mental activities led by a professional organisation. Staff will accompany residents for trips out either to the local shops or local outside Sussex Grange DS0000045863.V306823.R01.S.doc Version 5.2 Page 12 places of interest. Recently residents visited a local garden centre and enjoyed a tea. The dining area looked very inviting and was arranged to encourage residents to sit at tables laid for up to six persons but also to communicate with other residents. The resident’s comments included praise for the home cooked food and found it fulfilling with good choices. The inspectors spoke with the cook and it could be seen that dishes were prepared according needs and wishes of the residents. The inspector observed the high quality of the home-made meal, all prepared from fresh ingredients. The menus are changed regularly according to feedback. Where residents prefer an alternative, this is provided and on the day of the inspection, a choice of three main dishes was being provided. It was clear that meals are a high focus for all residents. The kitchen was fitted with spacious and well-organised work surfaces with well-maintained equipment giving staff the means of providing a good choice of meals in a hygienic and specialist area. Where residents are unwell or prefer to eat in their rooms, individual trays are laid with napkins, drinks condiments and a good range of cutlery. The inspector observed staff providing assistance where residents were unable to manage without help. Dietary needs are recorded in the individual care plans and these are taken into consideration when planning meals. Weight charts were not being maintained but the manager agreed to reinstate these and record weights monthly to facilitate the link between all aspects of health care and menu planning. Sussex Grange DS0000045863.V306823.R01.S.doc Version 5.2 Page 13 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16,17,18. Residents are confident that complaints are taken seriously and acted upon appropriately. Staff have had in-house training in adult protection procedures so are equipped to protect residents from abuse. Quality in this outcome area is good. This judgment has been made from evidence gathered during the inspection, which includes a visit to the service and takes into account the views and experiences of people using the service. EVIDENCE: The complaints procedure was available in the hallway with the Visitor’s Book and included in the Statement of Purpose and Service Users Guide. The complaints log was examined and there have been no complaints in over a year. Four residents told the inspector that they had no hesitation in speaking to the staff or manager if there was anything they felt unhappy about. The staff confirmed that in-house training for Adult Protection Training had been given this year and the training was certificated. The induction and foundation training included some training aspects of this. The West Sussex Multi Agency Guideline was present in the office and made available to staff at all times. Sussex Grange DS0000045863.V306823.R01.S.doc Version 5.2 Page 14 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19-26 inclusive. The indoor and outdoor areas used by residents are clean, safe and homely with good access to all parts. Resident’s rooms are suitable and homely. Quality in this outcome area is excellent. This judgment has been made from evidence gathered during the inspection, which includes a visit to the service and takes into account the views and experiences of people using the service. EVIDENCE: The inspector toured the home and observed the redecoration to the water stained ceilings giving it a fresh and homely atmosphere. A number of pictures relevant to the age group of the residents are hung in the corridors providing additional areas of interest. The communal areas consist of one large ground floor lounge with a separate dining room, furnished with tables accommodating six residents giving residents opportunities to socialise with each other. A Sussex Grange DS0000045863.V306823.R01.S.doc Version 5.2 Page 15 passenger lift, inspected regularly, provides access between the ground and first floors. All rooms exceed the required standard and have en-suite facilities with an assisted bath to meet the needs of residents. Thermostatic valves are in place to restrict water temperatures to safe levels. Radiators are guarded and the home was clean and hygienic. Resident’s rooms were visited and were homely and comfortably furnished with personal possessions around them. The manager confirmed that specialist equipment is regularly maintained to ensure residents are safe and enjoy surroundings. The indoor communal areas, garden and individual room areas are safe and well arranged to maximise independence without compromising a sense of freedom. The inspector observed that the ramp proving independent access has been extended and revamped allowing residents who use mobility aids unsupervised access. One resident commented particularly favourably on this saying it had improved her level of independence. Also the inspector observed that the outdoor paving areas have received additional attention to ensure residents are more confident in their use of this area and the large outdoor pond and surrounding area has been revamped to provide a quiet and shaded retreat during the hot weather. Throughout the tour the home presented as clean, pleasant and hygienic, equipment was being maintained and the redecoration, refurbishment programme continues. All doors are fitted with locks but residents also have additional lockable facilities. Radiators are guarded and thermostatic valves in place to restrict water temperatures to safe levels and protect residents from burns and scalds. Training records showed that staff have received training in fire safety procedures and from questionnaires directed at residents, safety is maintained at all times. All of the residents spoke highly of the quality and size of the accommodation. Sussex Grange DS0000045863.V306823.R01.S.doc Version 5.2 Page 16 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27,28,29,30. The duty rota indicated that sufficient staff with a suitable mix of skills and experience are on duty over the 24 hours period to ensure needs can be met. Recruitment processes were in place to ensure residents are protected. Quality in this outcome area is good. This judgment has been made from evidence gathered during the inspection, which includes a visit to the service and takes into account the views and experiences of people using the service. EVIDENCE: The inspector observed that the staffing rota, examined in conjunction with care plans, showed that the staffing levels do ensure residents needs can be met at all times. The inspector observed staff spending quality time with residents in the communal areas as well as ensuring residents who chose to remain in their rooms were given staff time as they needed or wished. During the fieldwork, the inspector spoke to residents about the time spent with staff and all of the comments were good. Residents also felt their privacy and dignity is maintained and three residents commented that “staff were very good”, “kind and thoughtful” and “they adjust themselves to what I want”. The homes use of agency staff is minimal as existing staff generally covers staffing absences but if needed, the deputies have authorised access to monies Sussex Grange DS0000045863.V306823.R01.S.doc Version 5.2 Page 17 for any emergencies. The inspector observed that domestic and catering roles are staffed separately with staff having clearly defined roles for these. The inspector examined recruitment procedures to ensure that the home continues to meet this standard. Two staff records were examined in conjunction with their training records and noted that the recruitment process was good and that all staff, whether care or ancillary, complete the induction and foundation training course work. All staff have received mandatory training at appropriate intervals with periphery courses on the care needs of this group of residents also provided. National Vocational Qualifications at levels 2 and 3 are continuously provided but although the home currently only meet 25 of care staff with National Vocational Qualifications, four other staff are currently undertaking levels 2 and 3 and when completed, will have achieved 45 of the 50 level. Records showed and staff on duty confirmed that they had only been employed following a Protection of Vulnerable Adults check and Criminal Records Bureau clearance. The staff on duty confirmed that training has been provided as per the training schedule and that there was no restriction on courses available to them. All staff had received some training applicable to their roles and level of expertise. Sussex Grange DS0000045863.V306823.R01.S.doc Version 5.2 Page 18 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31,32,33,34,35,36,37,38. The home is run in the best interests of the residents whose health, safety and welfare is promoted and protected. Quality in this outcome area is good. This judgment has been made from evidence gathered during the inspection, which includes a visit to the service and takes into account the views and experiences of people using the service. EVIDENCE: The manager has now completed the Registered Managers Award and following the resignation of his well experienced deputy to further her career, has recruited two deputies who complement each other with their skills and experience. Staff are relating well to this new arrangement and the dual roles are being well managed. Sussex Grange DS0000045863.V306823.R01.S.doc Version 5.2 Page 19 A new Quality Assurance System has been implemented in response to comments made by residents over the suppers provided. This has clearly assisted the manager in menu planning as well as demonstrating to the residents that comments are taken seriously and their views are important. The deputies and the manager meet weekly with other staff meetings taken place regularly. Planned meetings are arranged with residents and the resulting minutes are distributed to ensure all residents are aware of what has been discussed and where decisions can be revisited to included absent resident’s views. The inspector observed the suggestion box is still in place in the hall and that the informal and on-going system of seeking views from residents and visitors at every opportunity, when working with residents, was being maintained. Residents are encouraged to manage their own finances or a representative of the resident takes on the responsibilities for this. The supervision procedure was examined and this is currently being maintained at the right levels with the deputies leading the supervision process and then receiving supervision from the manager. The inspector observed that training needs are identified from this procedure. The inspector noted that the documents used to record accidents meet the Data Protection Act. Health and safety is maintained through training and servicing of necessary equipment. All equipment checks and servicing is carried out within the safe guidelines. Good moving and handling practise was observed that minimises risks to residents’ health safety and welfare. Policies and procedures were in place and had been updated recently. The inspector concluded that the health care needs of all of the residents were being safely met. Sussex Grange DS0000045863.V306823.R01.S.doc Version 5.2 Page 20 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 3 3 3 3 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 4 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 4 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 3 18 3 3 4 3 3 4 4 3 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 3 4 3 3 3 3 3 Sussex Grange DS0000045863.V306823.R01.S.doc Version 5.2 Page 21 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 Sussex Grange DS0000045863.V306823.R01.S.doc Version 5.2 Page 22 Commission for Social Care Inspection Worthing LO 2nd Floor, Ridgeworth House Liverpool Gardens Worthing West Sussex BN11 1RY National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Sussex Grange DS0000045863.V306823.R01.S.doc Version 5.2 Page 23 - 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!