Inspection on 20/01/09 for Sussex Grange

This inspection was carried out on 20th January 2009.

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

Sussex Grange 13/09/06

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 20/03/2009.

Inspecting for better lives Key inspection report Care homes for older people Name: Address: Sussex Grange 14 Vincent Road Selsey Chichester West Sussex PO20 9DH     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Sarah MacLennan     Date: 2 0 0 1 2 0 0 9 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. the things that people have said are important to them: They reflect This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop 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 Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Older People Page 2 of 25 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.csci.org.uk Internet address Care Homes for Older People Page 3 of 25 Information about the care home Name of care home: Address: Sussex Grange 14 Vincent Road Selsey Chichester West Sussex PO20 9DH 01243606262 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Sussex Grange care home 24 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 old age, not falling within any other category Additional conditions: Date of last inspection Brief description of the care home 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. 0 Over 65 24 Care Homes for Older People Page 4 of 25 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: The quality rating for this service is 2 star. This means the people who use this service experience good quality outcomes. The Commission for Social Care Inspection has, since the 1st April 2006, developed the way it undertakes its inspection of care services. This unannounced visit formed part of a key inspection and was carried out by Sarah MacLennan, Regulation Inspector. The Registered Manager, Dr Tom Jameson, was present as the representative for the establishment. It was a thorough look at how well the service is doing. It took into account detailed information provided by the manager and any information that CSCI has received about the service since the last inspection. Care Homes for Older People Page 5 of 25 A tour of the premises took place. On the day of this visit the inspector met with some people who use the service and some on-duty staff. Some of the comments made to the inspector are quoted in this report. Observations of the interactions between staff and the people who use the service were also used to form the judgements reached in this report. The home completed an annual quality assurance assessment (AQAA) prior to the visit and care plans of people who use the service, staff recruitment and training records, menus, health and safety check lists, activity records, policies, procedures, medication records and storage facilities were all sampled on the day of this visit. The inspector looked at how well the service was meeting the standards set by the government and has in this report made judgements about the standard of the service. We would like to thank the people who use the service and staff for their time, assistance and hospitality during this visit. What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 240 7535. Care Homes for Older People Page 7 of 25 Details of our 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) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 8 of 25 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Service users had been assessed prior to admission to the home to ensure that the home can meet their needs. The home does not offer intermediate care. Evidence: The inspector was advised that the Registered Manager carries out a pre-admission assessment on all prospective people who will use the service. This assessment is then discussed with the prospective service user or their representative and, if their needs can be met this is confirmed to the service user in writing. Visits to the service are encouraged and there is an option for admission on a trial basis. The home has a comprehensive admission policy. Three service user care plans were seen and contained a comprehensive pre-admission Care Homes for Older People Page 9 of 25 Evidence: assessment form. The form covered all elements of physical, mental, and social needs. It included person centred information and personal preferences including does not eat fish. In the AQQA, to demonstrate what the home does well, the Registered Manager stated that When an enquiry is first made we always send out an informative 5 page A4 brochure containing some of the information from our statement of purpose as well as comments from residents, visitors and inspectors. The brochure also includes clear pricing information and photographs illustrating life at Sussex Grange. New arrivals are greeted by me and one of our senior staff who will be allocated to ensure that the resident feels at home right from the start. We also make sure that the family or friends of the resident are made to feel welcome. To back up the personal greeting we also give every new resident a copy of our Residents Handbook. This contains the Service User Guide as well as a copy of our contract for reference purposes. The last page of this booklet contains information that previous newcomers have said they would like to have to hand when they moved in During your first few days It gives a brief summary about who we are, meals, baths, laundry etc. All people who use the service spoken to felt they had received enough information prior to moving to the home. Care Homes for Older People Page 10 of 25 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Care plans, procedures and practices were in place to ensure the service users health care needs are met. Evidence: The service user care plans and files were randomly sampled; three care plans and daily statements were looked at in detail. The people who use the service had detailed and comprehensive care plans, with risk assessments being completed. One service user assessed as being at risk of weight loss had a comprehensive nutritional screening tool in place with evidence of dietician involvement. All the care plans sampled contained evidence of monthly review. The daily statements evidenced that aspects of the care plans were followed and provided some details of the people who use the services 24hr day. In the AQQA, to demonstrate what the home does well, the Registered Manager stated that Individual care plans are drawn up and reviewed with each resident to ensure Care Homes for Older People Page 11 of 25 Evidence: that we are all in agreement about how to address their different health, personal and social care needs. The people who use the service spoken with were complimentary regarding the care that they received in the home. Comments included, the staff are very caring and helpful. A service user satisfaction survey was completed in December 2008, the results were seen and showed that 100 of the people who use the service were happy with the care provided and 98 would recommend the home to others. The people who use the service were registered with a local GP and had access to other health care services including chiropodist, dietician, optician, audiologist, district nurses and speech and language therapist as required. The service user care plans sampled contained a clear record of multi-disciplinary visits. In the AQQA, to demonstrate what the home does well, the Registered Manager stated that Health care at Sussex Grange is provided by doctors and nurses from the two local GP surgeries that operate from one building. Having previously qualified as a doctor myself I have a very effective relationship with the staff at the medical centre and this in turn means that residents at Sussex Grange get the right treatment at the right time. The homes medication storage facilities and administration records were seen and found to be in order. Service users were enabled to self-administer their medication if required, following an appropriate risk assessment, samples of which were seen. In the AQQA, to demonstrate what the home does well, the Registered Manager stated that As part of our effort to promote independence we will enable residents to selfmedicate as long as they are able to do so safely. We have a standard assessment process to check their capability and policies to review and support those who choose to self-medicate. Conversation with staff and the people who use the service evidenced that the service users are encouraged to be as independent as possible and to make their own choices, such interactions were observed. When asked if they received the support they required comments included Oh yes and they do a wonderful job. Care Homes for Older People Page 12 of 25 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The daily routines at the home promoted independence, individual choice and freedom of movement. Evidence: The home activities programme was displayed on the notice board in the hallway. Activities included music quizzes, bingo, exercise classes and reminiscence and the home also has a regular visiting entertainer. The home has a minibus and outings were organised every month / six weeks. Outings included shopping, visits to local garden centres, local pubs and Chichester yacht club. The people who use the service who were spoken with confirmed that they could choose what they wanted to do and that there were sufficient activities. The home has links with the local church. A regular communion service takes place at the home; however the people who use the service are able to visit the church if they prefer. In the AQQA, to demonstrate what the home does well, the Registered Manager stated that We therefore offer a wide range of social, cultural, religious and recreational opportunities to our residents both inside and outside of the home. We do not aim to please all of the people all of the time but we do regularly ask residents (in surveys or Care Homes for Older People Page 13 of 25 Evidence: at Residents Meetings) for their opinions on the activities currently on offer. We will then make changes to the activity programme. The minutes of the service user meeting from October 2008 were seen and these together with the activities programme provided evidence that changes to the activities had been made as a result of service users views. All of the people who use the service who were spoken to said that they were happy with the food provision within the home. The menu was on a four weekly rota with alternatives available on request. A record is maintained of the food eaten by the people who use the service and alternatives to the menu. No cultural diets are currently provided. A service user satisfaction survey was completed in December 2008 and the food provision within the home scored highly. In the AQQA, to demonstrate what the home does well, the Registered Manager stated that We are very lucky at Sussex Grange to have a head cook who has an excellent understanding of the needs of elderly people. She cooks delicious, nutritious and simple meals using fresh ingredients and she is also very focussed on good hygiene. The home had an environmental health inspection in June 2008, the report was seen during this visit and stated very clean and well organised kitchen found at time of inspection. Conversation with staff, relatives and service users evidenced that the people who use the service are encouraged to make their own choices, such interactions were observed. Staff were observed to treat the people who use the service with respect and care was provided in an unobtrusive and dignified manner. Care Homes for Older People Page 14 of 25 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home had a simple and accessible complaints procedure; the people who use the service felt safe. Evidence: The home had a simple and accessible complaints procedure. A copy is given to all the people who use the service in the service users guide and a copy is displayed in the hallway. Service users spoken to during the inspection were aware of who to speak to should they have any complaints and felt confident that they would be listened to. Comments included the staff are all very nice. There had been no complaints since the previous inspection. No complainants had contacted the Commission with information concerning the service. Safeguarding adults and whistle blowing policies and procedures were in place and readily available to staff. These policies and procedure were clear and concise and contained a flowchart detailing actions to be taken by staff. The home also had copies of the Sussex Multi-Agency Policy and Procedures for Safeguarding Vulnerable Adults. All staff spoken to were aware of these policies and procedures and their whistle blowing responsibilities. Care Homes for Older People Page 15 of 25 Evidence: Staff had received training in the protection of vulnerable adults and had read the homes policies. The home had an appropriate management of residents money and financial affairs policy and no staff were appointees for any of the people using the service. Care Homes for Older People Page 16 of 25 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home provides a comfortable, safe and well maintained environment for the people who live there. Evidence: The inspector toured areas of the home. The people who use the service were able to access all areas of the home and grounds. Service users were able to access upstairs via passenger lift. The decor was domestic in nature and free from offensive odours. In the AQQA, to demonstrate what the home does well, the Registered Manager stated that At Sussex Grange we have blended the charm and character of the original Tudor-style house with many modern features that enhance the comfort and safety of the people who live there. To enable the residents to control the temperature in their own rooms we have fitted thermostats to the radiators. In most cases the controls for the thermostats have been fitted level with the top of the radiator so that older people are able to reach them with ease. All of the bedrooms at Sussex Grange are well above the required size, with the average being seventeen square metres plus en-suite bathroom. Each bedroom contains a television aerial socket and a direct dial telephone socket (new residents from the local area can bring their old telephone number with them). All doors are fitted with locks but most residents choose not to use them. A level footpath leads around the perimeter of our large garden, weaving between Care Homes for Older People Page 17 of 25 Evidence: flowerbeds and lawns. The path is regularly jet-washed to prevent it from becoming slippery. There are ramps into the house and around the garden to ensure full access for wheelchair users. The garden at Sussex Grange is also home to a large number of squirrels and birds which are all well fed by our residents. One of our residents has also taken on the responsibility of feeding the fish in our pond. The inspector was informed that upstairs windows were not restricted at the request of the people who use the service as this did not present a risk; thermostatic valves were fitted to all taps in service user areas and checked regularly. Care Homes for Older People Page 18 of 25 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The staffing arrangements in place on the day of the inspection were sufficient to meet the needs of the people who use the service. Evidence: Discussion with the Registered Manager, staff and the people who use the service demonstrated that the staffing numbers and skill mix were appropriate to meet the assessed needs of the people living in the home. The duty rota demonstrated that the home maintains staffing number of three carers in the morning, two during the afternoon and at night; this is in addition to the Registered Manager or the deputy managers. Four staff files were seen during the visit and found to contain the required information and documents specified in paragraphs 1 to 9 of Schedule 2 of The Care Homes Regulations 2001 (as amended by The Care Standards Act 2000 (Establishments and Agencies) (Miscellaneous Amendments) Regulations 2004). However one staff member had been recruited prior to the Registered Manager obtaining a Criminal Records Bureau check or any references. The minutes from the residents meeting in October 2008 were seen. At this meeting the Registered Manager had discussed involving the people who use the service in the Care Homes for Older People Page 19 of 25 Evidence: recruitment of staff. None of the people who use the service wished to be involved as they were happy with things as they were. Samples of staff training certificates were seen, they evidenced that staff had received a comprehensive induction and training in moving and handling, fire safety, food hygiene, first aid, dementia awareness and safeguarding vulnerable adults. All service users spoken with were complementary about the staff at the home. In the AQQA, to demonstrate what the home does well, the Registered Manager stated that We place a great deal of emphasis on the recruitment and retention of excellent staff, because this gives us the best possible platform from which to build a service that focuses on providing the best possible level of care for our residents. We keep staffing levels high so that carers can do their job without rushing. We have never used agency staff. All interactions observed between the staff and service users were caring and respectful. Care Homes for Older People Page 20 of 25 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The people who use the service benefit from the management approach at the home, which provided an open, positive and inclusive atmosphere. The Registered Manager demonstrated a good knowledge and awareness of the needs of the people who use the service. Evidence: The Registered Manager, Dr Tom Jameson has been in post for more than five years. The people who use the service were seen to interact readily with him and an open and inclusive atmosphere was evident within the home. All staff and people who use the service appeared happy, contented and relaxed with the inspection process. The atmosphere within the home during the inspection was lively and cheerful. The Registered Manager stated that various quality audit systems were in place to Care Homes for Older People Page 21 of 25 Evidence: ensure the staff and service users had a forum for airing their views. These included staff meetings, residents meetings and staff supervisions. The minutes of these meetings were randomly sampled and there was evidence that action was taken following comments made. The people who use the service who were spoken to felt that their views were usually listened to and taken seriously. Procedures were in place to safeguard the financial interests of the people who use the service. No staff members were appointees for service users. The Registered Manager was aware of the need to maintain a safe environment for service users and staff. Required policies, procedures and safety checks were in place; samples of which were seen. The service user care plans sampled contained a fire procedure questionnaire, all the service users stated that they were aware of the fire procedures within the home. In the AQQA, to demonstrate what the home does well, the Registered Manager stated that As the manager I work hard to ensure that all the stakeholders at Sussex Grange are happy and proud to be a part of it. I believe that it is my responsibility to make sure that the staff are happy and confident in their work and that this in turn leads to a happy atmosphere throughout the home. Residents are consulted about many different aspects of the running of the home either in the form of surveys or at Residents Meetings. Minutes are sent out to all residents after these meetings. Staff were observed to be following appropriate health and safety practices as they went about their work. Care Homes for Older People Page 22 of 25 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 23 of 25 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations Care Homes for Older People Page 24 of 25 Helpline: 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 We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. Care Homes for Older People Page 25 of 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!