CARE HOMES FOR OLDER PEOPLE
Sussex Grange 14 Vincent Road Selsey West Sussex PO20 9DH Lead Inspector
Hilary Church Announced Wednesday, 7 September 2005, V241131
th 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 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 H60-H11 S45863 Sussex Grange V241131 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION
Name of service Sussex Grange Address 14 Vincent Road, Selsey, Chichester, West Sussex, PO20 PDH Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) 01243 606262 Dr R Jameson Dr T Jameson Care Home (CRH) 24 Category(ies) of Old age, not falling within anyother category registration, with number 24 of places Sussex Grange H60-H11 S45863 Sussex Grange V241131 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION
Conditions of registration: Date of last inspection 18 January 2005 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 detatched two storey building situated in the village of Selsey, West Sussex. It is within easy reach of Selsey village and all its amenieties 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 seperate 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 are the registered providers with Doctor Jameson being the registered manager providing day to day managenment of the home. Sussex Grange H60-H11 S45863 Sussex Grange V241131 Stage 4.doc Version 1.40 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This announced inspection, under the Commission for Social Care Inspection was undertaken at a time when the manager was available to give the inspector a good overview of the care being provided to the residents. The inspector examined the home’s records before spending time with the residents to hear their views of their life at Sussex Grange. To prepare for this announced inspection, previous report, letters and other documents were reviewed. The home provide a Statement of Purpose and Service Users Guide to inform any enquirer or resident how they may expect the home to be run or how their views can improve their lives there. These documents form a contract of service and care and are regularly reviewed to ensure the information they provide is up-to-date. During the inspection, out of the twenty-four places registered, twenty residents were being cared for but occupying all the registered rooms, some of which are double rooms. Seven residents were seen privately in their rooms and three residents in the lounge. Four residents’ records examined to see if they matched the way that the residents said they lived their lives there. All of the residents’ comments were very enthusiastic and it was clear that residents are encouraged to say what they like or don’t like about the home. The inspector also received nine residents and ten relatives/visitors comment cards. The comments made were very positive with one resident commenting “As a very independent person who once vowed I would be crawling on my hands and knees before going into a home, I appreciate the freedom I have here to retain my identity”. This view seemed to be confirmed by other residents who spoke to the inspector during her inspection. Two care staff said they felt Doctor Jameson provided good leadership and care plans showed that staff provide the appropriate amount of support. There were no requirements or recommendations made although some advice was given regarding disabled access into the home. What the service does well:
Sussex Grange provides a very good personal care service according to all the residents and enables them to own it as their own home by furnishing it with their own furniture and personal items. From information gained and through observation, care is recorded appropriately and provided by committed staff
Sussex Grange H60-H11 S45863 Sussex Grange V241131 Stage 4.doc Version 1.40 Page 6 who treat residents with respect and dignity. Residents are supported to lead fuller and happier lives as individuals and free to follow those activities provided by the home or that are personal to them. Residents are encouraged to make suggestions or propose any changes they feel would improve their lives through a number of ways from a suggestion box, personal conversation or residents meetings. The food is prepared and cooked to a very high standard and a good choice is available if residents are not keen on the main choice. The heating system was being revamped at the time of the inspection and the temperature control for individual radiators being re-sited to suit the needs of the residents. What has improved since the last inspection? What they could do better:
From previous reports it was clear that Sussex Grange have always provided care of the highest quality and provided a home where residents are well supported to take identified risks. It is difficult to find any aspect of improvement concerning the care provided but there were some minor areas of redecoration and refurbishment that could improve the appearance of the home. This included professional cleaning of the lounge and other communal carpets and re-stretching the lounge carpet to provide a flat surface. Some water damage to the stairwell and dining room ceilings also required attention although the new owners had been redecorating some resident’s rooms so a refurbishment programme is in place. The inspector observed that although there has been some effort made to provide disabled access into the home it is not without a minor step causing residents to seek assistance when using the entrance designated. Sussex Grange H60-H11 S45863 Sussex Grange V241131 Stage 4.doc Version 1.40 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. Sussex Grange H60-H11 S45863 Sussex Grange V241131 Stage 4.doc Version 1.40 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 Standards Statutory Requirements Identified During the Inspection Sussex Grange H60-H11 S45863 Sussex Grange V241131 Stage 4.doc Version 1.40 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 1,3,4,5. All 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. EVIDENCE: All of the residents asked about the information they received about the way the home operates confirmed that they had received the Statement of Purpose and Service Users Guide. Four care plans were examined and it was clear residents had been assessed to ensure the home would be able to meet their needs. Relevant risk assessments were in place and had been updated. Care plans to instruct staff how to meet identified needs had been written from the assessments and it was clear from the residents comments and staff care, that staff were well informed about the care needed and were updating records accordingly. Sussex Grange H60-H11 S45863 Sussex Grange V241131 Stage 4.doc Version 1.40 Page 10 Health and Personal Care
The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 7,8,10,11. All residents had an individual care plan set out for staff to follow. Staff are meeting the health care needs of the residents in a respectful manner. EVIDENCE: Sussex Grange provides residents with full information regarding managing all or any part of their medication. Four care plans were examined in detail and all residents had an up-to-date care plan with care that had been identified as needing to be given. Changes in care and condition are recorded on an update sheet to inform care staff of the new needs. Risk assessments were examined and gave staff good information about the risks to residents. Staff were observed speaking to and caring for the residents. From these observations the Inspector noted that residents are well cared for and staff treated them with respect. Staff knocked on doors before entering and then spoke to the residents in a caring manner. Residents said staff were “kind”, “obliging”, “best in Selsey”, “wonderful” and “nowhere else would care be any better”. Sussex Grange H60-H11 S45863 Sussex Grange V241131 Stage 4.doc Version 1.40 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 standard(s) 12,13,14,15. A number of regular activities are provided with individual activities arranged according to the requests and dependency of the residents. Visiting is positively encouraged. Residents are served meals that are nutritious and appetising. EVIDENCE: Few residents have high dependency needs and residents are encouraged to participate in the regular activities provided by a recognised outside organisation. Other residents follow their own activities and where staff are required to support these, two residents confirmed that this happens. The visitor’s book showed that visitors are welcomed at all times although one resident said that meal times are avoided. The main meal gives a choice of two dishes for main and sweet courses with other items available if both choices are not suitable. There was a choice of four fresh vegetables provided at the meal and all the food is home cooked. Most residents have lunch in the dining area but again; this is from choice or provided according to the needs of the resident. The inspector observed the lunch provided and it seemed to be of a high quality. All the residents spoke highly of the food provided with comments of “the food is lovely”, “it suits me” and “you can ask for something else”.
Sussex Grange H60-H11 S45863 Sussex Grange V241131 Stage 4.doc Version 1.40 Page 12 Sussex Grange H60-H11 S45863 Sussex Grange V241131 Stage 4.doc Version 1.40 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 standard(s) 16,17.18 The complaints process is on display. Staff training records confirmed they had all received some training in Adult Protection Procedures. EVIDENCE: The home has a complaints procedure displayed on the notice board in the hall. Residents spoken with said they knew who to complain to, but they have had no occasion to use it. Two complaints had been recorded since the last inspection and both had been investigated and responded to according to the procedure. The West Sussex Multi Agency guidelines were available in the office and staff had received appropriate training and were aware of the procedure. The manager told the inspector that arrangements were being made to update staff members in the near future. Sussex Grange H60-H11 S45863 Sussex Grange V241131 Stage 4.doc Version 1.40 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 standard(s) 19 - 26 The indoor areas used by residents are clean, safe and homely with good access to the front, side and rear gardens. The resident’s rooms are suitable for their needs and are homely. EVIDENCE: During a tour of the home the inspector noted that the plumbing and heating system was being revamped and altered to provide a safe environment. There is one large ground floor lounge with a separate dining room. This is furnished with tables accommodating six residents giving it a homely atmosphere. There is a passenger lift, inspected regularly, for access between the ground and first floors. All rooms 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. Training records showed that staff have
Sussex Grange H60-H11 S45863 Sussex Grange V241131 Stage 4.doc Version 1.40 Page 15 received training in fire safety procedures and fire risk assessments and that polices and procedures relating to these are regularly reviewed. Sussex Grange H60-H11 S45863 Sussex Grange V241131 Stage 4.doc Version 1.40 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 considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27,28.29.30. Sufficient staff are on duty over the 24 hours period to meet needs and staff are recruited to meet the Care Homes Regulations. Training records are kept and training provided to ensure staff are competent to do their jobs. EVIDENCE: The inspector noted that the staffing rota reflected the staff that were on duty. The numbers and skill mix of staff was appropriate to meet their needs with 23 of care staff having achieved National Vocational Qualification level 2 and a further 29 currently in the process of achieving this. When achieved, this will give the home the required level of trained care staff. As well as this, two other care staff are waiting for funding to start level 2. Both of the members of staff spoken with said they felt well supported by the manager and his deputy. From the recruitment records seen, an appropriate application form and reference request is available although the inspector did note that the inclusion of a standard interview questionnaire that meets equal opportunity requirements could enhance the recruitment pack. Records of induction and training were in place. However the manager was seeking different induction and foundation training packs to suit the ethos of the home. Supervision records are completed although a procedure to inform staff members is being completed. There was a high commitment to ongoing training for existing staff. All care staff have received Criminal Records Bureau clearance. Sussex Grange H60-H11 S45863 Sussex Grange V241131 Stage 4.doc Version 1.40 Page 17 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 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31,32,33,36,38. The registered manager is Doctor Tom Jameson. Doctor Jameson owns the home jointly with his wife Doctor Jameson who works as a doctor in the community. Doctor Jameson has the experience to manage the home. EVIDENCE: Doctor Jameson is completing the Registered Managers Award with his deputy, a senior care worker who continued her employment when Sussex Grange changed ownership. It was clear that Doctor Jameson is well supported by his deputy manager who has already achieved National Vocational Qualifications and has a number of years of experience at working at Sussex Grange. Staff clearly feel confident and well supported in their work and feel part of a team. All staff have access to job descriptions and care plans showed that staff provide the appropriate amount of support. The inspector could confirm that the residents take priority in the home, are cared for to a good standard and that the resident’s best interests were safeguarded.
Sussex Grange H60-H11 S45863 Sussex Grange V241131 Stage 4.doc Version 1.40 Page 18 Outcomes to accidents and incidents are being recorded appropriately and reported to the Commission for Social Care Inspection. Recruitment, induction and supervision are being provided appropriately with mandatory and periphery training being continuously provided to existing staff. Communal and individual room sizes exceed the National Minimum Standards of 4.1 sq metres per resident and 10 sq metres per resident rooms. The home is registered for twenty-four persons and although the home has nine rooms registered as double rooms, only four of these can be used as double rooms at any one time. Sussex Grange H60-H11 S45863 Sussex Grange V241131 Stage 4.doc Version 1.40 Page 19 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score 3 3 3 3 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 4 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 4 15 3
COMPLAINTS AND PROTECTION 3 4 3 3 3 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 Standard No 16 17 18 Score 3 3 3 3 3 3 3 3 3 3 3 Sussex Grange H60-H11 S45863 Sussex Grange V241131 Stage 4.doc Version 1.40 Page 20 NO Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. 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. 1. Refer to Standard Good Practice Recommendations Sussex Grange H60-H11 S45863 Sussex Grange V241131 Stage 4.doc Version 1.40 Page 21 Commission for Social Care Inspection 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
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