Inspection on 11/08/08 for The Grange

This inspection was carried out on 11th August 2008.

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

The inspector found no outstanding requirements from the previous inspection report, but made 8 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

The Grange 22/08/07

The Grange 12/05/06

The Grange 24/01/06

The Grange 12/08/05

The Grange 03/03/05

The Grange 19/10/04

The Grange 26/02/04

Similar services:

22 Sandown Road

The Highlands

Dilston College Of Further Education

West View House

Blenheim House

Prince Bishop Court

Park View (15)

Craigmore House

Extracts from inspection reports are licensed from CQC, this page was updated on 09/11/2008.

CARE HOME ADULTS 18-65 The Grange The Grange Redworth Road Shildon Durham DL4 2JT Lead Inspector Steve Tuck Key Unannounced Inspection 11th August 2008 10:00 The Grange DS0000007510.V371212.R01.S.doc Version 5.2 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 The Grange DS0000007510.V371212.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 Adults 18-65. 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. The Grange DS0000007510.V371212.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service The Grange Address The Grange Redworth Road Shildon Durham DL4 2JT 01388 775764 01388 771040 highleahomes@aol.com Telephone number Fax number Email address Provider Web address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Highlea Homes Ltd Thomas Johnson Care Home 19 Category(ies) of Learning disability (19), Physical disability (19) registration, with number of places The Grange DS0000007510.V371212.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The registered person may provide the following category of service only: Care home only - Code PC To service users of the following gender: Either Whose primary care needs on admission to the home are within the following categories: Learning disability - Code LD, maximum number of places: 19 2. Physical disability - Code PD, maximum number of places: 19 The maximum number of service users who can be accommodated is: 19 22nd August 2007 Date of last inspection Brief Description of the Service: The Grange provides care for up to 19 adults in ground floor accommodation on the outskirts of Shildon. The home was previously a school and has been adapted. The home is suitable and accessible to people with mobility problems. The home has communal lounges, a dining area, a small kitchen area for service users to make snacks and drinks, a conservatory and a leisure room. Highlea Homes Ltd owns the home. The company head office is based on the upper floor of The Grange. Toilet and bathing facilities are available throughout the home, many of which are adapted to support the service users accommodated. Fees range between £378.50 and £405.00 per week. The Grange DS0000007510.V371212.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 1 star. This means the people who use this service experience adequate quality outcomes. This inspection took place over three days and was a scheduled unannounced inspection. Before the visit: We looked at: • Information we have received since the last Key Inspection. • How the service dealt with any complaints & concerns since then. • Any changes to how the home is run. • The views of people who use the service, the people who have arranged for them to live at the home and the staff who support them by questionnaire. • The provider’s view of how well they care for people. We asked them to examine their own service and write to us with the results. The Visit: An unannounced visit was made on 11th August 2008. During the visit we: • Talked with the people who use the service, the staff and the manager. • Observed life in the home. • Looked at information about the people who use the service & how well their needs are met. • Looked at other records, which must be kept. • Checked that staff had the knowledge, skills & training to meet the needs of the people they care for. • Looked around parts of the building to make sure it was clean, safe & comfortable. • Checked on what improvements had been made since the last visit. We told the manager what we had found. What the service does well: The Grange DS0000007510.V371212.R01.S.doc Version 5.2 Page 6 What people who live there said about the home. “I live with my friends here.” “I like being in the conservatory it’s the best part of the home.” What staff said about the home. “The work is often very busy and challenging but I think we are making progress.” People who move to the home have their needs assessed in detail by social or healthcare workers and the manager so that everyone is sure that this is the right place for them to live. This is very important where people have complicated needs that require well-managed and agreed ways of supporting them. Staff help people to have more interesting lives, they help make sure that people can take part in activities they like and they help them to find and try new ones. The staff and manager help people to make choices about their lives and support them to be as safe as possible when they want to do something risky. Peoples’ bedrooms are private and they make them their own with furniture and possessions if they want to. The home is warm and comfortable with a number of different areas for people to use during the day. What has improved since the last inspection? What they could do better: All care plans must have enough detail to show the actions that staff are to take to make sure that peoples’ needs are met and to guide the way they are to work. Reviews of peoples’ plans must show any progress that has been made to meet these goals. There must be an accurate record of the amount of medication held and administered at the home tom make sure that people get the treatment that The Grange DS0000007510.V371212.R01.S.doc Version 5.2 Page 7 they have been prescribed. Where staff decide that people living at the people need to have medication or not, then the way that they make that decision must be written down. The bathrooms must be suitable with hot water that is safe for them to use; repairs must be better organised so that specialist equipment is repaired quickly. People must be consulted about their view of the quality of the service and those who support or represent those who live at the home must be included; so that their views can help to improve the home in their best interests. Staff working at the home must have suitable training in fire prevention and procedures so that people are protected in the event of a fire. 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. The Grange DS0000007510.V371212.R01.S.doc Version 5.2 Page 8 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection The Grange DS0000007510.V371212.R01.S.doc Version 5.2 Page 9 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 1 and 2 Quality in this outcome area is Adequate. This judgement has been made using available evidence including a visit to this service. Each persons needs are assessed before they move in which helps to make sure that these can be met at the home and inappropriate admissions are avoided. EVIDENCE: Each persons needs are assessed before they move to the home by a team of workers such a social worker, a community nurse, a psychologist, as well as the manager. This is to make sure that the home is suitable for meeting the needs of people who are going to live there. The manager has shown that he has a leading role to make sure that the home is able to successfully support people before they move there. Records show that the manager and staff have found out about the cultural and lifestyle needs of people who wish to move to the home to make sure that these can be met. All peoples’ assessment information is detailed enough to helps staff to plan the ways that they are going to support them. This is important where people have complicated needs which require a lot of insight and well-organised support. The Grange DS0000007510.V371212.R01.S.doc Version 5.2 Page 10 The home should have written information called the Service Users Guide which gives all of the important details that people need to know about what it is like to live there. But this could not be found at the home the day of inspection. This should include information about how to make a complaint, the most recent Inspection report and how much it costs to live there. The home does have a Statement of Purpose which should describe in detail what the home does but this did not include information about how the home supports people who move in on a temporary basis; which would be important to those people and those who live there permanently. The Grange DS0000007510.V371212.R01.S.doc Version 5.2 Page 11 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 6 7 and 9 Quality in this outcome area is Adequate. This judgement has been made using available evidence including a visit to this service. Each person has an individual plan of care, which should set out in their preferences and how their assessed needs will be met. But these do not fully describe the measures which staff use therefore making it difficult for them to consistently meet peoples’ needs. EVIDENCE: Some people at this home have needs which require the staff to respond to them in particular ways for example to give them support to feel confident and help them to manage their anxieties. All people living at the home have a plan of care, which should give a full and detailed description of how their physical, emotional and lifestyle needs are to be met. However care plans do not describe in enough detail the actual support and intervention which staff currently carry out and there was important The Grange DS0000007510.V371212.R01.S.doc Version 5.2 Page 12 information that was not written down. For example, some of the actions that staff take when people who live at the home become frustrated or worried were not written down; how the staff monitor and support someone’s mental health needs was not recorded. As well as this, there was a three month gap in everyone’s care plans where their needs had not been reviewed to see if there were any changes and decide if different approaches are needed. Care planning information is held in different places in the home making it difficult for staff to use. For example, peoples assessments, needs and background information were held in one record, but the information about how staff are to support them was stored separately making it difficult for staff to use these plans to effectively co-ordinate the way they meet peoples needs. Staff do have a good variety of knowledge and experience of caring for people living at the home. Most staff were seen to support people in the same ways some used similar phrases which people found reassuring. Staff were seen talking to each other about peoples needs so that they can continue to work well as a team and help them to be consistent. The manager agreed that improving the quality of care plans was one of his objectives for this service. He described how he intends to improve care plans so that they place people at the centre of a network of support and to fully coordinate their care and follow practices that are used in other services run by this organisation. People living at the home are treated with respect by staff who know them well. Relationships between people and with staff are relaxed, friendly and informal which helps them to feel comfortable. People appeared to be relaxed and happy with the support they get from staff. All people living at the home have access to someone outside of the home who can speak on their behalf and help to make decisions in their best interests. The home helps people to be as independent as they can and to take measured risks if they wish. The manager and staff take actions to support people and reduce the risks which they take so that that there is a balance between promoting peoples independence and rights and making sure that they are safe. The Grange DS0000007510.V371212.R01.S.doc Version 5.2 Page 13 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12 13 14 15 16 and 17 Quality in this outcome area is Good. This judgement has been made using available evidence including a visit to this service. People are encouraged and supported by the staff to lead fulfilling lives and contact with family and friends is supported where possible so that people have links with people outside of the home. EVIDENCE: People living at this home have lifestyles, with their own routines and activities many of which occur outside of the home. Most people have the opportunity to attend day services provided by other organisations although these were closed at the time of this inspection. The staff help people to choose activities that they would like to take part in or to try out and to find opportunities and arrange them although sometimes they find it difficult to find interesting opportunities and motivate people to take part. Examples of opportunities include shopping, fruit picking and planned days out to places of interest. The Grange DS0000007510.V371212.R01.S.doc Version 5.2 Page 14 One person who lives at the home said, “I enjoyed the bus trip yesterday.” Staff at the home are starting to understand and plan how individual support for people living at the home is to take place. For example one person has expressed an interest in using a spa pool which will also help with their mobility and staff are looking at ways that this can be organised. Staff help people to keep in touch with friends and relatives and some people visit the homes. Some people have taken college courses where they have an interest or skill and several certificates are displayed which show their success and commitment. Several choices of meals are offered at all times and people help to plan their meals. Attempts to offer a balanced diet whilst still responding to people’s choices were noted. However the cook was on planned leave and had not been replaced leaving care staff who have less expertise, to organise the catering for people at the home. The Grange DS0000007510.V371212.R01.S.doc Version 5.2 Page 15 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 18 19 and 20 Quality in this outcome area is Adequate. This judgement has been made using available evidence including a visit to this service. Not all of the measures that staff should take to meet peoples personal and health care needs are in place making it difficult for staff to make sure that they are met; and improvements in the way that peoples’ medication is given out and stored are needed to make sure that they get the treatment that has been prescribed and mistakes are avoided. EVIDENCE: Staff were noted to be discrete and made sure that people’s dignity and privacy is respected. Records of people’s healthcare needs are kept by staff in care plans. These show that staff usually look out for changes in their physical or emotional state which may need the involvement of specialist healthcare workers from outside the home. Plans should describe the ways that staff are to support people living at the home whose needs are difficult to meet or who may find it difficult to accept help. But there were some important parts of people’s care where plans were not in place. For example, how staff are to respond to someone The Grange DS0000007510.V371212.R01.S.doc Version 5.2 Page 16 who has difficulty understanding speech and language because of their disability; how someone is to be supported who has behaviour which challenges staff because of their mental ill health. Due to their levels of need, people living at the home are not able to administer their own medicines, and designated staff therefore assist in this area. Medication is securely stored and but there were errors. For example - One persons medication records, and a check of medication in stock showed that they had not been given medication that they had been prescribed on two occasions. Another person’s medication record and check with stock showed that there were seven dosages of medication which could not be accounted for. One person had been given another persons medication which could cause them harm or injury. One person was given their medication twice which placed them at risk of having an overdose. - - As well as this, some people’s Doctors have prescribed them medication that they can take if they are upset or stressed. But staff do not have descriptions of the techniques they use to divert or resolve peoples’ anxieties so that they only have to use this medication when it is absolutely necessary. Care staff said that they recognise when people should be encouraged to take their medication but the way that they make this decision is not written down so people might not get their medication at the right time. The manager confirmed that he and senior staff at the home are undergoing training to help them to be able to administer medication properly. The Grange DS0000007510.V371212.R01.S.doc Version 5.2 Page 17 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 22 and 23 Quality in this outcome area is Good. This judgement has been made using available evidence including a visit to this service. People who live at this home and their families can make a complaint if they are unhappy, have a grievance or dispute which helps them to have control over their lives and there are measures in place which protect people from being harmed which helps to promote their safety and security. EVIDENCE: There is a clear complaints procedure in place at the home, which tells people how to complain, and the length of time a response will take. Observations of the staff’s day-to-day practices show that they ask for the views of service users all the time and help people to make real choices and decisions. One person who lives at the home said, “I complain to the staff all the time and they sort it out – they know they have to.” Since the last inspection there have been two instances where people living at the home were suspected of being abused. On both occasions the manager used the homes adult protection procedure and worked alongside the Police and local authority who advised and co-ordinated the procedures. When the abuse was suspected the organisations managers made sure that people who were vulnerable safe and likely to be abused further. The Grange DS0000007510.V371212.R01.S.doc Version 5.2 Page 18 There is a staff guide, which gives clear instructions about the actions which they must take if abuse is disclosed or witnessed. All staff spoken to are knowledgeable of these practices and have had training either with their National Vocational Qualification (NVQ) or specific courses. The Grange DS0000007510.V371212.R01.S.doc Version 5.2 Page 19 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 24, 27 and 30 Quality in this outcome area is Good. This judgement has been made using available evidence including a visit to this service. The house is homely, well equipped and clean and provides people who live there with a comfortable environment in which to live. EVIDENCE: People who live at the home are encouraged to keep their own rooms tidy and they are helped by staff when this is needed. The home is kept clean by staff who take effective steps make sure that the home is clean and pleasant. The Grange DS0000007510.V371212.R01.S.doc Version 5.2 Page 20 The was previously a school and has had adaptations made so that it is suitable for its present use and has been designed so that the people who live there can have safe access to the house and garden without restricting their rights, freedoms or independence. There are two lounges one of which is very large, two dining areas and a conservatory where people can spend their time. And people are able to lock their bedroom doors so that they can have privacy. The bedrooms are pleasant attractive areas, which have a range of furniture, and fittings which are comfortable and suitable for people to use. All of the people living at the home have decorated their rooms with their items, photographs and keepsakes and some have bought their own furniture and soft furnishings. One person living at the home said, “This is my room these are my things – no one else can use it.” There are bathrooms spread around the home which is convenient for people to use. Two bathrooms have been refurbished, but one of the baths which is designed to help people who have mobility problems had been broken for some time and the manager unable to say how long it would take to be repaired; and there were faults to the hot water system so that water from the taps was too hot for people to use. The home is inspected by the Fire Prevention Service and overseen the local authority to make sure that risks from an accidental fire are lessened and a safe and healthy environment is promoted for the people who live and work there. The laundry is well organised and equipped with modern machinery so that people can be confident that their clothing and personal linen is hygienically cleaned within a reasonable space of time. Mistakes are rare. There is evidence that repairs and maintenance carried out and the manager is drawing up a refurbishment programme to improve those areas that are now looking dated. The Grange DS0000007510.V371212.R01.S.doc Version 5.2 Page 21 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 32 33 34 and 35 Quality in this outcome area is Good. This judgement has been made using available evidence including a visit to this service. There are enough staff at the home to support the people who live there. And they have the skills, training and support from the manager so that they can meet the needs of people living at the home. EVIDENCE: Information from the acting manager indicates that staff have received training relevant to their job roles and the specific needs of people living at the home. A training programme is in place which encourages staff to remain interested and motivated by the work they do and helps to improve the quality of the service. This covers National Vocational Qualifications (NVQ) as well as specialist courses which address the needs of the people who live at the home. Almost all of care staff have NVQ Level 2 or above and workers who have undertaken NVQ Level 2 training are being encouraged to continue their training to Level 3. New staff are given extra training which links with national training organisation standards so that they have sufficient skills to support people and work effectively with other team members. The Grange DS0000007510.V371212.R01.S.doc Version 5.2 Page 22 The staff team, care workers are organised so that shift patterns should respond to the demands of people living at the home. However these do not always work well, for example when the cook is absent, the care staff are required to provide the catering; when people are not at usual day time opportunities then more staff are required to meet their needs. Staff have regular contact with the manager who confirms that regular supervision takes place where staffs’ performance and the work they do with individuals is thoroughly discussed. One staff said, “The home is a busy place to work, I’m happy here.” The manager confirmed that all new staff have had checks carried out before starting work to make sure that they are suitable to work with vulnerable people. The Grange DS0000007510.V371212.R01.S.doc Version 5.2 Page 23 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. 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 are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39, and 42 Quality in this outcome area is Good. This judgement has been made using available evidence including a visit to this service. The manager makes sure that people who live there are supported properly and give leadership and direction to staff so that the quality of the service they give is improved. EVIDENCE: A new manager has been appointed at the home since the last inspection and has been assessed by the Commission to make sure that they have the skills qualities and experience to be able to be registered there. Before coming to this home, he worked in senior positions in several homes and as registered manager for around two years. He has a National Vocational Qualification (NVQ) in care at Level 4 and has enrolled on the NVQ Level 4 in management. The Grange DS0000007510.V371212.R01.S.doc Version 5.2 Page 24 The manager and his senior carry out a series of checks each month to see if the service is working at the standard that they expect. While people who live at the home are asked their views verbally, the views of friends, families or advocates are not yet considered as part of this; plans do not show what improvements will be made to the quality of life of the people living at the home. Staff at the home help people who live there to manage their money. Detailed records are kept of peoples’ day-to-day finances and where staff have supported them to make purchases. There were noticeable hazards at the home at the time of the inspection which were brought to the attention of the manager who took immediate steps to make sure that people living at the home were not put at risk. For example the bathroom water temperature was over sixty degrees centigrade which is too hot and put people at risk of being injured; there was no thermometer in the bathrooms so that staff could not check the water temperature and no records to show that the water temperature had been checked. The home has been subject to inspections by the Fire Prevention Authority and local authority environmental health officers to make sure that the home is safe. However, there were no records available to show that fire prevention training had been carried out for existing and new staff. The Grange DS0000007510.V371212.R01.S.doc Version 5.2 Page 25 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 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 2 3 3 X 4 X 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 3 25 X 26 X 27 3 28 X 29 2 30 3 STAFFING Standard No Score 31 X 32 3 33 2 34 3 35 3 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 2 3 X 3 X LIFESTYLES Standard No Score 11 3 12 3 13 3 14 X 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 2 X 3 X 2 X X 2 X The Grange DS0000007510.V371212.R01.S.doc Version 5.2 Page 26 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 YA1 Regulation 5 Requirement The manager must make sure there is a Service User Guide that can be used by the people who live at the home. This is so that people have important information about the home, their rights as residents and how they can complain. 2 YA6 15 This is a new Requirement. The manager must make sure that there are care plans in place which have enough detail to show the specific actions staff are to take to support their needs preferences and lifestyle. Reviews must reflect the progress towards those goals. This is to make sure that staff plan and review how they work with people and that they write this down so that everyone in the home works in the same way. This is a new Requirement. 15/11/08 Timescale for action 01/11/08 The Grange DS0000007510.V371212.R01.S.doc Version 5.2 Page 27 3 YA20 13 The manager must make sure that there is an accurate record of all medication held and administered at the home. This is to make sure that people get the treatment they have been prescribed. 15/09/08 4 YA20 13 This is a new Requirement. Where people are prescribed medication to take only when they need it, the manager must make sure that staff have clear guidance which show how staff have made these judgements. This is to help staff to make consistent judgements about when people need to take the medication they have been prescribed. 15/09/08 5 YA29 23 This is a new Requirement. The manager must make sure that adapted bathrooms are kept in a good state of repair. This is to make sure that people can be as independent as possible, have comfortable facilities and are not inconvenienced. 15/10/08 6 YA39 24 This is a new Requirement. The manager must make sure that people who live at the home and their representatives are consulted about the quality of the service. This is to make sure that the service is managed in the best interests of the people living at the home. This is a new Requirement 01/11/08 The Grange DS0000007510.V371212.R01.S.doc Version 5.2 Page 28 7 YA42 23 The manager must make sure that staff working at the home have suitable training in fire prevention and procedures. This is to make sure that there are adequate fire safety precautions for people who live at the home and those who work there. 15/08/08 8 YA42 13 This is a new Requirement The manager must make sure that hot water in bathrooms is regulated so that it is not above 43 degrees centigrade. This is so that people are not injured by bathing in water that is too hot. This is a new Requirement. 01/09/08 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 YA33 Good Practice Recommendations The manager should organise staff in a better way which makes sure that more people are supported at busy times and domestic tasks are carried out at the convenience of the people who live at the home. The Grange DS0000007510.V371212.R01.S.doc Version 5.2 Page 29 Commission for Social Care Inspection North Eastern Region St Nicholas Building St Nicholas Street Newcastle Upon Tyne NE1 1NB 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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