Inspection on 12/09/05 for The Grange

This inspection was carried out on 12th September 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

The Grange 29/10/08

The Grange 23/11/06

The Grange 01/03/06

The Grange 23/03/05

The Grange 04/11/04

The Grange 28/01/04

Similar services:

Clover House

Parkside

Park Lodge

Mere Hall View

St Bonaventures

Hudson Road

Whitewalls

Home Farm

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

CARE HOME ADULTS 18-65 The Grange 2 Park Vale Road Macclesfield Cheshire SK11 8AR Lead Inspector Julie Porter Announced 12 September 2005 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 Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationary 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 F51 F01 The Grange S6532 V 240176 120905 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service The Grange Address 2 Park Vale Road Macclesfield Cheshire SK11 8AR 01625 618146 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) Miss Kelly Brown Kelly Brown Care Home 3 3 Category(ies) of LD Learning Disability registration, with number of places The Grange F51 F01 The Grange S6532 V 240176 120905 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: 1 No more than 2 Service Users may be LD 2 No more than 1 Service User may be LD, aged under 18 years Date of last inspection 23/03/05 Brief Description of the Service: The Grange is a small, privately owned care home that is close to Macclesfield town centre. There are a variety of shops, churches and other facilities nearby. There are no designated car parking spaces at the home.The Grange was formerly a private dwelling that has been altered and adapted to become a care home for three service users with a learning disability.The Grange is a two-storey building with a cellar. It has five bedrooms, one of which is used as an office. The proprietor and Service users have their own bedrooms. Downstairs there is a lounge, dining room, bathroom and kitchen for service users. The resident proprietor uses a separate lounge. A small, enclosed yard provides opportunities for sitting outside during the summer months. The Grange F51 F01 The Grange S6532 V 240176 120905 Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection took place during the afternoon and evening of the 12 September 2005 and included a tour of the home, discussions, and an evening meal with the three people currently living there. Records kept in the home were checked. What the service does well: What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The Grange F51 F01 The Grange S6532 V 240176 120905 Stage 4.doc Version 1.40 Page 6 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 Standards Statutory Requirements Identified During the Inspection The Grange F51 F01 The Grange S6532 V 240176 120905 Stage 4.doc Version 1.40 Page 7 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 1 - 3 Residents’ care needs are assessed before they move in so that they know their needs can be met there. EVIDENCE: Residents in the home have lived there for a number of years. They spoke fondly about their move to the home and the support they get living there. They talked about their wishes for the future and how the owner was helping them to make steps to achieve them. All the residents spoke about moving on into their own homes in the future and what they were learning while living at The Grange to help them to do that. The Grange F51 F01 The Grange S6532 V 240176 120905 Stage 4.doc Version 1.40 Page 8 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 6 - 9 The manager and a small staff team look after the residents’ health needs well. However, care plans are not always kept up to date so there is a risk that residents may not receive the care that they need if the manager, who knows them well, is not available. EVIDENCE: The residents’ care files were checked. The care plans had not always been updated to reflect changes in the residents’ needs although the manager, who provides care for them every day, knew what all their needs were and what activities they had been involved with. For example, one resident is receiving intensive support from the advocacy service, but the care plan had not been updated to show this. If care plans are not updated, there is a risk that residents who are less able to communicate would not receive all the care they need, when the manager is not available. See requirement 1. Residents spoken with said that they are involved in every aspect of running the home and it was helping them to prepare for the future. However even after moving on they would still consider The Grange as home and the manager as “mum.” The Grange F51 F01 The Grange S6532 V 240176 120905 Stage 4.doc Version 1.40 Page 9 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 11 - 17 Residents are encouraged to maintain their current lifestyles and become involved in new activities to give them new experiences and help their personal development. EVIDENCE: An evening meal was shared with the residents and another visitor to the home; the evening was relaxed and sociable. The meal had been prepared by one of the residents and they said that they could invite guests to the home if it was their turn to cook. This had been a decision made by them all to ensure fairness. The residents’ spoke of friendships they had made with people from college and the local area. They talked of “sticking together” and “looking out for each other.” They very clearly regarded themselves as a “family” with the manager/owner as “Mum”. Two of the residents are working and spoke enthusiastically about the freedom their jobs gave them. The Grange F51 F01 The Grange S6532 V 240176 120905 Stage 4.doc Version 1.40 Page 10 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 18 &19 Residents are supported by a long-standing staff team who know them well so can meet their care needs well. EVIDENCE: The manager is available 24 hours a day and three other people who know the residents well are available to support the residents from time to time. The residents in the home are all able to manage their personal care themselves. Their understanding of the role of the manager was that she was around to talk things through, to help them with things like budgeting, saving and problem solving. All the residents are registered with the local G.P. The Grange F51 F01 The Grange S6532 V 240176 120905 Stage 4.doc Version 1.40 Page 11 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 22 &23 In the absence of suitable training for all staff, and supporting adult protection policies and procedures, residents, staff and the manager could be vulnerable. EVIDENCE: Residents said that they have regular discussions and meetings with the manager and staff about how the home is run and if there are any problems they are encouraged to sort them out and set boundaries and rules. The manager also has monthly meetings with individual residents and issues are recorded and discussed on a form call “Getting it right together”. Staff have not attended any training relating to adult protection procedures. See requirement 2 The Grange F51 F01 The Grange S6532 V 240176 120905 Stage 4.doc Version 1.40 Page 12 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 24 - 30 The home is maintained well and provides a comfortable, homely place for residents to live in. EVIDENCE: A guided tour was taken with the residents of the home who have access to all areas of the home except the owner’s private accommodation. All areas of the home were clean fresh and tidy. Residents’ bedrooms are personalised and reflected their individual personalities. During the summer the residents had undertaken a project to redecorate and furnish their lounge which had also managed to reflect their individual tastes and interests. The Grange F51 F01 The Grange S6532 V 240176 120905 Stage 4.doc Version 1.40 Page 13 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 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31-36 The staff know the needs of the current residents very well, having worked with them for a long time, and there are enough staff on duty to make sure that the residents’ needs are met. EVIDENCE: Two part-time support staff are employed to help the manager provide care. Although neither was there at the time of the inspection, they have both worked at the home for some time. There is no formal training and supervision provided, although the manager instructs the staff how to do their work. However, lack of training may lead to care not being provided as needed, if the manager was not available. See recommendations 1, 2 & 3 Personnel files contained all the necessary paperwork to show that staff had been properly checked out before starting work at the home; training certificates were also evident. The Grange F51 F01 The Grange S6532 V 240176 120905 Stage 4.doc Version 1.40 Page 14 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 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 37 -40 The owner/manager is at the home constantly and puts the best interests of the residents first. However, improvement is needed to supervision and training to ensure that residents continue to receive good quality professional care. EVIDENCE: One resident spoken with stated that “there needed to be more people like mum in the world”, “she was the best”. During the inspection the residents were seen enjoying themselves. They were confident and able to discuss what life was like in the home. The manager promotes independence and residents were constantly encouraged to say how they were feeling. The rapport between the manager and residents was light-hearted and caring. A visitor to the home was spoken with who said he was always made to feel welcome and enjoyed the family atmosphere in the home; if he could he would move in himself. The Grange F51 F01 The Grange S6532 V 240176 120905 Stage 4.doc Version 1.40 Page 15 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 CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score 3 3 3 x x Standard No 22 23 ENVIRONMENT Score 3 2 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 2 3 3 3 x Score Standard No 24 25 26 27 28 29 30 STAFFING Score 3 3 3 3 3 3 3 Standard No 11 12 13 14 15 16 17 3 3 3 3 3 3 3 Standard No 31 32 33 34 35 36 Score 3 2 3 3 2 2 CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 The Grange Score 3 3 x x Standard No 37 38 39 40 41 42 43 Score 3 3 3 3 x x x F51 F01 The Grange S6532 V 240176 120905 Stage 4.doc Version 1.40 Page 16 yes 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. 2. Standard 6 23 Regulation 14 13 Requirement Timescale for action 31/12/05 The residents care plans must be kept under review Staff must undertake training on 31/12/05 protecting vulnerable adults from abuse and harm. 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. 2. 3. Refer to Standard 32 35 36 Good Practice Recommendations The manager should achieve the Registered managers award There should be a training plan to show how staff will receive the training appropriate to the work they do Staff should receive formal, recorded, supervision at least 6 times per year. The Grange F51 F01 The Grange S6532 V 240176 120905 Stage 4.doc Version 1.40 Page 17 Commission for Social Care Inspection Unit D, off Rudheath Way Gadbrook Park Northwich Cheshire CW9 7LT National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI The Grange F51 F01 The Grange S6532 V 240176 120905 Stage 4.doc Version 1.40 Page 18 - 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. 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