Inspection on 17/08/06 for The Grange

This inspection was carried out on 17th August 2006.

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

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

The Grange 10/10/05

The Grange 21/04/05

The Grange 07/02/05

The Grange 25/05/04

Similar services:

Byars Care Home

St Marys Nursing Home

Bramble Lodge

Parkmanor Residential Home

Thornham Grove

Hunter`s Lodge

London Road Neurological and Specialist Care Unit

Carlton Care Home

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

CARE HOMES FOR OLDER PEOPLE The Grange Staverton Road Daventry Northants NN11 4EY Lead Inspector Mrs Pat Harte Unannounced Inspection 17th August 2006 10:00 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address DS0000035002.V307959.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. DS0000035002.V307959.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service The Grange Address Staverton Road Daventry Northants NN11 4EY 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) 01327 705226 01327 709758 www.northamptonshire.gov.uk Northamptonshire County Council Mrs Mary Frances Craig Care Home 38 Category(ies) of Dementia (5), Dementia - over 65 years of age registration, with number (25), Old age, not falling within any other of places category (38) DS0000035002.V307959.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. 4. 5. 6. No person falling within the OP category can be admitted where there are already 38 people of OP category already in the home. No person falling within the DE(E) category can be admitted where there are already 25 people of DE(E) category already in the home. No person falling within the DE category can be admitted where there are already 5 people of DE category already in the home. No person admitted with the DE category will be below the age of 60. The total number of service users within the DE(E) and the DE category must not exceed 25. Total number of service users in the home must not exceed 38. Date of last inspection 10th October 2005 Brief Description of the Service: The Grange provides residential care for up to 38 Elderly Residents of both sexes with 20 places for Residents with Dementia, five of whom may be aged 60 to 65 years. The Home offers 28 permanent places and 10 Interim care places for up to 12 weeks when arrangements are made for discharge to the community or to another care home. The Home is owned by Northamptonshire County Council and managed by Mrs. M. Craig. The Home is situated within a residential area of Daventry with easy access to the local facilities and amenities. The premises consist of all ground floor accommodation. There are central lounge/dining areas and all Residents are provided with single bedrooms. There are dedicated areas for Residents with Dementia. Residents have the use of safe garden areas. The Home charges £76 to £348.00 per week; Residents are assessed to pay according to their means. Extra charges are made for Hairdressing, Chiropody, Toiletries and Newspapers. DS0000035002.V307959.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The focus of inspections undertaken by the Commission for Social Care Inspection is upon outcomes for Service Users and their views of the service provided. Inspection planning took half a day and consisted of a full review of the inspection record, the Homes service history record including notifications of complaints, accidents, events and incidents, the pre inspection information submitted by the Home and correspondence and contacts between the Commission and the Home. At the time of the Inspection Residents and Relatives questionnaires had not been received back. The information was collated and analysed to form the plan of inspection focusing on the outcomes for Residents. The primary method of inspection used was ‘case tracking’ which involved selecting three Residents and tracking the care they receive through review of their records, talking with them and the care staff. In addition six Residents, four staff, two Relatives and a visiting Specialist Nurse were spoken with. Observations were made on routines and care practices. Selected areas of the premises were viewed and a selection of records was inspected. Discussions were held with the Registered Manager. The Inspection took place during the morning and afternoon over a period of 6 hours and was carried out on an unannounced basis What the service does well: The Grange continues to have a stable staff group who demonstrated their commitment to the well being of their Residents. Staff turnover was low and this means that familiar staff are on hand to provide care for the Residents. Residents spoke very highly of the staff group commenting that they were very caring, helpful and on hand to quickly respond to their needs. Residents commented and observations confirmed that relationships between themselves and the staff group were very good. Comments included “the staff couldn’t do more for me,” “staff help me to find my way around,” “staff couldn’t be kinder” and “If I ring for help staff quickly come.” DS0000035002.V307959.R01.S.doc Version 5.2 Page 6 The information given to all prospective Residents had been updated and Residents felt it gave them good descriptions and accurate information on the Home and it’s services. The assessment process ensured that prospective Residents were visited prior to admission, where possible, and a thorough assessment carried out to ensure that their needs could be met. In the case of interim placements it was not always possible to visit due to the emergency nature of the admission or to the timing of discharges from Hospitals. In these instances the Care Management assessment was used to identify needs and further information was gathered from relevant sources, such as Hospital Staff and Relatives. The Manager demonstrated, through discussions, that only People whose needs could be met in full would be admitted to the Home. Staff demonstrated that they involved all their Residents in the planning of their care, including those Residents with Dementia. Residents’ commented that staff treated them as individuals and respected their individual wishes and preferences on how the care was to be provided. The care planning process took account of any cultural or religious needs paying respect to Peoples’ differing backgrounds and lifestyles. Arrangements were made to support the Residents, uphold their wishes and enable them to pursue their religious observances. Health care needs were carefully monitored and Residents confirmed they were enabled to see their relevant medical professionals promptly and in private. Records showed that specialist professionals such as the Continence and Falls Advisers were called in to give staff advice on how best to support their Residents in these areas. Residents confirmed that they were aware of the home’s complaints procedure and felt confident to raise any issues or concerns with staff or the Manager. There have been no complaints since the last inspection. Routines were relaxed and flexible and Residents had choice in how and where they wished to spend their time. Residents’ comments included “I can get up and go to bed when I want to,” “ I can chose whether I wish to join in activities,” “Staff offered me the choice of a bath or a shower” and “I can spend my time in my room if I wish.” Observations confirmed that staff took care to protect Residents’ dignity and privacy by ensuring personal care tasks were carried out in private. Residents commented that staff took care to ease any embarrassment and make them comfortable when intimate tasks such as bathing were carried out. Residents’ comments and the review of records showed that they were encouraged to remain as independent as possible and do things for themselves. DS0000035002.V307959.R01.S.doc Version 5.2 Page 7 The Activity programme was viewed as excellent. Residents were encouraged to pursue their interests and hobbies and to develop new ones. There were opportunities for individual as well as group activities. Meaningful activities were provided for Residents with Dementia and observations confirmed that the activities promoted interaction and conversation between Residents. Residents’ comments on the food provision were very positive. They felt that they were provided with a good range of meals, choices were available and staff went out of their way to “tempt” their appetites. The catering staff were fully aware of their dietary needs and likes and dislikes. The serving of the midday meal was efficient and Residents were given help, by staff, to eat their meals. Records showed that Residents’ weight is monitored and staff noted daily nutritional intake to ensure any problems were quickly identified. Arrangements were made for Residents to pursue their religious observances and local Clergy visit individuals in the Home and hold services. Residents were provided with a safe and comfortable environment including access to safe garden areas. Residents saw the communal areas in the centre of the premises as the very heart of the Home. They felt that whilst there were separate lounge areas the open plan nature of the design promoted social interaction and created a sense a “Family atmosphere”. 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. DS0000035002.V307959.R01.S.doc Version 5.2 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 Outcomes Statutory Requirements Identified During the Inspection DS0000035002.V307959.R01.S.doc Version 5.2 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 the following standard(s): 1, 2, 3, 4, 5 & 6 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Good information is made available to prospective Residents on the Home’s services and facilities, the assessment process is thorough and effective ensuring that the needs of Residents admitted to the Home can be met in full. EVIDENCE: We looked at the information given to prospective Residents on the Home’s services and the process of assessment to see that this was thorough in identifying Peoples’ needs and ensured that those needs could be met. Residents confirmed that they had been given the Home’s Service User Guide, which has recently been reviewed. They felt this contained accurate and good information on the services and facilities and how to raise any issues or concerns. The Home’s Statement of Purpose, which describes the aims and objectives, had also been reviewed and updated. Copies of both the Guide and Statement are available in the main foyer so that anyone visiting the Home DS0000035002.V307959.R01.S.doc Version 5.2 Page 10 may access together with other information such as Independent Advocacy, the last Inspection report and the results of satisfaction surveys. The assessment process was discussed with the Manager and three assessment records were viewed. The process ensured that the Manager or senior staff visit prospective Residents, where possible, to carry through a needs assessment. Where at all possible prospective Residents and their Relatives are encouraged to visit the Home to view the facilities, meet with staff and other Residents and discuss further their care needs before coming to a decision on admission. The nature of emergency admissions from the Community or discharges from Hospitals does mean that Staff do not always have time to carry through an assessment. In these instances the Care Management assessment information was used to determine whether needs could be met and to establish the overall aim of a possible return to community living or permanent residential care. The Manager showed, through discussions, that she considered the needs of each prospective Resident carefully and balanced these with the dependency levels of People already living in the Home. Admissions are not made where there is any doubt that the needs can be met or where it is felt that the staffing levels would not be sufficient to manage additional high dependency needs. The assessment records were thorough and holistic and took account of all areas of need including Residents’ emotional and psychological care needs. Historical information had been gathered from Residents, Families and relevant professionals to broaden the understanding of the needs. Care had been taken to establish the Residents’ wishes in relation to routines, food likes and dislikes, their hobbies and interests and their preferences for their support. Care had also been taken to identify any cultural or religious needs. The Manager showed that arrangements can be made to provide cultural diets and to enable Residents to pursue their different religious observations although currently there are no specific needs other than those4 made for visits from local Christian Clergy. Recognised assessment tools were used to assess any risk areas such as skin and nutritional needs. Where Residents were suffering from Dementia an additional assessment of their mental abilities, awareness and understanding had been carried through. Assessments of physical care needs identify any aids or equipment that may be needed for individuals. Resident’s records showed that they had been given contracts detailing the terms and conditions of their placement, details of the fees to be charged are provided direct from the County Council following a financial assessment. The Service User Guide stated the areas where additional charges could be made. DS0000035002.V307959.R01.S.doc Version 5.2 Page 11 For example Residents pay for their toiletries, newspapers and services provided by external professionals, such as Chiropody and Hairdressing. DS0000035002.V307959.R01.S.doc Version 5.2 Page 12 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9, 10 & 11 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents are supported to take acceptable risks, make decisions about their lives and are assured that the staff group know their needs, aspirations and goals. EVIDENCE: We looked at the Home’s care planning processes to ensure that staff were given instruction and guidance on how to meet Service Users’ needs. Three Residents care plans were inspected. The records showed a holistic approach to recording the Residents’ needs and providing staff with good levels of instruction and guidance on how the care is to be carried through. It was clear that Residents were involved in the development of their plans and agreement reached on how the care was to be provided. The plans showed Residents were enabled to continue to maintain their individual lifestyle routines, for example preferred rising and going to bed times were clearly stated. The care plans gave step-by-step guidance to staff DS0000035002.V307959.R01.S.doc Version 5.2 Page 13 on the areas where they needed assistance. For example personal care routines such as bathing were thoroughly documented giving detailed instructions to staff on the equipment needed and how the task was to be carried through. The plans detailed the areas that the Residents could safely undertake for themselves showing they were encouraged to maintain as much control over their lives and be as independence as possible. Reminders were incorporated into the plans for staff to routinely monitor skin and nail conditions, which meant that any changes were quickly picked up and the necessary action taken. Risk assessments were carefully undertaken and plans were in place to eliminate the risks as much as possible. For example the plans gave instructions to staff on reminding Residents to use their mobility aids or to escort them when they moved about the Home to prevent falls or provide assistance to find their way around the Home. Night routines were clearly detailed and instructions were given to staff where checks were needed. Residents confirmed that the night checks had been discussed and agreed with them. They stated that they felt reassured and had peace of mind that staff were popping in to make sure they were all right. Records showed that good use if made of historical information to help staff understand and provide support for Resident’s with Dementia. For example information on past interests, events and people of importance to individual Residents are documented to help staff understand and respond to their Residents in their confusion. Strategies are in place to help Residents who were confused or who suffered from memory loss and the plans showed detailed instructions for the management of behaviours that could make Residents vulnerable. For example staff monitored some Residents closely to ensure they were on hand to guide them around the Home, reassure them if they were distressed or take them for walks when they wanted to go out. Discussions with the Manager and staff and observations of practice showed that attention has been paid to developing effective communication methods. Care plans detailed the need to speak clearly, explain carefully and give time for Residents respond. Staff showed that they were sensitive and took care and time to work at their Residents pace enabling them to express choice and make their wishes and opinions known. The care plan records showed that Residents were constantly monitored and where changes in need were identified new instructions were provided for staff. Where no changes have occurred there is a system for reviewing the plans on a monthly basis. Health care records were very detailed. They showed that health care professionals were routinely involved with Resident’s health care and that staff were quick to respond to any changes and request visits from the relevant DS0000035002.V307959.R01.S.doc Version 5.2 Page 14 medical practitioners. Residents felt that staff kept a close eye on their health care needs and quickly arranged Doctors visits; they confirmed that staff took care to ensure they met with medical professionals in private. A visiting specialist Nurse stated that she felt staff took a proactive approach to monitoring health care needs and followed her direction and advice in caring for a Resident suffering from cancer. She had trust and confidence in the staff group to call her whenever necessary. Procedures were in place for the management of medication. Storage was safe and appropriate. The required records for incoming, administration and disposal of medication were in good order. Observations confirmed that Medication was safely and appropriately administered. Assessments are carried out to determine whether Residents can safely continue to manage or part manage their own medication if at all possible. Where a Resident can manage undertake this for themselves they are provided with safe storage arrangements and staff monitor for any change in abilities. Observations confirmed that Staff ensured the protection of Residents privacy and dignity by carrying through personal care tasks in private. Residents felt that staff knew their care needs very well and provided them with good support and encouragement. Several Residents spoke of staff helping them to find their way about as they were forgetful and easily got lost. Other Residents commented that staff allowed them to do things for themselves and only supported where necessary, they saw this as being very important in encouraging them to maintain their independence. Residents’ records showed that staff made every effort to secure their wishes in relation to death and funeral arrangements. The Home can provide care for Residents who are ill or dying so long as their needs can be met and the relevant medical professionals are involved with their care. DS0000035002.V307959.R01.S.doc Version 5.2 Page 15 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 & 15 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service Residents are enabled to exercise control and choice in the way they wish to lead their lives and are provided with good activity programmes in keeping with their interests. EVIDENCE: We looked at the routines of the Home and the activities programmes to ensure that Residents were able to live relaxed and fulfilled lives reflecting their personal preferences. Residents stated that routines were relaxed and flexible. They commented, and observations confirmed, that they were free to decide on how and where they wished to spend their time. They said that timings such as getting up and going to bed were wholly in accordance with their wishes. Residents were very satisfied with the activity programme they said that there was always something to do but they could chose whether they wished to join in or not. Those with specific hobbies or interests are encouraged and enabled to pursue them, for example one Resident loved reading and commented that DS0000035002.V307959.R01.S.doc Version 5.2 Page 16 there was a plentiful supply of books available. Another Resident stated that staff always ensured she had wool to do her knitting. Magazines, books on local history are available to stimulate memories and interest. The activity programme for Residents with Dementia has been developed. Staff take care to gather historical information on Residents hobbies and interests and provide equipment or books that will help stimulate their memories and encourage interest. Quizzes are designed with reminiscence in mind so that Residents can get the full benefit of joining in and recalling past events and ways of life. Activities are provided on both a group and individual basis and include games, craftwork, quizzes, and Bingo and general entertainment. During the morning a lively and exciting game of Bingo was taking place with most Residents and a visiting Relative joining in. Staff helped Residents with failing eyesight to join in, the pace of the activity gave everyone time to complete their cards and everyone had a good time competing to win prizes. In the afternoon there was time for one to one sessions where staff assisted Residents to complete jigsaw puzzles or simply sat and talked with them. In one of the Dementia care lounges Residents joined in a reminiscence quiz that provoked memories and resulted in much hilarity and stimulated conversation and interaction. There is an open visiting policy. Residents confirmed that they were enabled to receive their visitors in private if they wished. Visiting Relatives spoke of the real family feel of the home. They said that they were always made welcome and were extended hospitality. They stated that staff made time to discuss their Resident’s care needs and commented that they were kept well informed of any changes or concerns. Special events are celebrated and care is taken to involve families and other Residents. For example a Resident recently celebrated her birthday, she agreed to the local press being invited to the event and was really pleased with the resulting pictures in the local paper. Residents were fully satisfied with the food provision. They felt that staff respected their individual likes and dislikes and they stated that they were provided with a good range of choice. Records showed that care is taken to identify any nutritional needs or cultural preferences. One Resident commented, “If there were any fault there is too much food.” Other Residents stated that staff went out of their way to tempt their appetites and provide alternatives. Observations of the mid day meal confirmed that the meal was nicely presented, efficiently served and that staff were on hand to assist Residents where necessary. Records showed that care is taken to routinely monitor Residents weight and appetites. This ensured that any nutritional concerns are quickly identified so that action can be taken. For example food and fluid charts are used to ensure sufficient intake and the advice of the DS0000035002.V307959.R01.S.doc Version 5.2 Page 17 Dietician or Doctors is sought to determine any need for additional supplements. DS0000035002.V307959.R01.S.doc Version 5.2 Page 18 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16, 17 & 18 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. The Home has effective systems in place to ensure complaints are listened to, investigated and acted upon and to ensure that Residents are protected from abuse. EVIDENCE: We looked at the systems in place to ensure that any concerns and complaints are listened to and acted upon and that Residents are protected from abuse. Residents confirmed that they had been given the Home’s complaints procedure which is also displayed in the Home. Those spoken with felt confident and able to raise any issues or concerns with staff. A complaints record is maintained. No complaints have been made to the Manager or to the Commission since the last inspection. Residents are registered on the Electoral roll and are given assistance to exercise their voting rights by postal votes or visiting the local polling stations. Robust procedures for the Protection of Vulnerable Adults are in place. Staff receive training in recognising abuse and in the reporting procedures to the relevant Authorities. Two notifications have been made since the last DS0000035002.V307959.R01.S.doc Version 5.2 Page 19 inspection concerning incidents of Resident-to-Resident violence. The incidents were reported to the relevant Authorities including the Commission, were fully investigated by the Manager and action was taken to increase the monitoring of the Residents concerned to prevent any further occurrences. The careful monitoring of Residents ensures that such incidents are rare. DS0000035002.V307959.R01.S.doc Version 5.2 Page 20 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 20, 21, 22, 23, 24, 25 & 26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents are provided with a warm, safe, clean, comfortable and wellmaintained environment suitable for their needs. EVIDENCE: We looked at the premises to ensure that they were suitable for the Residents needs and offered them a comfortable and safe environment. The premises were in good order, clean, warm, safe, comfortable and well maintained. Standards of domestic and hygiene maintenance were viewed as very good. Residents stated that cleaning routines were carefully organised to ensure no disruption to their preferred routines. DS0000035002.V307959.R01.S.doc Version 5.2 Page 21 Residents’ bedrooms viewed were comfortable and safely maintained. Residents commented that they were able to have their furniture and belongings around them and personalise their rooms as they wished. The Home has on going programme of maintenance and redecoration. A Handyman is employed to carry out minor repairs. Residents confirmed their satisfaction with the communal facilities stating that they were comfortable and homely. They particularly liked the fact that all the lounge/dining areas are at the heart of the Home and by the front door. They stated that when they were in the lounges they could see exactly what was going on and were able to mix freely with other Residents and visitors. Residents have the use of pleasant secure and safe garden areas, one with a raised flowerbed that they themselves can maintain if they wish. Several Residents spoke of making good use of the gardens during the recent fine weather. The service does not cater for Residents with severe Physical disabilities. However if Residents deteriorate physically specialist equipment is provided to help them with their mobility and to safely carry through movement and handling practices. Equipment such as pressure relieving mattresses and cushions may also be obtained where needed. DS0000035002.V307959.R01.S.doc Version 5.2 Page 22 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 & 30 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Recruitment procedures are robust and sufficient numbers of competent care staff are deployed to meet the Residents needs. EVIDENCE: We looked at staff recruitment procedures and staff training to ensure Residents were in safe and competent hands. Residents spoken with said that the all the staff, including ancillary staff, were very kind, committed and caring. They felt that care needs were promptly attended to. Observations showed that staff constantly monitored their Residents, responded promptly to their needs and relationships were excellent. The rotas showed that a minimum of four care staff are deployed on daytime shifts and 3 night carers provide night care. In addition a Residential Care Supervisor is on duty on all daytime shifts and provides guidance and support for staff. The Manager mainly works office weekdays hours. Staff stated that they were always able to contact her or other County Council representatives in an emergency out of office hours. Daytime care staff are deployed to and have responsibility for specific areas of the home, where it is necessary for two care staff to carry through care tasks a DS0000035002.V307959.R01.S.doc Version 5.2 Page 23 staff member from another area will give assistance. The deployment of regular staff to specific areas provides consistency and continuity of care and enables Residents with Dementia to become familiar with and recognise their staff group. In addition to the care staff, domestic and catering staff are employed together with a Handyman. The ancillary staff provision ensures that care staff are not diverted from their care duties. Two staff members’ records were viewed and showed that the recruitment practice was good and protected Residents. The necessary Criminal Records Bureau Checks had been undertaken and references obtained. Records showed that new staff were provided with an induction programme, which is linked to the Sector Skill Council’s recommended guidelines and was carried through within the recommended timeframes. The Manager showed that she keeps the annual staff training plan under review and accesses core and specific training on an on going basis. Staff spoken with expressed positive comments on the training provided. They stated that they were enabled to undertake regular updates and specialised training such as Dementia Care. They were encouraged to undertake National Vocational Qualifications. Currently about 75 of the staff group have obtained an NVQ and this is well above the expected standard of 50 . DS0000035002.V307959.R01.S.doc Version 5.2 Page 24 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 32, 33, 34, 35, 36, 37 & 38 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. The Management of the Home is effective and in the best interests of the Residents. Safe systems are in place for the management of Residents monies and items held for safekeeping. EVIDENCE: We looked at the overall management of the Home and Health and Safety to ensure that the Home was effectively managed and Service Users were not at risk. The Manager demonstrated her ongoing commitment to maintaining the required Regulations and Standards and ensuring the Home is run in the best interests of her Residents. This is demonstrated by the fact that no requirements have been made in this report. DS0000035002.V307959.R01.S.doc Version 5.2 Page 25 She closely involves her Residents in the running of their home. Residents said that she was readily available to them and was in contact with them on a daily basis. They confirmed and records showed that regular Residents meetings are held. These have been adjusted so that the Manager meets with small groups to ensure that all Residents have a voice. It was clear from the records and Residents comments that their opinions, comments and wishes are listened to and acted upon and that any issues raised are looked at and resolved. The Manager has undertaken surveys with the Residents, Relatives and stakeholders, such as Doctors, Nurses, Chiropodists, Hairdressers and other visiting professionals, to gain their opinions of the services. The results have been collated and published and have been made available to all in the information area at the entrance to the Home. Staff spoken with felt that the Manager was easily accessible to them and was willing to discuss any issues, guide them in practice and offer support. Records showed that formal staff supervision is undertaken bi monthly. The Home’s policies and procedures were all revised last year by the County Council and are now in place to guide and instruct staff. Visit reports made by the County Council’s representatives show that the Home is visited monthly with quality areas reviewed and Residents comments sought. The systems for the safekeeping, where necessary, of Residents moneys were in good order. Two records inspected showed that receipts were carefully maintained for any purchases made by staff on a Resident’s behalf or charges incurred for services such as Hairdressing and Chiropody. There is an internal auditing and reconciliation system to ensure the accuracy of the individual accounts and balances. The approach to general health and safety was assessed as excellent. Fire records were well maintained indicating that the fire systems were regularly checked in accordance with the guidance given by the Fire Officer. Accident/Incident records were well maintained and showed that every accident or incident was analysed and action was taken to prevent similar occurrences. Staff records confirmed training is provided in Health and Safety. The Home was safe and no hazards were observed. DS0000035002.V307959.R01.S.doc Version 5.2 Page 26 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 3 3 4 4 3 3 HEALTH AND PERSONAL CARE Standard No Score 7 3 8 4 9 3 10 3 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 4 13 4 14 4 15 4 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 3 18 4 3 3 3 3 3 3 3 3 STAFFING Standard No Score 27 3 28 3 29 3 30 4 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 4 X 3 3 3 4 DS0000035002.V307959.R01.S.doc Version 5.2 Page 27 Are there any outstanding requirements from the last inspection? No STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations DS0000035002.V307959.R01.S.doc Version 5.2 Page 28 Commission for Social Care Inspection Northamptonshire Area Office 1st Floor Newland House Campbell Square Northampton NN1 3EB 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. 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