Inspection on 19/04/05 for The Grange

This inspection was carried out on 19th April 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. 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 no outstanding requirements from the previous inspection report, but made 5 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

The Grange 22/10/09

The Grange 19/01/08

The Grange 19/01/07

The Grange 15/11/05

The Grange 09/02/05

The Grange 20/05/04

Similar services:

Ashlea Mews Residential Home

Eastwood

West Lodge

Arran House

Avenue Community Nursing Home

Cosin Lodge

Farmborough Court

Cragston Court

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

CARE HOME ADULTS 18-65 The Grange Galbraith Terrace Trimdon Grange Durham TS29 6EG Lead Inspector Bill Drumm Unannounced 19 April 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 DB54 S60137 The Grange V218986 190405 Stage 4.doc Version 1.20 Page 3 SERVICE INFORMATION Name of service The Grange Address Galbraith Terrace Trimdon Grange Durham DL29 6EG 01429 882043 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) Soverign Care North East Limited Ms Dawn Tombling (Acting Manager) CRH 17 Category(ies) of MD Mental Disorder (17) registration, with number MD(E) Mental Disorder -over 65 (6) of places The Grange DB54 S60137 The Grange V218986 190405 Stage 4.doc Version 1.20 Page 4 SERVICE INFORMATION Conditions of registration: None. Date of last inspection 9th February 2005 Brief Description of the Service: The Grange is a care home providing personal care and accomodation for 17 adults with a mental disorder, which includes 5 adults over the age of 65. The homes owners are Sovereign Care North East and Mr Steven Hunter is the Responsible Individual. The home is located on the edge of the small village of Trimdon Grange, close to shops, pubs and other amenities. There are local bus services, which reach a number of larger towns in the area. There are thirteen single and two double bedrooms. There are no en-suite facilities but adequate bathing and toileting facilities are provided. There is a spacious lounge and a dining room both of which overlook the front garden and main street, which are easily accessible. There is no passenger lift as the home does not people with a physical disability. The Grange DB54 S60137 The Grange V218986 190405 Stage 4.doc Version 1.20 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection took place over 4.5 hours and was carried out as part of the annual inspection process. Five residents who live at the home, 3 members of staff, the acting manager and homes’ owner were spoken to during the inspection. During the inspection all of the communal areas of the building were looked at including bathroom and toilets as well as the records kept by the manager. The outside of the building and grounds were also inspected. On this occasion none of the residents’ relatives were contacted or spoken to. What the service does well: What has improved since the last inspection? What they could do better: The new owners and manager recognise that the assessment of residents prior to admission, the care planning, review and risk assessment processes all need to be reviewed and updated, as the processes inherited by them from the previous regime are inadequate. The Grange DB54 S60137 The Grange V218986 190405 Stage 4.doc Version 1.20 Page 6 The supervision and ongoing training of staff also needs to improve and suitable mechanisms put in place to ensure that, regular meetings with management take place. The homes owners also need to ensure that they visit the home on a monthly basis in order to monitor quality standards and service improvements. Please contact the provider for advice of actions taken in response to this inspection. The full report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The Grange DB54 S60137 The Grange V218986 190405 Stage 4.doc Version 1.20 Page 7 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 DB54 S60137 The Grange V218986 190405 Stage 4.doc Version 1.20 Page 8 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) 2. Residents of the home have not been admitted following comprehensive assessments of need and the homes manager has not undertaken pre-admission assessments. Staff within the home will not therefore have a good understanding of the residents support needs on admission. EVIDENCE: Residents spoken to all stated they were happy to be living at The Grange and spoke very highly of the staff and care they receive. They were unable to confirm whether or not they had had assessments of need prior to admission or whether staff from the home had carried out a pre-admission assessment. The last person admitted to The Grange took up residence in February ’04. Records examined confirmed that assessments prior to admission were not routinely undertaken and the home did not carry out its own pre-admission assessments. The manager and homes’ new owner confirmed that the previous owners and management had not routinely undertaken these tasks and the homes admissions protocol was not comprehensive. However, they did confirm their intention to have a robust admissions procedure in place in the next few months. The Grange DB54 S60137 The Grange V218986 190405 Stage 4.doc Version 1.20 Page 9 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, 7 and 9. There are no clear or consistent care planning and risk assessment systems in place to adequatley provide staff with information they need to staisfactorily meet residents needs. EVIDENCE: Residents spoken to at the time of the inspection were unable to give an indication that they had an up to date care plan highlighting their assessed needs and how they would be met. Records examined with the manager indicated that care plans and risk assessments were in need of comprehensive review in order to reflect the individual needs of residents and to provide a person centred approach to their care. There was evidence that resident meetings have taken place. The manager confirmed that these meetings, will be used in future to help increase and improve the daily activities offered to residents. Since the new manager came in to post staff rota’s and shift patterns have undergone a significant review. Staff spoken to confirmed that this review had improved their working conditions and will enable them to carry out their duties more effectively. The Grange DB54 S60137 The Grange V218986 190405 Stage 4.doc Version 1.20 Page 10 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) 12, 13, 15, 16, and 17. Links with the local community are good and support residents social inclusion. The Development of other opportunites wil serve to enrich the lives of residents further. EVIDENCE: The Grange is located in the small village of Trimdon Grange where community facilities and resources are limited. However a recent review of staff rota’s has helped to identify times where staff members will be able to support and enable residents to access community resources in neighbouring larger towns. Residents spoken to appeared to have a limited number of hobbies and interests. The manager and staff were aware of this and have confirmed their intention to offer a wider range and variety of activities to residents and that this will be discussed fully with them during resident meetings. The manager and owner also confirmed that the home is an established part of the local community. Passers by were noted to be friendly and communicative toward residents whilst outside the home and the local Catholic Church was also considered to be very supportive. The Grange DB54 S60137 The Grange V218986 190405 Stage 4.doc Version 1.20 Page 11 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 and 20. The staff have a very good understanding of the residents support needs this is evident from the positive relationships, which have been formed between the staff and service users. The manager needs to be more pro-active in ensuring visiting professionals (CPNs/Social Workers) are activley engaged in feeding back the outcome of their involvement with residents in order to keep staff fully briefed of any changing needs. The systems for the administration of medication are good with clear and comprehensive arrangments being in place to ensure service users medication needs are met. EVIDENCE: Residents spoken to confirmed that staff members are caring, friendly and approachable. Staff, were observed to have a positive working relationship with residents and to treat them with respect and dignity. Residents are all registered with a local GP practice and some continue to receive CPN / Social Work input. The manager reported that when CPN’s / Social Worker’s visit the home to see residents they often fail to brief staff or management of the outcome of their visit. An examination of a number of resident files found little evidence of their input and of the review of their care needs. The manager was advised to be The Grange DB54 S60137 The Grange V218986 190405 Stage 4.doc Version 1.20 Page 12 more pro-active in engaging with CPN’s / Social Work staff with regard to the residents they care for. 1 resident presently manages their own medication, all other residents within the home are actively supported by staff within the home to manage their own medication needs. The Grange DB54 S60137 The Grange V218986 190405 Stage 4.doc Version 1.20 Page 13 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 and 23. The home has a satisfactory complaints system with some evidence that service users feel that their views are listened to and acted upon. EVIDENCE: Residents spoken to were of the opinion that staff both listened to them and cared about them. The home has regular residents meetings and has comprehensive procedures for dealing with allegations or suspicions of abuse or exploitation. A comprehensive procedure for dealing with complaints is also in place and has recently been reviewed to include the timescales for dealing with any complaints made. The Grange DB54 S60137 The Grange V218986 190405 Stage 4.doc Version 1.20 Page 14 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 and 30. The standard of the environment and decor within this home is good and there is evidsence of improvement through on-going maintenace and future planning. Residents are provided with an attractive and homley place to live. EVIDENCE: All communal areas were visited during the inspection and were observed to be clean, tidy and in good repair. Most areas of the home have undergone refurbishment and re-decoration. Staff members spoken to also confirmed that plans exist for the full refurbishment of the kitchen area. The owner and manager confirmed that, the home will benefit from regular maintenance repairs and upkeep in order to ensure high standards are maintained. Residents spoken to confirmed that they can decorate their rooms to suit their own individual tastes. The Grange DB54 S60137 The Grange V218986 190405 Stage 4.doc Version 1.20 Page 15 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) 35. The procedures for the supervision and appraisal of staff have not been adhered to. Staff members will not therefore know what is expected of them, which residents needs have changed and what the precise aims and objectives of the home are. EVIDENCE: The owner and manager both acknowledged that staff training and supervision needs to be developed within the home. The manager also confirmed that a training agency had been identified to provide staff with some mental health training. There was also evidence to confirm that staff supervision procedures had not been followed whilst the home was awaiting the appointment of a new manager. The manager is now in post and has agreed to address the issues of staff supervision and training with some urgency. The Grange DB54 S60137 The Grange V218986 190405 Stage 4.doc Version 1.20 Page 16 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) 39 and 42. The home does not regularly review aspects of its performance through a good programme of self-review and consultation, which includes seeking the views of residents, staff members, relatives and visiting professionals such as CPNs / Social Workers. EVIDENCE: Residents spoken to gave positive feedback about how the home is managed and run. However there was no evidence to suggest that Regulation 26 visits are regularly undertaken and that quality standards are monitored as a matter of routine. Now that a manager has been appointed a review of staff training needs to be undertaken in order to ensure that all staff have the necessary qualities and skills to promote the health, safety and welfare of themselves and the residents. The Grange DB54 S60137 The Grange V218986 190405 Stage 4.doc Version 1.20 Page 17 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. Where there is no score against a standard it has not been looked at during this inspection. 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 x 1 x x x Standard No 22 23 ENVIRONMENT Score 3 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 2 3 x 2 x Score Standard No 24 25 26 27 28 29 30 STAFFING Score 3 x x x x x 3 Standard No 11 12 13 14 15 The Grange x 3 3 x 3 Standard No 31 32 33 34 35 36 Score x x x x 2 x Version 1.20 Page 18 DB54 S60137 The Grange V218986 190405 Stage 4.doc 16 17 3 3 CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 x Standard No 37 38 39 40 41 42 43 Score x x 2 x x 3 x The Grange DB54 S60137 The Grange V218986 190405 Stage 4.doc Version 1.20 Page 19 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 YA2 Regulation 14(1 2) Requirement The registered manager must ensure that new residents to the home are only admitted after a comprehensive assessment of their needs has been undertaken by the relevent health or social care professional, and that they themselves have carried out a pre-admission assessment. The registered manager must ensure that upto date accurate care plans are in place for all residents, that residents are directly involved in the care planning and that care plans are reviewed on a regular basis. The registered manager must ensure that residents of the home have upto date risk assessments relating to their day to day care and that any risk assessments are periodically reviewed. The registered manager must ensure that staff members within the home receive regular supervision and a review of their training needs. The homes owner must ensure that monthly visits to the home are undertaken and copies of the Timescale for action 29/08/05 2. YA6 15(1 2) 01/11/05 3. YA9 13(4) (b c) 01/11/05 4. YA32 18(1)(i) (2) 29/08/05 5. YA39 26 29/08/05 The Grange DB54 S60137 The Grange V218986 190405 Stage 4.doc Version 1.20 Page 20 reports of these visits are forwarded to the CSCi 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 YA19 Good Practice Recommendations It is recommended that the homes manager be more proactive in meeting with residents CPNs / Social Workers in order to ensure changing needs of residents are accuratley recorded and acted upon. The Grange DB54 S60137 The Grange V218986 190405 Stage 4.doc Version 1.20 Page 21 Commission for Social Care Inspection No 1 Hopetown Studios Brinkburn Road Darlington DL3 6DS 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 DB54 S60137 The Grange V218986 190405 Stage 4.doc Version 1.20 Page 22 - 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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