Inspection on 19/01/07 for The Grange

This inspection was carried out on 19th January 2007.

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 no outstanding requirements from the previous inspection report, but made 1 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 15/11/05

The Grange 19/04/05

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 TS29 6EG Lead Inspector Bridgit Stockton Unannounced Inspection 19 January 2007 10:30 th The Grange DS0000060137.V314482.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 DS0000060137.V314482.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 DS0000060137.V314482.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service The Grange Address Galbraith Terrace Trimdon Grange TS29 6EG 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) 01429 882043 P/F No e-mail Sovereign Care North East Ltd Care Home 17 Category(ies) of Mental disorder, excluding learning disability or registration, with number dementia (17), Mental Disorder, excluding of places learning disability or dementia - over 65 years of age (6) The Grange DS0000060137.V314482.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 15th November 2005 Brief Description of the Service: The Grange is a care home providing personal care and accommodation 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. The weekly fee charged at the home is £364.50 The Grange DS0000060137.V314482.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was carried out over a period of 4 hours on the 19th January 2007. The home did not know the inspection was going to take place. The plan for the inspection was to check whether the home had implemented the requirements and recommendations made at the previous inspection; to talk with the residents about living in the home; to meet with care staff and the home’s management team; and to look at records. The manager supplied some information on a pre inspection questionnaire, and Service users and relatives returned surveys to the Commission for Social Care Inspection (CSCI.) Some of this information has been used in the report. What the service does well: What has improved since the last inspection? There is an ongoing redecoration and refurbishment program, which has included so far some resident’s bedrooms, and some of the communal areas. The kitchen has been totally re fitted with new units and worktops. The way in which staff personnel files are set up has been improved; supervision of staff is now taking place. All the training staff have undertaken is now recorded properly. Currently a new bedroom is being added, benefiting service users by reducing the rooms that are of shared occupancy to one. The Grange DS0000060137.V314482.R01.S.doc Version 5.2 Page 6 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 DS0000060137.V314482.R01.S.doc Version 5.2 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 Outcomes Statutory Requirements Identified During the Inspection The Grange DS0000060137.V314482.R01.S.doc Version 5.2 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 the following standard(s): 1,2&5 Quality in this outcome area is good. People could be assured the home was able to meet their needs and had enough information to make a decision before moving into the home. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The assessment documentation and recording of a new service user was good and in sufficient detail so as to make it possible for the care needs to be identified and from which a care plan can be developed. The staff spoken to explained how they were able to meet the needs of the service user and spoke with individual knowledge of particular clients. The statement of purpose and service user guide needs to be reviewed, as some information requires updating. A contract or statement of terms and conditions is given to all service users or their representatives. The contract and statement of terms and conditions were signed and included a space to enter a full breakdown of fees and who is responsible for paying them. The Grange DS0000060137.V314482.R01.S.doc Version 5.2 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 the following standard(s): 6,7, &9 Quality in this outcome area is adequate. Whilst service user plans and risk assessments have been revised they still require further work to ensure that staff are aware of the care and support that is required for the individual. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Service users care plans were inspected. They have improved since the previous inspection. They are reviewed on a monthly basis and service users are involved in this process. However the lack of detailed information about the diverse needs of each service user and the specific support needed from staff can result in inconsistent practice and runs the risk of failing to meet service users needs. From observation it was evident that service users needs were being met in some areas, but the plans did not properly reflect this. Service user said that they felt very well supported by staff and were very complimentary about the care and support staff give them Risk assessments were in place for some activities service users take part in, however they were not properly recorded. The Grange DS0000060137.V314482.R01.S.doc Version 5.2 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 the following standard(s): 12,13,15,16&17 Quality in this outcome area is good Flexible visiting arrangements allow the residents to maintain good and regular contact with family and friends. Residents living at the home are supported to have choice and control over how they choose to live and have a varied and interesting lifestyle. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The staff have a very good understanding of the residents needs this is evident from the positive relationships, which have been formed between the staff and service users. One service user commented ‘the staff are like my family, if I feel down they will always cheer me up and get me sorted’ There was evidence that service users are encouraged to use the local community facilities, one service user attends a ‘pop in’ day centre which they said they really enjoyed. During the inspection several service users were going out to the local shop. Service users were spending there time as they wished some were in there own bedrooms watching television or listening to music, others were chatting to staff. The Grange DS0000060137.V314482.R01.S.doc Version 5.2 Page 11 Service users confirmed they liked the food that was provided, and that menus and food were always discussed at the monthly meetings. The Grange DS0000060137.V314482.R01.S.doc Version 5.2 Page 12 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 the following standard(s): 18,19,20 Quality in this outcome area is good Service users can be assured that their health and personal care needs are met. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Service users are registered with a local GP and have access to community health services, including the community psychiatric nurse and the local consultant psychiatrist. There a policies and procedures in place for the administration of medication. The medication records and system of administration of medication were inspected and satisfactory. The Medication Administration Records were inspected, and found to be in good order. Medication was stored correctly and staff spoken with were knowledgeable about the medication policy and procedure at the home regarding service users medication. The Grange DS0000060137.V314482.R01.S.doc Version 5.2 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 the following standard(s): 22&23 Quality in this outcome area is good. Service users can be confident that their views are listened to. As far as possible service users are protected from harm and abuse. This judgement has been made using available evidence including a visit to this service EVIDENCE: As far as possible service users are protected from harm. Training for all staff has taken place in the protection of vulnerable adults. All staff prior to employment at The Grange has a criminal records bureau check carried out, and references from previous employers are obtained. All of the service users had a copy of the complaints procedure. They all confirmed that they knew who to complain to and were confident that any concerns would be dealt with immediately. The Grange DS0000060137.V314482.R01.S.doc Version 5.2 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 the following standard(s): 24&30 Quality in this outcome area is good The home was comfortable and clean. Service users private rooms reflected and promoted their individuality and choice. This judgement has been made using available evidence including a visit to this service EVIDENCE: Some service users rooms were inspected and all of the communal areas in the home were looked at. Service users rooms were all individual. One service user said ‘I love my room, I have all my own things here, I do all my own cleaning, I like to keep things nice’. Currently the two bathrooms on the upper floor have been adapted and knocked into one room to make a further bedroom. This will benefit service users by reducing the amount of double rooms to one. There is an on going refurbishment plan for the home, with service users bedrooms getting decorated and new carpets being fitted. Priority for redecoration and refurbishment needs to be given to the lounge in the home. This is the main area where all service users sit; it is also a designated smoking area. The walls and soft furnishings are heavily stained with nicotine and some of the furniture is looking worn and shabby. The Grange DS0000060137.V314482.R01.S.doc Version 5.2 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 32, 34 and 35 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 32,34&35 Quality in this outcome area is good Staff are employed in sufficient numbers who have appropriate skills and knowledge to meet the service users needs. This judgement has been made using available evidence including a visit to this service EVIDENCE: The home had staff files in place that provided evidence that the appointment of a new staff member is made through proper recruitment processes. This includes the vetting of staff through the use of references, POVA first checks and Criminal Record Bureau (CRB) checks. The new manager to the home is committed to having a trained workforce. All new staff receive a thorough induction and this was documented in the staff files examined. Supervision and appraisal of all the staff team has now taken place. Staff are trained to be competent to deliver a good standard of care to the people who live at the home. Training has taken place in moving and handling service users, fire safety, protection of vulnerable adults and care planning. From the rota supplied Staff are employed and deployed in sufficient numbers to meet the needs of service users. Service users said that they thought there were enough staff on duty to help them and that they were always given plenty of time and never hurried when staff were assisting them. The Grange DS0000060137.V314482.R01.S.doc Version 5.2 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 37, 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 37,39&42 Quality in this outcome area is good Service users can be confident that the home is managed properly and their safety is protected and promoted This judgement has been made using available evidence including a visit to this service EVIDENCE: At the time of inspection the manger had only been in post a matter of weeks. An application to the Commission needs to be submitted for her to become registered. Improvements had already taken place in the way in which staff information is recorded and stored in the home, and all staff have now received supervision and appraisal. She hopes to continue to review policy and procedures at the home and in addition look at the way in which peoples care plans are recorded and how risk assessments are implemented. Monthly informal residents meetings are taking place, they are recorded and any points raised at the meeting are acted upon. The main topic of discussion centres on menu planning and communal social events. The Grange DS0000060137.V314482.R01.S.doc Version 5.2 Page 17 The home provided evidence that such things as the central heating systems, electrical wiring and water temperatures were monitored and serviced regularly to ensure service users and staff were provided with a safe environment The Grange DS0000060137.V314482.R01.S.doc Version 5.2 Page 18 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 3 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 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 X 34 3 35 3 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 2 2 X 2 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 3 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 2 X 3 X X 3 X The Grange DS0000060137.V314482.R01.S.doc Version 5.2 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 YA37 Regulation 9&10 Requirement An application must be submitted without delay to register the manager of the service with the Commission. Timescale for action 31/03/07 The Grange DS0000060137.V314482.R01.S.doc Version 5.2 Page 20 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. Refer to Standard YA1 Good Practice Recommendations It is recommended that the statement of purpose is reviewed to make sure that the information provided in it is up to date. It is recommended that the review of care plans and risk assessments takes place as a matter of priority. This is to ensure that staff are clear as to what support and care they are to give to service users in order to assist the individual in fulfilling personal goals and achievements. YA6 YA7 YA9 The Grange DS0000060137.V314482.R01.S.doc Version 5.2 Page 21 Commission for Social Care Inspection Darlington Area Office 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 DS0000060137.V314482.R01.S.doc Version 5.2 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. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!