Inspection on 19/01/08 for The Grange

This inspection was carried out on 19th January 2008.

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

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 19/01/07

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 Key Unannounced Inspection 19h January 2008 11:00a The Grange DS0000060137.V356865.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.V356865.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.V356865.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 thegrange-scne@btconnect.com Sovereign Care North East Ltd Position Vacant 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.V356865.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 19th January 2007 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 home’s 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.V356865.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 2 star. This means the people who use this service experience good quality outcomes. The purpose of this inspection was to assess the quality of the care and support received by the people who live at The Grange, and to monitor the progress the home has made in meeting with requirements that we asked the home to do at the previous inspection. The methods I used to gather information included a visit to the home, conversations with the people who live there, healthcare professionals and the staff. I looked in detail at the care and records of two people, examined other records and looked around the home. I spent four hours at the home. What the service does well: The people I spoke to said they are happy with the care and support they receive. One person said ‘I am very happy living here, it’s great.’ Another said that the staff are ‘very very good’. The pre-admission assessments are thorough and the majority of people spoken to told me that they had sufficient information about the home before choosing to live there. One person said ‘when I came for a visit, I was made very welcome.’ The people who live at the home confirmed that they know how to raise a concern or make a complaint, if they needed to. One person said ‘I would tell the staff if I have a problem’. The staff are aware of their responsibilities if they believe that neglect or poor care practice is taking place and were confident that, if they raised any issues, the manager would investigate. There are proper recruitment and selection procedures in place, to make sure that staff are suitable and safe to work with the people who live at the home. People looked well cared for, and there was a nice open friendly relationship between staff and people living at The Grange. Residents had the opportunity to walk into the nearest village to get personal shopping etc, and some people attend the ‘pop in’ centre, which is close by. The Grange DS0000060137.V356865.R01.S.doc Version 5.2 Page 6 What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. The Grange DS0000060137.V356865.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.V356865.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. JUDGEMENT – we looked at outcomes for the following standard(s): 2,4&5 Quality in this outcome area is good. People’s needs are properly assessed prior to admission. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The care plans I looked at showed that comprehensive pre-admission assessments had been carried out before offering someone a place. This is to make sure that the home can meet the person’s needs. A senior member of staff visits the person at home or in hospital to discuss their care needs. Social Services assessments are also used to determine this as well; these were also available to look at. People are welcome to visit the home before reaching a decision. Generally, people come and look around the home, meet the other people who live at The Grange, and the staff, on several occasions before they make a decision to move into the home. I also looked at contracts people have with the home. These were detailed and included a breakdown of the fees and who was responsible for paying for the care provided. The Grange DS0000060137.V356865.R01.S.doc Version 5.2 Page 9 The home does not provide intermediate care. The Grange DS0000060137.V356865.R01.S.doc Version 5.2 Page 10 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 6,7&9 Quality in this outcome area is good. People are supported and encouraged to make choices and their care plans reflect this. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Two care plans were looked at; they contained information on how individuals wanted to be cared for. Goals were set by the resident and reviewed on a monthly basis to monitor progress. More detailed guidance needs to be available for staff on how they are going to support this person in achieving these goals. Risk assessments and management plans need to be linked to these goals. The plans also need to have clear instructions for staff on how to deal with people who could be both verbally and physically challenging. The Grange DS0000060137.V356865.R01.S.doc Version 5.2 Page 11 People’s needs were individually planned for, and choice was encouraged. People who lived at The Grange said that staff were very supportive, one person said ‘we are well looked after here, I feel supported, helped and very lucky to live here’. Staff were observed to treat people with dignity and respect. People said they felt very well supported by staff and were very complimentary about the care and support staff give them. The Grange DS0000060137.V356865.R01.S.doc Version 5.2 Page 12 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,15,16&17 Quality in this outcome area is good. People’s lifestyle reflected individual expectations and preferences. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The staff have a very good understanding of people’s needs, this is evident from the positive relationships which have been formed. One person had been shopping with a member of staff, another was attending a day centre. One person commented ‘the staff are like my family’. During the inspection, people were going out to the local shops and to visit the doctor. There are a variety of activities for people to take part in, should they want to. One person was busy painting, another person told me he enjoyed bird watching and was a member of the RSPB. Some people were watching television whilst some were in their own bedrooms. The Grange DS0000060137.V356865.R01.S.doc Version 5.2 Page 13 As far as possible, family links are maintained, some people visit family on a regular basis and staff support people to keep in touch with relatives and friends. People told me they liked the food that was provided, and that menus and food were always discussed at the residents’ meetings. Some of the people who live at the home help prepare meals, wash up and set the tables. The Grange DS0000060137.V356865.R01.S.doc Version 5.2 Page 14 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 18,19,20 Quality in this outcome area is good. People 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: People are registered with a local GP and have access to community health services, including the community psychiatric nurse and the local consultant psychiatrist. The home has become a non-smoking home and some people have been helped and supported on a smoking cessation programme. Staff members had a good knowledge and understanding of residents and how care is provided to them. From observation, it was clear that good communication exists between service users and the staff team and residents The Grange DS0000060137.V356865.R01.S.doc Version 5.2 Page 15 were confident to ask for advice and help. One person said ‘if I feel unwell or down in the dumps the staff always cheer me up, they are always around to listen’. There are policies and procedures in place for the administration of medication. The medication records and system of administration of medication was looked at. Staff were knowledgeable about the medication policy and procedure at the home regarding people’s medication. At the moment, nobody in the home looks after there own medication, however the manager said this would not be a problem if someone requested to do this. The Grange DS0000060137.V356865.R01.S.doc Version 5.2 Page 16 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 22,23 Quality in this outcome area is good. People can be confident that their concerns and complaints are dealt with appropriately and that safeguards are in place to protect them from abuse. This judgement has been made using available evidence including a visit to this service. EVIDENCE: There are adequate written policies and procedures in place to deal with complaints and the staff confirmed they were aware of these. Staff knowledge of this helps ensure that they are able to address any issues or anxieties of the residents, relatives and visitors to the home. Every person who lives at the home has been given a copy of the complaints procedure. There have been no formal complaints recorded. Staff training has taken place in the protection of vulnerable adults in abuse. Staff recruitment procedures were adequate and staff were employed and deployed following appropriate CRB and POVA checks. The manager and staff team were clear and confident in the protection of vulnerable adult procedures. The procedure for dealing with abuse at the home needs to be made more user friendly, it was difficult to find in the procedure manual and could be made more specific to the home by detailing the appropriate contact numbers of placing authorities and the local police. The Grange DS0000060137.V356865.R01.S.doc Version 5.2 Page 17 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 24,30 Quality in this outcome area is good. The home was comfortable and clean. People’s 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 people’s rooms, and all of the communal areas in the home, were looked at. People’s rooms were all individual. One person told me they were about to get their room redecorated and had chosen the colour scheme. Other bedrooms have also been decorated and carpets replaced. One person said ‘ I like my room it’s just as I want, nice and comfy’. Another person said ‘I love my room, I have all my own things here it’s great’. There is an ongoing refurbishment plan for the home, with service users’ bedrooms getting decorated and new carpets being fitted when required. The Grange DS0000060137.V356865.R01.S.doc Version 5.2 Page 18 The communal lounge area has been redecorated and a new carpet fitted. The home was nice and fresh and clean. The Grange DS0000060137.V356865.R01.S.doc Version 5.2 Page 19 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 32,34,35 Quality in this outcome area is good. Staffs are employed in sufficient numbers and have appropriate skills and knowledge to meet the needs of people living at The Grange. 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. Training files for two members of staff were examined. Most staff are working towards a formal qualification in care. Mandatory training takes place in moving and handling, first aid and protection of vulnerable adults in abuse. The fire training for all staff was out of date but training was scheduled for the The Grange DS0000060137.V356865.R01.S.doc Version 5.2 Page 20 following week. The fire and rescue services state that fire safety instruction should take place at intervals of 3 monthly for night staff and six monthly for day staff. The Grange DS0000060137.V356865.R01.S.doc Version 5.2 Page 21 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 37,39 &42 Quality in this outcome area is good. People can be confident that the home is well managed. Systems and safeguards are in place to ensure the health, safety and welfare of service users, and staff, is protected. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The manager has the qualifications and the skills to manage the home effectively. 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 centre on menu planning and communal social events. The Grange DS0000060137.V356865.R01.S.doc Version 5.2 Page 22 The records regarding administration of residents’ personal allowances were inspected. All transactions are recorded correctly and receipts are kept. Policies and procedures are kept up to date; to make sure they provide relevant information to guide staff on how to act in every situation. All the regular health and safety checks for the home are carried out in a timely manner. Staff have basic health and safety training. All these measures make sure that the health, safety and welfare of the people who live at the home is promoted and safeguarded. The Grange DS0000060137.V356865.R01.S.doc Version 5.2 Page 23 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 X 2 3 3 X 4 3 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 3 3 X 2 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 X 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 2 X 3 X X 3 X The Grange DS0000060137.V356865.R01.S.doc Version 5.2 Page 24 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 31/03/08 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. YA9 Refer to Standard Good Practice Recommendations It is recommended that the review of care plans and risk assessments takes place. To ensure that staff are clear as to what support and care they are to give in order to assist the individual in fulfilling personal goals and achievements, in a risk assessed and managed way. 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