Inspection on 21/04/05 for The Grange

This inspection was carried out on 21st 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 1 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

The Grange 05/06/07

The Grange 06/12/06

The Grange 22/06/06

The Grange 03/11/05

The Grange 18/11/04

The Grange 30/04/04

Similar services:

Thorndene

Insight - Eastchurch

Southfields

Magenta

Seabourne House

33 St John`s Church Road

Dovedale Court

Lyncol House

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

CARE HOME ADULTS 18-65 The Grange 75 Reculver Road Herne Bay Kent CT6 6LQ Lead Inspector Tina Thomas Unannounced 21 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 H56-H05 S23231 The Grange V223153 210405 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service The Grange Address 75 Reculver Road, Herne Bay, Kent, CT6 6LQ 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) 01227 741357 Lifetime Care Development Limited Mr Eddie Fisher CRH 4 Category(ies) of Care Home for Younger Adults (18 - 65) - 4 registration, with number of places The Grange H56-H05 S23231 The Grange V223153 210405 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 18 November 2004 Brief Description of the Service: The Grange is a care home which is registered to care for four adults with learning difficulties. it is owned by Lifetime Care Development Ltd. Mr E. Fisher is the ower and Manager. The Home is situated 1/2 mile from the shops and seafront in Beltinge. It is also located within easy access of public transport.The Home is a detatched bungalow. It has an attic room which has been converted into an office area. All bedrooms are single. The Home has a lounge/dining room for communal use. The Grange H56-H05 S23231 The Grange V223153 210405 Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was unannounced. The Inspector arrived at the Home at 6.30 in the morning and stayed until 12.15hrs. The Inspector conducted this Inspection to look specifically at anonymous allegations received, which resulted in an adult protection alert being raised. The Inspector found that mostly the allegations investigated could not be substantiated, or where they were substantiated the Home had acted appropriately and had recorded events in an appropriate and timely manner. The adult protection alert was closed later that day. The Inspector spoke with the Manager, three people who use the service and three members of staff. The Inspector looked at documentation including Service User care plans and the accident book What the service does well: What has improved since the last inspection? The Home has recognised that Service Users need to be more involved in activities in the evening. A pub trip had been arranged for Friday evening and some activities were being arranged at the Ramsgate Centre. The Grange H56-H05 S23231 The Grange V223153 210405 Stage 4.doc Version 1.30 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 H56-H05 S23231 The Grange V223153 210405 Stage 4.doc Version 1.30 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 H56-H05 S23231 The Grange V223153 210405 Stage 4.doc Version 1.30 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) 0 These standards were not inspected at this inspection. EVIDENCE: The Grange H56-H05 S23231 The Grange V223153 210405 Stage 4.doc Version 1.30 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) 6,7,9 Service Users needs are not consistently met. There are shortfalls in the level of documentation needed to ensure this. EVIDENCE: Individual care plans are available and hold valuable information on Service Users needs including health, care and social care needs. Plans and risk assessment had been suitably reviewed. Daily records were well written and significant events suitably recorded and when necessary cross-referenced i.e. the accident book. The Owner/Manager described how, for some service users, it had been agreed between care management, the Home, Service Users and their representatives, that if Service users displayed certain behaviours, items of their property could be confiscated. This was not recorded in their care plans. There was no guidance in the care plan as to when this could be implemented, whether the Service User should receive warnings, or how long the confiscation should last. Therefore, this could lead to inconsistencies between staff in the implementation of these confiscations. A requirement has been made that the home more suitably record strategies for enforcing positive behaviour. The Grange H56-H05 S23231 The Grange V223153 210405 Stage 4.doc Version 1.30 Page 10 Service Users are encouraged to take risks as part of an independent lifestyle. Risk assessments regarding this were suitably documented. Two service users have tricycles and are supported to use these. The Grange H56-H05 S23231 The Grange V223153 210405 Stage 4.doc Version 1.30 Page 11 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 11,12,14, Service users have opportunities for personal development. They take part in appropriate activities. Service users enjoy a healthy diet. EVIDENCE: Three people living at the home were spoken with about the activities they enjoy. One person, on the day of inspection was attending college, another was attending a day centre. After recent care management reviews there has been some concerns that activities offered in the evening are limited. The home has addressed this, and arrangements were in place for some evening activities ie a visit to a pub and activities at the Ramsgate centre. The Inspector joined Service Users whilst they ate their breakfast. Everyone spoken to said they enjoyed their meals, giving examples of their favourite meal. A menu was viewed and was healthy and nutritious. The Grange H56-H05 S23231 The Grange V223153 210405 Stage 4.doc Version 1.30 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 standard(s) 18,19, The people who live at the Home are supported in such a way as to promote their independence, privacy and dignity. Their health care needs are monitored. EVIDENCE: The Inspector observed the people who live in the Home going about their usual morning routines. They were supported to independently shower, clean their teeth and dress. They were offered choices ie Do you want to get ready now? What do you want to wear? The Home has both male and female staff. Care plans and discussion with the Manager indicated that specialist support had been sought on several occasions ie dietician, speech therapist and clinical psychologist. The Home uses the key worker scheme. The Grange H56-H05 S23231 The Grange V223153 210405 Stage 4.doc Version 1.30 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) 23 The Home does not have adequate systems of recording to ensure that Service Users are protected from abuse. EVIDENCE: As previously mentioned in the report the Home does not have adequate systems of recording strategies to cope with behavioural problems i.e. The confiscation of personal possessions. The Manager agreed that sometimes staff need to speak in a very firm manner to Service users to gain compliance, if this is necessary it should be part of their care plan, agreed by a multi disciplinary team, the Service users or their representative. Otherwise this may be perceived as abuse. The Home has suitable financial systems in place regarding service users own money. A recommendation has been made that two members of staff sign to witness transactions between the Home and the Service user. The Grange H56-H05 S23231 The Grange V223153 210405 Stage 4.doc Version 1.30 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) 24,25,26,27,28,30 The Home creates a safe and comfortable environment for the people who live there. Parts of the Home have recently been redecorated. EVIDENCE: The lounge/dinner has recently been redecorated. The Home is clean and free from offensive odours. All the people that live at the Home have their own bedrooms. The Inspector viewed three bedrooms and found that they were all individual and reflected the personalities and interests of those that live there. They were appropriate for the age/ gender of the Service user. The Inspector observed service users enjoying the communal space. The Grange H56-H05 S23231 The Grange V223153 210405 Stage 4.doc Version 1.30 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) 31,32,33,34,35,36 Policies and procedures relating to staff recruitment, training and supervision ensure Service Users are appropriately supported and their needs met. EVIDENCE: When the Inspector arrived at 6.30am there were three members of staff on duty. This included the Registered Manager who had completed a sleep in night duty. The Home has four service Users. The Inspector spoke with the Deputy Manager who is trained to N.V.Q Level 3 and one member of night staff who had completed N.V.Q Level 2 training and was completing N.V.Q Level 3. Staff files indicated that the Home had undertaken recruitment checks including Criminal Records Bureau checks. Staff files also indicated that staff received supervision, appraisal and training. The Grange H56-H05 S23231 The Grange V223153 210405 Stage 4.doc Version 1.30 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) 37, 40, 41, 42 The Home is well managed and has a clear line of accountability. The Manager/Owner has developed an ‘open culture’. The health and safety of those that live and work in the Home is protected. EVIDENCE: The Staff and Service users who were able indicated that they felt able to approach the Manger/Owner with concerns or ideas. Service Users and staff indicated a clear understanding of the line of management. The Home has policies and procedures in place that are regularly reviewed. Record keeping is generally of a good standard and documentation is suitably stored in line with Data Protection. The Manager endeavours to ensure the health and safety of Service users and staff. The inspector observed compliance with health and safety legislation and environmental health issues. The visitors book and accident book were viewed. The Grange H56-H05 S23231 The Grange V223153 210405 Stage 4.doc Version 1.30 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. 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 x x x x Standard No 22 23 ENVIRONMENT Score x 2 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 2 3 x 3 x Score Standard No 24 25 26 27 28 29 30 STAFFING Score 3 3 3 3 3 x 3 Standard No 11 12 13 14 15 16 17 3 3 x 3 x x x Standard No 31 32 33 34 35 36 Score 3 3 3 3 3 3 CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 The Grange Score 3 3 x x Standard No 37 38 39 40 41 42 43 Score x 3 x 3 3 3 x H56-H05 S23231 The Grange V223153 210405 Stage 4.doc Version 1.30 Page 18 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 YA6 Regulation 12.b Requirement care plans must indicate fully stratagies for coping with challaging behaviour. Timescale for action 21/06/05 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 23 Good Practice Recommendations Two members of staff should witness and sign financial transactions which occur between the Home and Service User i.e the giving of pocket money. 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