Inspection on 21/12/06 for The Grange

This inspection was carried out on 21st December 2006.

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

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

Other inspections for this house

The Grange 29/08/08

The Grange 13/03/08

The Grange 06/02/06

The Grange 23/08/05

The Grange 10/11/04

The Grange 18/05/04

Similar services:

St Vincents

The Cotswold Home

Newbeech House

Winton House

Rush Court

Hillyfield Rest Home

The Maypole Nursing Centre

The Briars

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

CARE HOMES FOR OLDER PEOPLE The Grange Grange Close, Manor Road Goring On Thames Oxfordshire RG8 9DY Lead Inspector Ruth Lough Unannounced Inspection 21st December 2006 10:45 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address The Grange DS0000013090.V325534.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. The Grange DS0000013090.V325534.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service The Grange Address Grange Close, Manor Road Goring On Thames Oxfordshire RG8 9DY 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) 01491 872853 01491 873397 The Grange Limited Mrs Susan Lewis Care Home 42 Category(ies) of Old age, not falling within any other category registration, with number (42) of places The Grange DS0000013090.V325534.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. Condition 1 The four rooms for double occupancy must be identified to CSCI by number and used for the purpose of accommodating married couples as stated in the application dated 20 September 2004. 6th February 2006 Date of last inspection Brief Description of the Service: The Grange is a residential home registered for 42 older persons who require personal care and accommodation. The home is privately owned and is situated in a quiet residential area in the village of Goring. The accommodation is a large Victorian house that has been altered and adapted for its purpose but also retains many of the features of a family home built over 100 years ago. The home provides service users with the opportunity of using the large extensive grounds that lead down to the river but also the convenience of the village close by. The village offers shops, pubs and cafes with transport links to Reading and Oxford. Service users’ bedrooms are provided over 3 floors with 2 lifts available should they wish to use them. The current fees range from £550.00 to £850.00 with additional charges made for Hairdresser, Chiropodist, and incontinence pads. The Grange DS0000013090.V325534.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced inspection visit that took place over one day. The inspection included a review of information provided by the home and service user surveys returned prior to the visit. Three service user questionnaires were returned to the commission. The documents and records that were available on the day were used as part of the information gathering. Service users and visitors opinions of the service were also obtained during the day visit. Discussion with and observation of the management and care staff were also included. Contact was made with local healthcare practitioners who visit the home. What the service does well: What has improved since the last inspection? What they could do better: They manager and staff need to ensure that the care plans actually reflect how the staff are to provide the personal care and support to service users. They also need to make sure that the processes that are in place to support the staffs handling and storage of service users’ money and property that is brought into the home. The condition of some of the aids and equipment for assistance in the bathrooms and toilets is poor in places and the home need to ensure that this is rectified. The Grange DS0000013090.V325534.R01.S.doc Version 5.2 Page 6 They should look at how they can improve the systems for prevention of cross infection and safety with particular reference to the use of carpets in communal bathrooms and toilets. The home also need to ensure that liquid soap and paper towels are placed in all areas where staff and service users need to wash their hands, again to reduce the risk of cross infection. The home is required to ensure that it keeps evidence of the induction training, written references and photograph of new staff when they commence working in the home. 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 DS0000013090.V325534.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection The Grange DS0000013090.V325534.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 3. Quality in this outcome area is good. The service users’ needs are assessed appropriately by the home before they are admitted. This judgement has been made using available evidence including a visit to this service. Standard 6 is not applicable to the home. EVIDENCE: Service users and relatives were asked if they received enough information about the home before they moved in so they could decide if it was the right place for them. One chose to respond with, “Mum has lived in Goring-onThames for 42 years – I knew it was where I wanted her to stay” The records of 2 service users were reviewed. The manager confirmed that service users are generally referred to the home by self-referral, families and some social services. Prospective service users and their families are invited to visit the home before making the decision to live in the home. The manager The Grange DS0000013090.V325534.R01.S.doc Version 5.2 Page 9 usually assesses the service users’ needs either in their own homes or in hospital. They use additional information that is supplied by medical practitioners, social services and relatives as part of the process. The documents used to record the service users’ information also notes service users’ choices and wishes and has key information about personal contact details of relatives or professionals involved in their care. The record does identify some of the medical conditions of the service users but of the 2 reviewed this was very brief. What they do well is use in depth assessment tools for service users’ skin and nutritional status and moving and handling assessment to support the process when the service user is admitted to the home. There is a very brief comment about their life history – but this could be recorded in greater detail. The Grange DS0000013090.V325534.R01.S.doc Version 5.2 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,9 and 10 Quality in this outcome area is adequate. The care plans do not give enough information of how the staff are to provide support and care to the service users. The recorded policies and procedures for the administration and safekeeping of service users’ medication need to ensure that they give staff the necessary information for safe practices. Service users are treated with respect and provided with privacy. These judgements have been made using available evidence including a visit to this service. EVIDENCE: Service users were asked in the questionnaire if they felt that they received the care that they needed and all 3 who responded said that they did. Others stated on the day of inspection that the staff made sure that their needs were met. The Grange DS0000013090.V325534.R01.S.doc Version 5.2 Page 11 The care plan documents for 2 service users were reviewed. One had been admitted in August 2006 the other had been living in the home for more than a year. The care plan documents gave information about the bathing care plan, dietary preferences and some information about service users’ mental health. The detailed assessments of the service users carried out before admission were not supported by the information for staff provide their care or the actions to reduce or eliminate the risks for service users and staff. The service users responded positively in the questionnaire that they thought that they received the medical care that they needed. One service user stated “Yes, very caring in this respect”. The records do support that service users are assisted to obtain any medical assistance such as district nurse, opticians, dental and chiropody should they wish. A service user was very complimentary about the swiftness of the care staff to implement emergency care and assistance when a health problem arose. However, the information about the change in health and the concerns and the action taken was not reflected in the individuals care plan. The care plans are regularly reviewed by the manager. The service users are provided with their required medications by the home staff. The medications are stored safely in a locked cabinet that is secured safely. They use the services of a local pharmacy that undertake the responsibility of regular audits of all the medications provided. Any controlled medications are stored appropriately and are administered by two staff members. The staff are provided with an accompanying photograph of the service user with the MDS prescription to ensure that the medications are given to the right person. The staff have been given medication training by a local college. The policies and procedures for medication administration, service users’ self-administration, storage and disposal need to be reviewed to ensure that they are relevant to regulations, the home’s practices and National Minimum Standards. The service users were asked in the questionnaire if the staff listened to what they say. All three confirmed this and one stated, “Always listen and usually act!” A family member who spoke to the inspector stated that the staff were very good and quick to respond. The staff were seen to be communicating well with service users, respectful in their terms of address to them and when entering service users’ rooms. Service users who have chosen to have private telephone lines in their rooms are able and staff assist with reading their mail where requested. The four rooms that are registered for accommodating married couples do not have any form of fixed screening between the beds. However, these rooms currently have single occupancy or the couples do not wish for this. Some information is recorded in the care plan about the service users and their families choices and wishes about how they wished to be cared for at the end of their lives and what care is provided after their death. The Grange DS0000013090.V325534.R01.S.doc Version 5.2 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,14 and 15 Quality in this outcome area is good. The home supports service users to continue with activities and interests of their choice but they need to improve how they record the information about service users’ interests. The home needs to improve its policies, procedures and current practices for handling service users’ money. Service users enjoy the quality and variety of the meals provided. These judgements have been made using available evidence including a visit to this service. EVIDENCE: Service users and relatives were asked in the questionnaire and during the inspection visit about the activities made available in the home. They responded positively that there were and “But do not take part”, “Certainly more than there used to be” and “Living in London – I’m usually down at the wrong time but I know one of mum’s friends has joined in with the chair exercises”. Service users told the inspector that staff were respectful to service users’ choices of not wishing to take part in planned events. The Grange DS0000013090.V325534.R01.S.doc Version 5.2 Page 13 The service users’ care plans, daily records and the activities diary were reviewed. These supported that they do record the service users’ interests but for some, only minimal information. The service users spoken to did confirm that staff support them how they wish, encouraged them to take part in the activities on offer and that they were informed of the planned events in a newsletter. The staff do record service users’ involvement in the events and activities in a central record book and in the daily records of the individual. Some of the current activities on offer are Tai Chi, reading club, flower arranging and armchair exercises. Some service users when spoken to did state that activities did not always happen, but this had improved recently. The Statement of Purpose and Service User Guide do state that the home does not handle service users’ monies, but this is not clear as staff do hold small amounts of money on their behalf, if only for an interim period. There is not a policy/procedure that reflects what they actually do. Service users are able to bring their personal possessions and some furniture into their rooms but this needs to be recorded formally and kept under review. Service users were asked in the questionnaire and during the inspection visit about the meals provided. The 3 service users responding to the questionnaire indicated that they usually liked the meals provided and commented “Not always very exciting but quite adequate” and a relative, “Mum has always said how she likes the food.” The inspector was told by one “Food variable – not much choice sometimes.” Service users are provided with 3 main meals a day, including cooked breakfast and hot food available in the evening. All service users are encouraged to eat in the main dining room for the midday meal but they usually partake the breakfast and evening meal in their rooms should they wish. There is a rotational menu that is developed with the cook’s and service user involvement through meetings and feedback from individuals. Nutritional and dietary needs and wishes of the service users are recorded in the service users’ plans but they do not evidence that they are provided as part of the individual’s care plan. They do record these in the kitchen for all staff to adhere to. Where assistance or guidance with meals is needed the staff give help discreetly. Staff are able to provide snacks and hot drinks whenever requested. Some service users who spoke to the inspector did comment about the limited choices for the main savoury dishes during the midday meal, others stated they were very happy with what was on offer. It was evident from the menu plans and talking to staff that there are other dishes available should the service users wish to have something different. The home does provide a very good variety of at least 6 desserts at each meal for service users to have. The home makes great effort to provide food for service users’ celebratory events such as birthdays and anniversaries and in the recent year a wedding between two service users living in the home. Service users and relatives spoke of their appreciation for this. The Grange DS0000013090.V325534.R01.S.doc Version 5.2 Page 14 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18 Quality in this outcome area is good. The service users and their relatives have confidence that their concerns and complaints are listened to but these need to be recorded and monitored effectively by the home. The policies and procedures for protection of service users’ money and property need to ensure that the processes fully protect them. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Service users confirmed that they knew who to speak to if they were unhappy and how to make a complaint should they wish. One person also stated that the complaints policy, “It is written in the contract.” The records for the recorded complaints and comments received by the home were reviewed. The home has not had any formal complaint since the last inspection visit. The service users are provided with copies of the complaints process in the Statement of Purpose and Service User Guide. The home does not have a method of recording any expressions of concern as they usually rectify these immediately as confirmed by service users and relatives. Occasionally this is recorded in the service user’s individual plan but there is not a system for analysing trends or common concerns together. Where they do record a complaint it is logged in a complaints book that does not provide The Grange DS0000013090.V325534.R01.S.doc Version 5.2 Page 15 confidentiality if needed or show that it has been acted upon in the given timescales set out in the complaints policy. The staff are provided with sufficient knowledge about protecting service users from possible abuse or harm through the regular training programme provided to staff. The policy and procedures refer staff to the local interagency procedure and give comprehensive information of how to recognise if abuse is occurring. The documented procedures for safe handling of service users’ money and their property need to be developed further. The Grange DS0000013090.V325534.R01.S.doc Version 5.2 Page 16 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 19,22,25 and 26 Quality in this outcome area is adequate. The condition of some of the bathing equipment and aids needs to be reviewed to ensure that it is kept clean and hygienic and will not cause physical harm to service users using them. The service users could be put at risk from weak control of infection protocols. This judgement has been made using available evidence including a visit to this service. EVIDENCE: A service user’s relative commented “To me it resembles a country house hotel” about the home in the questionnaire. Another said during the inspection visit that they liked the home and that they were very pleased. A selection of service users’ rooms including the shared accommodation and communal bathrooms and toilets were reviewed. The building has been converted in several stages to provide the present facilities. Many of the The Grange DS0000013090.V325534.R01.S.doc Version 5.2 Page 17 bedrooms and communal rooms retain original features such as marble fireplaces and nooks and crannies that provide a more homely atmosphere but also makes the positioning of the beds and furniture limited. Twenty-nine of the thirty-five of the bedrooms have en- suite facilities, the others have to share 6 toilets and 3 assisted bathrooms. The home has a programme of maintenance. The communal and general areas accessible to service users are kept clean, tidy and decorated. There are systems in place to protect service users from hot surfaces such as radiators but not all the radiators are covered with guards. One radiator in the en-suite in a shared room was exceedingly hot and not protected and this was passed to the manager at the time who instigated action immediately to rectify this. Service users were asked about the standard of cleanliness in the home. The 3 service users responded with, always (2) and sometimes (1). A relative commented to the inspector, that the rooms were kept tidy and clean. The exception to the good standard of facilities was seen in some of the communal bathrooms where the bath and toilet aids have lime scale or rust where the protective paint layer is missing. The majority of all the bathrooms, including the en-suites, have carpet some of which looks worn, stained and ill fitting. The conditions of these floor coverings indicate that staff have difficulty keeping these clean. The poor standard of these compromises the prevention of cross infection and could cause physical injury to service users. Cross infection is further compromised by insufficient provision of liquid soap and paper towels in bathrooms and en- suites wherever service users and staff may need to wash their hands. The service users have a large garden area that is accessible to use and is well maintained. It has seating for service users to use and level pathways to the lawn area. The service users were complimentary about the laundry services that the care staff provide. The laundry is sited at the rear of the kitchen/scullery area and is accessible from a separate corridor. The staff are only able to wash their hands at the sink in the corridor outside the laundry rooms. The home has a system of red bags for particularly soiled items but the staff did comment that there was not a high level of service users who have a need for their clothing and bed linen to be handled in this way. The Grange DS0000013090.V325534.R01.S.doc Version 5.2 Page 18 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 27,28,29 and 30 Quality in this outcome area is good. The home has a sufficient number of staff with the necessary skills and experience employed to meet the needs of the service users. The records of evidence of the processes for recruitment are not detailed enough as some employees full work history, written references and photograph are not obtained. The home do not ensure that they have records of how they have provided induction training for new staff. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Service users were asked in the questionnaire if staff were available when they needed them, they responded with all 3 ‘yes’ and commented with “Nearly always, inevitable you have to wait sometimes” and “And always happy”. The staff rota was reviewed and there was a discussion with service users, staff and visitors identified that there were sufficient staff on duty. The manager gave information that there are 16 care staff and 8 ancillary employed at the home. The recorded rota shows the staff on duty, times of shift and the areas of the home they are to work in. But they do need to make The Grange DS0000013090.V325534.R01.S.doc Version 5.2 Page 19 clear on the rota who is in charge of the home when the manager is not on the premises. A professional healthcare practitioner commented that it was difficult to identify a responsible person to discuss service users’ care when visiting the home. The home has domestic staff and catering staff employed specifically to provide housekeeping services and the meals. Care staff provide the support for the laundry services as additional time to their care work or during the night shift. Specific staff are employed for maintenance and care of the external areas of the home, with additional support from contractors where necessary. The employment files of 2 staff members were reviewed as part of the process to identify that staff are recruited appropriately. One staff member had been recently employed in the last 6 months, the other had been working in the home for some time. Staff are required to complete an application form, health declaration and provide 2 referees. The application form seen does not request a full work history and only one applicant supplied a CV with information to support this. Schedule 2 of the Care Homes Regulations requires this information to be obtained and for a satisfactory written explanation of any gaps in employment to be kept. One applicant’s file did not provide evidence that the verbal references that had been obtained had been followed up with written references. The Criminal Records Bureau and Protection of Vulnerable Adults list checks are carried out before employment. The records show that copies of previous training and qualifications are obtained as are proof of address and identity of the individual but did not have recent photographs as required in the Regulations. They do carry out a formal interview process but need to record their decision to employ the applicant. The files reviewed did not provide evidence of any induction process. However, staff spoken to, did confirm that they had at least a 3 day period where they had been told key information about the home and had had some training for the key topics such as fire and health and safety. All staff are given a job description, contract of employment and formal letters of offer of employment, copies of which are kept in their records. The manager supplied information that there is over 50 of the care staff with an NVQ 2 or above, qualification. Thirteen of the staff have had first aid training and seven of the staff have had specific training for medication administration. There is a rolling programme of training provided that includes the mandatory health and safety topics, abuse and infection control. Additional training obtained by some staff has been eating and drinking, laundry disinfection, foundation in care and intermediate care. The Grange DS0000013090.V325534.R01.S.doc Version 5.2 Page 20 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31,33,35,36 and 38 Quality in this outcome area is adequate. The home is run by a trained, experienced manager and staff have received suitable supervision. Service users are consulted about their opinion of the service and the home continues to develop the quality assurance process to monitor how it performs. The home needs to improve how they manage, record and handle service users’ money given to them for safekeeping. The home has some suitable systems in place to promote the health, safety and welfare of service users and staff but need to improve others relevant to safe equipment and hot surfaces. This judgement has been made using available evidence including a visit to this service. The Grange DS0000013090.V325534.R01.S.doc Version 5.2 Page 21 EVIDENCE: The manager has been working in a care environment and the home for a considerable period. She has gained qualifications in care management and continues to maintain her knowledge for health and safety and protection of service users through training updates. There are two senior carers to support the manager in her role with the supervision of the staff and care planning for service users. The home uses several processes to review how it provides the service and whether it meets service users’ needs and expectations. There is a good programme of regular formal supervision, meetings that include observation of practice and appraisals for all the staff team employed in the home. There are regular staff meetings also. The service users are consulted about the service through questionnaires, service users and relatives meetings and on a day-today basis by all the staff. The home does have several processes for selfmonitoring the medication administration, care plan reviews, the supervision and appraisal of staff. The manager informed the inspector that this was under development with a planned service user consultation process in the next few months. The Statement of Purpose and Service User Guide informs service users and their families that the home does not provide support or safekeeping of service users’ money by the staff. However, through discussion with the manager it was evident that they do hold small amounts of service users’ money on a temporary basis for payments for activities such as hairdressing and planned events. The home does not have policies, procedures and records to support this and needs to improve its storage facility for any money received. Service users are able to have lockable spaces in their rooms for valuables should they wish. Just under 50 of the service users are able to continue with their own financial affairs, the others have support by families and advocates. The records for maintenance and those relevant to the running of the home were reviewed. The home provides staff with the necessary training for them to have sufficient knowledge about safe working practices. They have systems in place for water testing, lift and equipment servicing and for gas and electrical supplies. The staff are provided with information about reporting accidents and injuries, COSSH, safe handling of food and infection control. However, the home need to improve how it reviews the safety of service users for hot surfaces such as radiators left unprotected and the condition of some of the bath and toilet aids to prevent cross infection and possible skin damage. They also need to improve the process of recording and implementing actions in response to identified risks to service users’ health and welfare. The Grange DS0000013090.V325534.R01.S.doc Version 5.2 Page 22 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 2 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 2 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 2 X X 2 X X 2 2 STAFFING Standard No Score 27 3 28 3 29 2 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 2 3 X 2 The Grange DS0000013090.V325534.R01.S.doc Version 5.2 Page 23 Are there any outstanding requirements from the last inspection? No STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1 Standard OP7 Regulation 15 Requirement That the care plans give staff information and instruction of how the care is to be provided to service users. That the medication policy and procedures are reviewed and developed to ensure that they are compliant to regulations, National Minimum Standards and safe practices. That the home has the necessary policies, procedures and records to support the safe handling of service users’ money and property. That the carpets and floor coverings in the bathrooms and toilets are reviewed and suitable action is taken to eliminate any risks to service users’ safety and reduce cross infection. That the aids and equipment for bathrooms and toilets are reviewed and replaced where necessary to ensure service users safety and prevent cross infection. That the home ensures that they provide service users and staff DS0000013090.V325534.R01.S.doc Timescale for action 28/02/07 2 OP9 13.2 28/02/07 3 OP14 OP35 16, Schedule 4 13.4.c 28/02/07 4 OP22 31/03/07 5 OP22 23 28/02/07 6 OP26 23 28/02/07 The Grange Version 5.2 Page 24 7 OP29 19, Schedule 2 and 4 8 OP30 18, Schedule 4 with suitable provisions such as liquid soap and paper towels in bathrooms and toilets to reduce the risks of cross infection. That recruitment records 28/02/07 evidence; • that the home ensures that they obtain and keep copies of written references to support those obtained verbally. • that records are kept to support that the gaps in the applicant’s full work history have been explored. • a recent photograph of the employee is kept That a record of the induction 28/02/07 training of the staff provided by the home is kept. 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 OP3 OP12 Good Practice Recommendations That the staff record greater information about the service users’ medical/health needs in the assessment process. That the service user’s personal history and interests are recorded in greater detail to support staff to be able to provide activities and service users to continue with their interests. That there is a recorded system of monitoring concerns and complaints made to the home. 3 OP16 The Grange DS0000013090.V325534.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Oxford Office Burgner House 4630 Kingsgate Oxford Business Park South Cowley, Oxford OX4 2SU National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 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 DS0000013090.V325534.R01.S.doc Version 5.2 Page 26 - 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. 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