Inspection on 23/08/05 for The Grange

This inspection was carried out on 23rd August 2005.

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 21/12/06

The Grange 06/02/06

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 Andy McGuckin Announced 23 August 09:30 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 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 H57-H08 S13090 The Grange V235819 230805 Stage 4.doc Version 1.40 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 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 thegrangegoringltd@tiscali.co.uk The Grange Limited Mrs Susan Lewis Care Home 38 Category(ies) of Old age, not falling within any other category registration, with number (38) of places The Grange H57-H08 S13090 The Grange V235819 230805 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: 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. Date of last inspection 10 November 2004 Brief Description of the Service: The Grange is a residential home registered for 42 older persons who require personal care and accommodation. The home has recently changed its registration to 4 rooms to be used for couples or those wishing to share. The home is privately owned and is set in a beautiful location in the village of Goring. The accommodation is provided in a large Victorian house. The house has been altered and adapted for its purpose. Many rooms are large and bright with views of the countryside and the sound of the river Thames. Care is provided over three floors with lift access to the two top floors. There have been no changes to the physical layout of the home. The grounds have had the advantage of the addition of a summerhouse which will be very beneficial in the current warm weather. The village offers shops, pubs and cafes with transport links to Reading and Oxford. The home is managed by an experienced manager. Staff are provided in adequate numbers to enable care to be provided in a relaxed manner, taking account of service users’ privacy and dignity. The inspector interviewed 5 service users and 6 staff during the inspection. Comments recived from both sections were very positive about what the home had to offer. Comments from a range of professionals involved in the home demonstrated satisfaction with the service. The inspector was made to feel welcome on the day of the inspection and thanks the manager and staff for their co-operation. The Grange H57-H08 S13090 The Grange V235819 230805 Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection took place on a bright summer’s day. The home had several windows open and the overall feel was one of a bright, airy and pleasant atmosphere. This inspection was announced and took place on a weekday. Questionnaires had previously been sent out to a random selection of relatives and professionals who use the service. Feedback from these was very positive. On the day of the inspection five residents were spoken to by the inspector and feedback from this was generally positive. Where negative comments had been made these had been passed back to the manager and proprietor in a confidential manner. The inspector was assured that these matters would be looked into. Staff were interviewed to check the recruitment and training processes. The inspector was satisfied that these were robust. The inspector witnessed the day’s meal being prepared, which used fresh ingredients and was being freshly prepared. It looked and smelt very appetising. The inspector toured the building and no health and safety issues were identified. What the service does well: 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 Grange H57-H08 S13090 The Grange V235819 230805 Stage 4.doc Version 1.40 Page 6 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 Standards Statutory Requirements Identified During the Inspection The Grange H57-H08 S13090 The Grange V235819 230805 Stage 4.doc Version 1.40 Page 7 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 1,2,3,4 &5. Information is provided to prospective service users in a manner, which enables them to make an informed decision as to the choice of home for their needs. EVIDENCE: The home makes available documentation and information on which prospective residents can make decisions as to the suitability of the home. This documentation is presented in clear and concise language and sets out the terms and conditions of the home’s contract. Residents or their representatives sign the contract and retain a copy. Prospective residents are assessed by the home in collaboration with other interested professional agencies. Where possible prospective residents are invited to spend some time at the home prior to taking up a vacancy. Prospective residents are invited for a meal or overnight stay. A trial period is agreed to allow either party to assess the suitability of the home to meet the needs of the individual. The placement and Care Plan are reviewed regularly. Where there has been significant change, which may affect the suitability of the placement, a full review meeting would be held involving all interested parties. An assessment The Grange H57-H08 S13090 The Grange V235819 230805 Stage 4.doc Version 1.40 Page 8 would be made as to the current continued suitability of the placement. On the day of the inspection the inspector witnessed friends and relatives being made welcome into the home. Standard 6 is not applicable, as the home does not offer an intermediate care facility. The Grange H57-H08 S13090 The Grange V235819 230805 Stage 4.doc Version 1.40 Page 9 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 7,8,9,10,11. Residents’ health and care needs are set out in a care plan, which is regularly reviewed. EVIDENCE: Personal care plans are drawn up to identify the individual needs and wishes of residents. Where possible residents are fully involved in this process. Residents are encouraged to be fully involved in all aspects of the home if they are willing or able. Where residents do not want to participate in activities this is respected. Previous inspection reports have not found errors in medication. The inspector omitted to inspect medication on this occasion but had no reason to doubt that there were robust procedures in place for its distribution and administration. An unannounced spot check will be undertaken in the near future. Many residents are responsible for the management and administration of their own medication. This is encouraged by the home. The Grange H57-H08 S13090 The Grange V235819 230805 Stage 4.doc Version 1.40 Page 10 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12,13,14,15. Residents within the home are encouraged to maintain as much independence as they are willing or able. EVIDENCE: Feedback from relatives and residents indicated that where activities had been identified that every effort had been made to provide these. The home provides a monthly newsletter, which contains information on the day-to-day activities of the home but also advertises special events. Residents meetings are held regularly and are well attended. Evidence was found through reading care files and in discussion with residents and friends that contacts made whilst living in the community are being maintained where possible and appropriate. Residents are encouraged to maintain as much control over their lives as they are able or willing to do. On the day of the inspection the meal for the day had been freshly prepared. Ingredients for the meal are freshly bought and included fresh meat and fresh vegetables. Lunch was taken in the main dining area and was unhurried and relaxed. The Grange H57-H08 S13090 The Grange V235819 230805 Stage 4.doc Version 1.40 Page 11 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 inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 16,17,18. The home has a complaints procedure that is understood by the residents. EVIDENCE: The inspector spoke to a relative of a current resident who was very complimentary about the home and its management team. The relative would have no hesitation in complaining if necessary and was aware of the home’s complaints procedure. The inspector felt that the system for recording complaints was satisfactory. Due to the management style of the home complaints/concerns are dealt with at source and usually with a satisfactory outcome. Formal processes are in place if complaints cannot be resolved in this manner. Residents spoken to were very clear as to how they could use the complaints process. The home has a procedure in place to identify and deal with potential issues of abuse. Staff are being trained in these procedures and the home links in with the local authority that would take the lead where potential cases have been identified. The home has had no need to implement these procedures as yet. The Grange H57-H08 S13090 The Grange V235819 230805 Stage 4.doc Version 1.40 Page 12 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 19,20,21,22,23,24,25,26. The home provides care in a safe and well-maintained environment. EVIDENCE: The building and grounds are of a very high standard and are well maintained. A new summerhouse has been added since the last inspection. This will provide a valuable addition to the home and its residents. The inspector toured the building and with permission visited residents’ bedrooms. Bedrooms inspected were warm, clean and showed individuality. All rooms were well decorated with furnishings and bedding of a good quality. The exterior of the building and gardens are similarly well maintained and provide a pleasant area for quiet reflection or communal recreation. The home is able to provide sufficient washing, bathing and toileting facilities. Evidence was found that where residents required specialist equipment, this had been provided and that staff had been trained to use it. All residents have their own room, which has either en suite facility or toilets and bathrooms nearby. Lockable facilities are available in residents’ rooms for valuables or medication. On the day of the inspection the home was found to be clean and smelt fresh. The Grange H57-H08 S13090 The Grange V235819 230805 Stage 4.doc Version 1.40 Page 13 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 considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27,28,29,30. The home is managed by an experienced manager in the provision of care for the elderly. Staff are employed in sufficient numbers and with the required skills to provide care to the home’s residents. EVIDENCE: On the day of the inspection there were sufficient staff to meet the needs of the current service user group. The manager is both experienced and qualified with a diploma in Care Management. Care Staff are undertaking or are being selected for N.V.Q 2 training. Staff files evidenced that staff are being recruited appropriately and that regular training is taking place. Future training has been identified for all staff. Staff are being supervised on a regular basis and issues identified at supervision are dealt with appropriately. The inspector spoke to 6 staff members on the day of the inspection and evidence was found that staff are being trained and supervised to enable them to complete the required tasks in a safe and dignified manner. Evidence of staff meetings taking place was found and minutes reflected that subjects covered were relevant to the care of the residents. The Grange H57-H08 S13090 The Grange V235819 230805 Stage 4.doc Version 1.40 Page 14 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 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31,32,33,34,35,36,37,38. The home is professionally run and managed. EVIDENCE: The registered manager is experienced and trained to manage the care provision offered by the home. The registered manager is supported to do this by a staff group of sufficient numbers and experience in the care of the elderly. There is much evidence of family involvement in the home and the ethos, leadership and management stems from this and the desire to provide a good quality service. The home has sufficient policies and procedures to assist in the protection of potentially vulnerable adults. The home is managed in a professional manner and the inspector was informed that it was financially sound. Accounts are available for inspection if required. Accounts were not required as part of this inspection. The health, safety and welfare of residents are being promoted and protected. The inspector concludes that the home is professionally run and managed. The Grange H57-H08 S13090 The Grange V235819 230805 Stage 4.doc Version 1.40 Page 15 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score 3 3 3 3 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION 3 3 3 3 3 3 3 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 3 3 3 3 3 3 3 3 3 3 The Grange H57-H08 S13090 The Grange V235819 230805 Stage 4.doc Version 1.40 Page 16 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 Regulation None. Requirement Timescale for action 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 None. Good Practice Recommendations The Grange H57-H08 S13090 The Grange V235819 230805 Stage 4.doc Version 1.40 Page 17 Commission for Social Care Inspection Burgner House, 4630 Kingsgate, Cascade Way, Oxford Business Park South, Cowley, Oxford OX4 2SU 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. 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