Inspection on 23/11/06 for The Grange

This inspection was carried out on 23rd November 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 found no outstanding requirements from the previous inspection report, but made 2 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

The Grange 29/10/08

The Grange 01/03/06

The Grange 12/09/05

The Grange 23/03/05

The Grange 04/11/04

The Grange 28/01/04

Similar services:

Clover House

Parkside

Park Lodge

Mere Hall View

St Bonaventures

Hudson Road

Whitewalls

Home Farm

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

CARE HOME ADULTS 18-65 The Grange 2 Park Vale Road Macclesfield Cheshire SK11 8AR Lead Inspector Ms Julie Porter Unannounced Inspection 23 November 2006 10:00 The Grange DS0000006532.V296299.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 DS0000006532.V296299.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 DS0000006532.V296299.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service The Grange Address 2 Park Vale Road Macclesfield Cheshire SK11 8AR 01625 618146 01625 430831 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) Miss Kelly Brown Care Home 3 Category(ies) of Learning disability (3) registration, with number of places The Grange DS0000006532.V296299.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. No more than 2 Service Users may be LD No more than 1 Service User may be LD, aged under 18 years Date of last inspection 1st March 2006 Brief Description of the Service: The Grange is a small, privately owned care home that is close to Macclesfield town centre. There are a variety of shops, churches and other facilities nearby. There are no designated car parking spaces at the home. The Grange was formerly a private dwelling that has been altered and adapted to become a care home for three service users with a learning disability. The Grange is a two-storey building with a cellar. It has five bedrooms, one of which is used as an office. The proprietor and Service users have their own bedrooms. Downstairs there is a lounge, dining room, bathroom and kitchen for service users. The resident proprietor uses a separate lounge. A small, enclosed yard provides opportunities for sitting outside during the summer months. The home charges between £1357.40 and £2449.04 per four-week period for residential care. This information was provided by the manager and submitted to CSCI on 30 November 2006. The Grange DS0000006532.V296299.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. An unannounced visit took place on the 23 November and 08 December 2006 lasted 4.5 hours. The visit was carried out by one inspector. This visit was just one part of the inspection. Before the visit the home owner/manager was also asked to complete a questionnaire to provide up to date information about services in the home. Questionnaires were also made available for residents and health and social care professionals to find out their views. Other information received by CSCI since the last key inspection was also reviewed. During the visit various records and the premises were looked at. Two of residents were also spoken with and they gave their views about the service. What the service does well: What has improved since the last inspection? One member of staff has attended training in relation to Adult Abuse so that residents are protected from harm. Robust recruitment processes are in place to ensure that staff are “fit” to undertake the work for which they are employed. The Grange DS0000006532.V296299.R01.S.doc Version 5.2 Page 6 What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The Grange DS0000006532.V296299.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 DS0000006532.V296299.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1,2,5 Quality in this outcome is good. This judgement has been made using the available evidence including a visit to this service. Information is available to the residents and professionals so they know what the home can offer. EVIDENCE: The current residents have lived in the home for a number of years. Information is available to prospective residents and professionals about the services the home can offer and was informative. Two residents care files were inspected and included information about what is and what is not included in respect of the fees charged. One resident spoken with was able to describe what she could expect from living in the home. The Grange DS0000006532.V296299.R01.S.doc Version 5.2 Page 9 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6,7,8,9 Quality in this outcome is adequate. This judgement has been made using the available evidence including a visit to this service. In the absence of clear records relating to care planning, staff may be vulnerable when providing care and residents may not receive the care/support they need. EVIDENCE: The residents in the home are very able to discuss their needs in relation to what support they need. All are planning for the future and intend to move to a more independent setting. Care plan documents are available in the home although the manager confirmed that these are not often used. Staff meeting records showed evidence of the immediate needs or current issues relating to providing care and the action staff should take, however this does not give a full clear picture of the needs of the individuals. The home has a small staff team and the owner/manager is always available for advice, staff are kept aware of the residents needs on each occasion when they come to work in the home. Care plans must identify residents’ needs and how they will be met including any agreements that have been made between residents and staff regarding The Grange DS0000006532.V296299.R01.S.doc Version 5.2 Page 10 their actions and behaviour. Care plans must identify any risks relating to residents’ behaviour/and or actions and include the agreed consequences of not following the care plan. The residents know what skills they need to become more independent and their timetables reflect this. All are offered one to one support to participate in activities at various times during the week. Each person living in the home participates in the running of the home and knows their responsibilities to ensure the home runs smoothly. The Grange DS0000006532.V296299.R01.S.doc Version 5.2 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 the following standard(s): 11,12,13,14,15,16,17 Quality in this outcome is good. This judgement has been made using the available evidence including a visit to this service. Residents are encouraged to try new things and participate in all aspect of running the home so that they will be equipped to move to a more independent setting. EVIDENCE: All the residents living in the home are aware that the home provides support for them to promote further independence, with the intention that they will move to their own homes in the future. One resident spoken with said that she enjoyed living at The Grange and was working hard to be responsible, look after her health and eat healthily. Residents attend college and are encouraged to work. One resident was very proud to show evidence of her achievements with questionnaires held on her file from college and work placements. Residents are encouraged to try new activities for example joining the local football club or the gym and when necessary one to one staff support is provided. The Grange DS0000006532.V296299.R01.S.doc Version 5.2 Page 12 Residents are encouraged to maintain contact with family when appropriate and are supported to learn the skills to travel independently to meet them. All residents are involved collectively in creating “house rules.” These were seen relating to cleaning, cooking, visitors and behaviour. All the residents sign the agreements and reviews take place when necessary. An individual contract was seen regarding spending time away from the home, and the consequences of not following the contract. The agreements and any restrictions imposed must be included into the care plan. Friends and visitors are encouraged to spend time in the home often for meals and parties. The residents are responsible for menu planning, shopping and cooking. One resident questionnaire states, “we do our own menus, some of us are better cooks than others.” The Grange DS0000006532.V296299.R01.S.doc Version 5.2 Page 13 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 18,19,20 Quality in this outcome is good. This judgement has been made using the available evidence including a visit to this service. The homes policy regarding medication and healthcare supports the residents in maintaining and promoting further independence. EVIDENCE: Residents in the home do not need support relating to personal care. The home has good links with community services and all are registered with the local G.P. The manager confirmed that residents are encouraged to make and attend doctors, dentists and opticians appointments independently. Support is given to attend when appropriate. One resident said “I don’t need mum to go with me.” Residents can manage their own medication subject to a risk assessment. The Grange DS0000006532.V296299.R01.S.doc Version 5.2 Page 14 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 22,23 Quality in this outcome is good. This judgement has been made using the available evidence including a visit to this service. The home has an effective complaints procedure; policies and training regarding adult protection are in place to ensure residents are protected from harm. EVIDENCE: The home has a formal complaint procedure available to the residents, information was seen about the home and the process and relevant addresses are included in the statement of purpose. Evidence was seen that concerns/complaints are raised and recorded in the resident meeting minutes. One resident said that this was better as you can say what you feel and sort things out together. Two residents questionnaire returned state that they “always” know who to speak to if you they are not happy. Policies and procedures are in place relating to adult protection and since the last inspection one member of staff has attended Adult Abuse training. The Grange DS0000006532.V296299.R01.S.doc Version 5.2 Page 15 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 24,25,26,30 Quality in this outcome is good. This judgement has been made using the available evidence including a visit to this service. The home is clean a fresh and well maintained to ensure that residents live in safe comfortable surroundings. EVIDENCE: The residents have access to all areas of the home except the owners’ private accommodation. On the day of the inspection the home was clean, fresh and well maintained. During the summer the residents undertook a project to decorate the dining room to learn the skills needed in maintaining their own home. Each resident has their own bedroom, which they have personalised and is decorated to their own taste. The Grange DS0000006532.V296299.R01.S.doc Version 5.2 Page 16 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 32,34,35 Quality in this outcome is good. This judgement has been made using the available evidence including a visit to this service. Recruitment processes are robust to ensure that the residents’ welfare is protected. EVIDENCE: The home has a low turn over in staff, residents are supported daily by the manager who has achieved National Vocational Qualification (NVQ) level 4. One part-time staff member has NVQ level 2 and another is currently undertaking this qualification. Information provided by the manager identifies that training arranged for next year includes updating current staff 1st Aid and NVQ enrolment for another staff member. One staff personnel record was inspected and contained information as required by Schedule 2; including an application form, references, POVA 1st clearance and a Criminal Record Bureau (CRB) disclosure. One member of staff spoken with said that she enjoyed working in the home and felt that she was able to discuss anything with the manager and felt supported by her. Staff meetings are held every six weeks to ensure that all staff are aware of what is expected of them. The Grange DS0000006532.V296299.R01.S.doc Version 5.2 Page 17 The Grange DS0000006532.V296299.R01.S.doc Version 5.2 Page 18 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 37,39,42 Quality in this outcome is good. This judgement has been made using the available evidence including a visit to this service. The owner/ manager is aware of her responsibilities in respect the day-to-day running of the home to ensure the residents are well cared for and kept as safe as possible. EVIDENCE: The homes owner/manager is registered with the Commission for Social Care Inspection and has achieved The Registered Managers award, National Vocational qualification (NVQ) level 4. The policies and procedures relating to the running of the home are monitored and up dated annually. During the inspection two residents were at home, they were confident and able to discuss what life was like in the home. The manager promotes independence and residents were constantly encouraged to say how they were feeling and what life was like for them. The rapport between the manager and residents was light-hearted and affectionate. All the residents in the home refer to the manager as “mum.” The Grange DS0000006532.V296299.R01.S.doc Version 5.2 Page 19 The home is domestic in size and benefits from fire detection equipment. Escape routes in the event of a fire are clear to the residents. Information was seen around the home relating to washing and food hygiene. A gas safety certificate and central heating safety certificate were issued in June 2006. The Grange DS0000006532.V296299.R01.S.doc Version 5.2 Page 20 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 3 2 3 3 X 4 X 5 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 3 25 3 26 3 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 X 34 3 35 3 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 2 3 3 2 X LIFESTYLES Standard No Score 11 3 12 3 13 3 14 3 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 3 X 3 X X 3 X The Grange DS0000006532.V296299.R01.S.doc Version 5.2 Page 21 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 15(1) Requirement Timescale for action 31/01/07 2 YA9 The manager must prepare a written care plan that identifies the residents’ needs and how those needs will be met. 13(4)(b)(c) Risks relating to residents chosen activities must be identified, so far as possible minimised and recorded in the residents care plan. 31/01/07 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations The Grange DS0000006532.V296299.R01.S.doc Version 5.2 Page 22 Commission for Social Care Inspection Northwich Local Office Unit D Off Rudheath Way Gadbrook Park Northwich CW9 7LT National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI The Grange DS0000006532.V296299.R01.S.doc Version 5.2 Page 23 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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