Inspection on 05/06/07 for The Grange

This inspection was carried out on 5th June 2007.

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 06/12/06

The Grange 22/06/06

The Grange 03/11/05

The Grange 21/04/05

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 Christine Lawrence Key Unannounced Inspection 5th June 2007 11.30 The Grange DS0000023231.V337714.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 DS0000023231.V337714.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 DS0000023231.V337714.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service The Grange Address 75 Reculver Road Herne Bay Kent CT6 6LQ 01227 741357 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) lifetimecare@tiscali.co.uk Lifetime Care Development Limited Mr Eddie Fisher Care Home 4 Category(ies) of Learning disability (4) registration, with number of places The Grange DS0000023231.V337714.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 6 December 2006 Brief Description of the Service: The Grange is a small care home for four people with learning disabilities. It is within the village of Beltinge which has some local facilities, and a short distance from Herne Bay, a nearby town with more facilities. A bus route is close by and there is a mainline rail station at Herne Bay. Parking is not restricted in the roads around the home. The statement of purpose relating to the home, as well as business cards and information leaflets are made available to prospective residents and their representatives on request, as is a copy of the latest Commission for Social Care Inspection (CSCI) inspection report. Mr Fisher confirmed the fees as starting from £600 per week. Personal toiletries, newspapers and magazines are not included in the fees. The Grange DS0000023231.V337714.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was unannounced. The proprietor, Mr Fisher, who owns Lifetime Care Development Limited, had previously sent in an Annual Quality Assurance Assessment (AQAA) with information about the home, staff and residents. There are currently two residents living in the home. During the site visit I spoke to the residents and the deputy manager. I also spoke with Mr Fisher. I looked at both residents’ rooms, in their company and other parts of the building. Information from the previous inspection was also used for this inspection. 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 summary of this inspection report can be made available in other formats on request. The Grange DS0000023231.V337714.R01.S.doc Version 5.2 Page 6 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 DS0000023231.V337714.R01.S.doc Version 5.2 Page 7 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 2 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Prospective residents can be confident that their needs and aspirations will be assessed. EVIDENCE: The pre-admission assessment which will be used for any new resident is person centred and would therefore take account of aspirations as well as needs. I was told that any assessment would be carried out by Mr Fisher with the help of the deputy, both of whom have national vocational qualifications at level 4. The Grange DS0000023231.V337714.R01.S.doc Version 5.2 Page 8 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7 and 9 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Needs and goals are reflected in individual plans. Residents and/or their representatives are involved in the care planning process, ensuring that staff know how to support residents according to their own wishes. EVIDENCE: Two individual care plans were seen. There are care plans from care managers and the records also contain reviews carried out by the care manager, involving residents, relatives, staff from the home etc. A format for ‘person centred planning’ is being used. One of these was signed by the resident, with a comment from staff … “Written and compiled with xxxx’s help”. An example was noted of pictures being used to illustrate daily living activities. Risk assessments are included within individuals’ records. There is general information and more specific guidelines and these are reviewed monthly. Some examples seen were out on own, employment, bowling, kitchen safety and swimming alone. The Grange DS0000023231.V337714.R01.S.doc Version 5.2 Page 9 Examples were noted of residents being enabled to make choices and decisions about their lives, either in simple everyday things like food, spending time in own room, times for going to bed etc and also wherever possible in more complex ways such as wishing to have employment, which activities to pursue, issues about relationships and whether or not to continue with visits from speech and language therapists. Residents’ abilities to manage their own money vary and this was reflected in the way they are supported by staff. The Grange DS0000023231.V337714.R01.S.doc Version 5.2 Page 10 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 15, 16 and 17 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents take part in appropriate activities and use community facilities. Personal and family relationships are supported and an appropriate menu is provided. EVIDENCE: Residents take part in a variety of activities and viewing records and talking to, and observing residents confirmed this. This includes leisure, educational and household activities. Some things are planned and others are more spontaneous. A record is maintained of what activities individuals do. One person has been supported to find a job and this seems to have been successful. There is a television in the lounge and one resident has his own set. Residents also enjoy playing CDs in their own rooms. Facilities within the local community are used for things such as swimming, bowling, going to local pubs, eating out and personal shopping. One resident is involved in some food The Grange DS0000023231.V337714.R01.S.doc Version 5.2 Page 11 shopping. Staff work evenings and weekends to enable residents to do things at these times. One resident has been given a different key for his own room which promotes his privacy and independence. Information was noted showing that individuals are supported regarding their family contacts (including regular phone calls and invitations to have a meal at the home) and the opportunities for personal relationships. The menus seen by the inspector were satisfactory and a record is kept of individual’s choices. Specialist dietary advice has been sought and the special requirements of residents regarding diet and monitoring of weight have been responded to. The Grange DS0000023231.V337714.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19 and 20 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents’ preferences are known and their physical and emotional care needs are responded to. Residents are protected by the homes’ policies and procedures regarding medication. EVIDENCE: Where a resident is able to speak up about preferences this is responded to. If a resident is not able to fully articulate things on a day-to-day basis, more information is included within the care plan information including the use of pictures. Residents were individual in their style of dressing. Additional support will be sought from outside professionals such as dieticians, chiropodist, dentist, GP and specialist learning disability doctors. Physical needs, and wishes associated with them, are noted for each individual and it is clear that residents are supported to attend appointments. Physical health care needs are identified and although a ‘health action plan’ format is not used, there is very clear information about how needs are identified and responded to. As previously noted, 6 monthly reviews are carried out under the auspices of the placing authority’s representative (care manager). Written information The Grange DS0000023231.V337714.R01.S.doc Version 5.2 Page 13 about particular health care needs is included on individual’s records for staff information. All staff have received training regarding medication administration. The medication administration records viewed were appropriately maintained. Storage and policies and procedures are satisfactory. The Grange DS0000023231.V337714.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. JUDGEMENT – we looked at outcomes for the following standard(s): 22 and 23 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents’ views will be listened to and they will be protected from abuse. EVIDENCE: The home has a suitable complaints procedure. No complaints have been received by the home since the last inspection. Mr Fisher said that he has informed the representatives of residents about the complaints procedure and he would ensure that this information would be given to prospective/new residents. One resident said he would talk to the deputy manager if he had any concerns. There are policies and procedures relating to adult protection, including whistle blowing and Mr Fisher has the up to date policies and procedure from Kent and Medway social services. Guidelines for staff are available relating to the challenging behaviour of one person but they have not been needed since the resident moved to the home. Mr Fisher stated that staff have received training with regard to challenging behaviour and adult protection The Grange DS0000023231.V337714.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. JUDGEMENT – we looked at outcomes for the following standard(s): 24 and 30 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Residents benefit from a home which is comfortable and homely and clean and hygienic. EVIDENCE: In general the home provides a homely and comfortable environment. Furniture and fittings are domestic in style and as a home in existence prior to 1 April 2002, the personal and communal space is sufficient. The building is adequately maintained. A new carpet has been provided in the lounge and the inspector was informed that the dining area would be next. Mr Fisher said that he plans to carry out further decoration. The garden area needs some attention to make it more attractive. There is access to buses locally and to a mainline railway station in nearby Herne Bay and the home also has its own vehicle, which allows residents to access local amenities. Some things are within walking distance as the home The Grange DS0000023231.V337714.R01.S.doc Version 5.2 Page 16 is on the edge of a village type community. The house fits in with the local community. At the time of the inspection the home was clean and free from any unwelcome odours. Conditions in the laundry have been improved and Mr Fisher said that he intends to do some more work on the laundry area. The Grange DS0000023231.V337714.R01.S.doc Version 5.2 Page 17 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 32,34,35 and 36 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Residents benefit from supported and supervised staff who are adequately trained. EVIDENCE: The deputy has completed level 3 and level 4 national vocational qualifications (NVQs) for care and is now pursuing the NVQ 4 for management (registered manager’s award). Mr Fisher said that one other member of staff is currently undertaking NVQ level 2. There is some written information relating to specific disabilities on individuals’ care plans and specialist advisors have been and are involved with residents. Throughout the time of the inspection staff were observed to be responsive to residents. Staff numbers have reduced since the last inspection. There are only two residents at the moment and Mr Fisher said that the staffing levels meet their current needs. He said that he would review staffing levels if needs change or when a new resident is admitted. The Grange DS0000023231.V337714.R01.S.doc Version 5.2 Page 18 There has been no new member of staff employed since the last inspection. The records viewed at the last inspection showed that the recruitment process includes using an application form, asking for at least two references, undertaking criminal record bureau checks, providing written terms and conditions of employment and providing staff with copies of the general Social Care Council code. The deputy confirmed that there have been no changes to the procedures. Staff members have received appropriate training. The staff records viewed previously indicated that supervision is being provided. The format used covers training needs, any concerns, any suggestions, where going and any personal issues. The deputy does the supervisions and she confirmed that they are ongoing. The Grange DS0000023231.V337714.R01.S.doc Version 5.2 Page 19 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents benefit from a home which is run by a qualified manager. Residents benefit from the manager identifying areas for improvement. Residents’ health, safety and welfare is promoted and protected. EVIDENCE: Mr Fisher is the registered manager. He has more than three years experience of managing within a care setting and has his National Vocational Qualifications (level 4) in care and management. Mr Fisher completed an annual quality assurance assessment prior to this inspection (AQAA). He has identified for himself the wish to involve residents more in the running of the home and he is also reviewing and improving the feedback questionnaire used to gather opinions about the home. I was enabled to spend time privately with the residents. The policies and procedures were reviewed in April. The Grange DS0000023231.V337714.R01.S.doc Version 5.2 Page 20 Health and safety training has been provided to staff. A spot check on maintenance and service contracts at the previous inspection showed that these are appropriate and up to date. Accident recording is compliant with the Data protection Act (1998). Fire safety records and checks were viewed and were appropriately maintained. Risk assessments are in place for various aspects within the home eg secure storage of sharp knives. Water temperatures are monitored. The Grange DS0000023231.V337714.R01.S.doc Version 5.2 Page 21 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 X 2 3 3 X 4 X 5 X 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 2 25 X 26 X 27 X 28 X 29 X 30 2 STAFFING Standard No Score 31 X 32 3 33 2 34 2 35 2 36 2 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 X 3 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 X 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 3 X 3 X X 3 X The Grange DS0000023231.V337714.R01.S.doc Version 5.2 Page 22 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. Standard Regulation 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 2. 3 Refer to Standard YA24 YA30 YA33 Good Practice Recommendations The planned redecoration etc should go ahead. The rear garden area should be improved The further work planned for improving the laundry should go ahead. Staffing levels should be reviewed as part of the regular review of residents’ needs and on admission of any new resident The Grange DS0000023231.V337714.R01.S.doc Version 5.2 Page 23 Commission for Social Care Inspection Maidstone Local Office The Oast Hermitage Court Hermitage Lane Maidstone ME16 9NT 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 DS0000023231.V337714.R01.S.doc Version 5.2 Page 24 - 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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