Inspection on 25/11/05 for The Grange Care Centre

This inspection was carried out on 25th November 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 Care Centre 04/06/08

The Grange Care Centre 01/06/07

The Grange Care Centre 22/03/06

The Grange Care Centre 18/11/04

The Grange Care Centre 20/04/04

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

CARE HOMES FOR OLDER PEOPLE The Grange Nursing Home Eastington Stonehouse Glos GL10 3RT Lead Inspector Ms Gillian Goldfinch Unannounced Inspection 25th November 2005 1:30 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 Nursing Home DS0000016609.V271340.R01.S.doc Version 5.0 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 Nursing Home DS0000016609.V271340.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service The Grange Nursing Home Address Eastington Stonehouse Glos GL10 3RT 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) 01453 791513 thegrange@eastington.freeserve.co.uk Saddlers Hotels Limited Mrs Linda Rose Barnes Care Home 50 Category(ies) of Dementia (50) registration, with number of places The Grange Nursing Home DS0000016609.V271340.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 18th November 2004 Brief Description of the Service: The home is registered to accommodate 50 older people whose nursing/care needs arise from frailty due to a dementia illness. The Grange is a Grade II listed Georgian Country House situated on the fringe of the Cotswolds and the outskirts of the village of Eastington, near Stonehouse. It is set in five acres of parkland with well-maintained gardens to both the front and side of the property. There are plenty of lounge and dining areas on the ground floor. A recently refurbished and extended conservatory provides additional lounge and dining space. The conservatory also provides easy access to a landscaped secure garden area. The accommodation consists of both single and double en-suite bedrooms. They are well furnished and maintained to a good standard. There are en-suite facilities in all but one room; there are assisted bathrooms/shower room and a number of toilets in the home for service users to access. Specialised equipment is provided to meet with individual needs. . The Grange Nursing Home DS0000016609.V271340.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The unannounced inspection took place over four and a half hours from mid afternoon to early evening on a weekday. The inspection consisted of a visit to the nursing and residential wings, examination of residents care plans, staff files and other management documents. The inspector had discussion with the registered manager, the training and development officer, three service users, six relatives and three care staff. What the service does well: What has improved since the last inspection? Refurbishments at the home have increased lounge, dining and bedroom space. Refurbishment has also included development of a secure garden providing easy access and a safe environment for service users. Care plans have been revised using a format in keeping with current developments in dementia care. Requirements made at the last inspection have been met. The home has achieved the Investors in People Leadership and Management Award. The Grange Nursing Home DS0000016609.V271340.R01.S.doc Version 5.0 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 Nursing Home DS0000016609.V271340.R01.S.doc Version 5.0 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 Nursing Home DS0000016609.V271340.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1 and 3 The home has a very informative Statement of Purpose and Service Users Guide, a copy of which has been sent/given to a representative of each service user. Every service user is assessed prior to admission and wherever possible they and/or their representatives are encouraged to visit the home prior to admission. EVIDENCE: A copy of the Statement of Purpose was seen detailing evidence of the services provided. Two assessment documents were seen which covered all areas of residents’ needs. It was recommended that the person completing the written assessment signs and dates the document. Relatives of service users spoken to at the inspection confirmed that visits and assessments had been undertaken by the home before their relative had The Grange Nursing Home DS0000016609.V271340.R01.S.doc Version 5.0 Page 9 moved in. This included opportunity for the prospective service user to visit the home prior to admission. The Grange Nursing Home DS0000016609.V271340.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8, and 10 Care planning systems in the home ensure that residents’ needs are understood and met. EVIDENCE: Each service user has a full assessment completed prior to and following admission, which includes a number of risk assessments. From this assessment care is planned, implemented and regularly reviewed with the family/or other representatives wherever possible. Some of the care records seen did not contain a photograph of the service user as required. All of the records seen reflected the current needs of the service users. Relatives spoken to stated they had no concerns about the care offered. Daily records showed that the primary health care team were consulted and called in as necessary and service users had access to chiropody, opticians and other community health services. Recommendation made at the previous inspection to date liquid medication on opening, ensuring out of date medication is not used, was being implemented. The Grange Nursing Home DS0000016609.V271340.R01.S.doc Version 5.0 Page 11 Observations made during the inspection showed the staff were respectful and promoted service users dignity. Staff spoken to were clear about how they would respect the privacy and dignity of service users. Relatives stated staff at all levels were respectful of the needs of service users. The Grange Nursing Home DS0000016609.V271340.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,14 and 15 Service users were able to choose their daily routine and there were activities available for them to join in if they wished to do so. Their visitors were made welcome. The provision of food was good and mealtimes were promoted as a social activity. EVIDENCE: The Grange Nursing Home DS0000016609.V271340.R01.S.doc Version 5.0 Page 13 Staff aim to establish the lifestyle needs and preferences of service users before their admission to the home. The social, cultural, religious and recreational interests of service users are detailed in the initial assessment and form part of their care plan. There was evidence that leisure and recreational activities were focussed on an individual basis to suit individual preferences and needs. One relative spoke positively about the support the home had provided for his wife enabling her to participate in a family wedding. This had included shopping trips, transport and a staff member to provide care for the service user on the day of the wedding. The home has one full and one part time activities officer. The role of these staff is to keep up to date with the activity needs of service users through discussion with them, their relatives and their carers. Activities are planned according to the needs and preferences of the service user group. There was evidence of planned activity taking place in the home. Visitors were welcomed into the home at any reasonable time and relatives spoken to confirmed this. One relative stated, “My family are always welcomed by the staff and always provided with refreshments”. The home maintains links with the pensioners club. PAT dogs visit each Tuesday, two hairdressers visit the home every Thursday, Communion service is held at the home each month and visits are also made to the local church. Buses are hired for regular trips. The service users and staff will be going to a local hotel for a meal during the Christmas holiday. All service users spoken to said they enjoyed the food provided in the home. One relative spoken to felt that portions could sometimes be bigger. Staff were aware of the specialist dietary requirements of service users and ensured their needs were catered for at each meal. Kitchen staff had not been provided with comprehensive information in the kitchen about the likes and dislikes of individual service users. It is recommended that kitchen staff be provided with this information. Staff stated they inform service users each day of the food to be provided. It is recommended that in addition to this the home provide notice boards where the daily menu can be displayed. The Grange Nursing Home DS0000016609.V271340.R01.S.doc Version 5.0 Page 14 The Grange Nursing Home DS0000016609.V271340.R01.S.doc Version 5.0 Page 15 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 the following standard(s): 16 The home has a clear complaints procedure, which can be accessed by relatives to ensure that the welfare of residents is protected. EVIDENCE: The home has a complaints procedure in place that is accessible to all visitors to the home. It was reported that there have been no serious complaints received. Some minor problems concerning laundry had been dealt without initiating the full complaints procedure. Relatives spoken to were confident about raising any concerns and confident they would be listened to by staff. Any complaints received would be recorded together with any action taken. The Grange Nursing Home DS0000016609.V271340.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19 There is evidence of improvement within the environment to provide the service users with a comfortable and safe home. EVIDENCE: Major building work has been completed since the last inspection. The new extension is built to a very high standard offering all single en suite accommodation and under floor heating. The home has a rolling programme of maintenance, redecoration and refurbishment. The pleasant newly created secure garden area is accessible by ramps. Garden furniture is provided. Those areas seen were clean and free from offensive odours. The Grange Nursing Home DS0000016609.V271340.R01.S.doc Version 5.0 Page 17 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 29 Good employment practices ensure that staff are thoroughly checked prior to employment, providing good protection to the residents. EVIDENCE: The home has a comprehensive recruitment procedure in place. Staff records are being maintained as required. Requirement made at the last inspection for staff recruitment files to contain a recent photograph of the staff member, had been met. CRB/POVA checks are applied for prior to appointment. The Grange Nursing Home DS0000016609.V271340.R01.S.doc Version 5.0 Page 18 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 32 and 33 The management approach of the home creates a positive, open and inclusive atmosphere. The home has a formal quality assurance program that measures its success in meeting the aims, objectives and statement of purpose of the home. EVIDENCE: The atmosphere in the home was open and inclusive. All staff and representatives of service users who were spoken to, gave positive feedback about the managers of the home stating they were always open in their approach, supportive and available to service users, their representatives and staff. Staff stated they were actively encouraged to participate creatively in the planning and development of the home. All staff spoken to stated they felt a strong sense of leadership and that they felt able to raise any matters openly with the management team. The Grange Nursing Home DS0000016609.V271340.R01.S.doc Version 5.0 Page 19 The home has achieved the Investors in People Award and the Investors in People Management and Leadership Award. Quality and assurance and quality monitoring systems were in place. These had formed part of the assessment for the Investors in People Awards. Feedback was actively sought from service users about the services provided. This had been undertaken through use of pictogram surveys. Staff surveys are also undertaken. The Grange Nursing Home DS0000016609.V271340.R01.S.doc Version 5.0 Page 20 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 3 X 3 X X X HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 X 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 4 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 X 3 X X X X X X X STAFFING Standard No Score 27 X 28 X 29 3 30 X MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score X 3 3 X X X X X The Grange Nursing Home DS0000016609.V271340.R01.S.doc Version 5.0 Page 21 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 17 (1)(a) Requirement The registered person must ensure that records held in respect of service users contain all the information stated in Schedule 3 of the Care Homes Regulations 2001. Timescale for action 10/01/05 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 2 3 Refer to Standard OP3 OP15 OP15 Good Practice Recommendations The person completing written assessments of service users care needs should sign and date the assessment at the time it is written. More comprehensive information should be provided to kitchen staff about service users likes and dislikes in relation to food. Daily menus should be displayed in the home. The Grange Nursing Home DS0000016609.V271340.R01.S.doc Version 5.0 Page 22 Commission for Social Care Inspection Gloucester Office Unit 1210 Lansdowne Court Gloucester Business Park Brockworth Gloucester, GL3 4AB 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 Nursing Home DS0000016609.V271340.R01.S.doc Version 5.0 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. 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