Inspection on 28/06/06 for The Grange Care Home

This inspection was carried out on 28th June 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 there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

The Grange Care Home 17/09/07

The Grange Care Home 05/09/05

The Grange Care Home 14/04/05

The Grange Care Home 23/11/04

The Grange Care Home 18/05/04

Similar services:

The Shelley

Springfield House

Sutton Lodge Nursing Home

St Helier`s Residential Hotel

St Joseph`s

Ridgemount

Wingham Court

Old Hastings House

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

CARE HOMES FOR OLDER PEOPLE The Grange Care Home 22 Cornwallis Avenue Folkestone Kent CT19 5JB Lead Inspector Ms Patricia Green Unannounced Inspection 28th June 2006 10:00 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 Care Home DS0000041005.V300717.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. The Grange Care Home DS0000041005.V300717.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service The Grange Care Home Address 22 Cornwallis Avenue Folkestone Kent CT19 5JB 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) 01303 252394 01303 252394 Ashwood Court Healthcare Ltd Mrs Carol Weeks Care Home 20 Category(ies) of Old age, not falling within any other category registration, with number (20) of places The Grange Care Home DS0000041005.V300717.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 5th September 2005 Brief Description of the Service: The Grange is a large detached property situated in its own grounds, with well maintained gardens at the front and back of the home. There are two lounge/dining rooms on the ground floor. There is also a spacious porch, where service users are able to relax. The property has two floors and the home has a shaft lift. There are 20 single bedrooms, 12 of which have en suite facilities. The home is situated near to Folkestone, close to local shops and other public amenities including the local bus service. The current range of Fees is £295 - £450. The Grange Care Home DS0000041005.V300717.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This site visit took place on 28th June 2006 and was unannounced. During the visit the premises were toured, the manager, Proprietor, staff and a number of residents were spoken to and a broad range of documentation was viewed. The home is currently being extended to accommodate an additional 8 residents. Surveys forms were sent out by the Commission requesting feedback on the service: Six replies were received from residents and three from relatives/visitors; the responses in generally were very positive about the service and particular praise was given in regards to the support provided by the manager and the staff team in general. What the service does well: What has improved since the last inspection? The Grange Care Home DS0000041005.V300717.R01.S.doc Version 5.2 Page 6 The management have addressed the requirements made during the last Inspection of the home: care planning now contains additional relevant information, risk assessments have been developed and the recording of accidents/incidents is now included as part of these records; in addition written information on medical administration sheets is now countersigned. A Quality Assurance process is in place, with a questionnaire given out to residents/relatives at regular intervals for feedback on the service; a written record is made of the responses received with any action needing to be taken identified. As part of the current building works, the sluice facility is to be relocated to a separate area within the home. 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 Care Home DS0000041005.V300717.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection The Grange Care Home DS0000041005.V300717.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 2, 3, 4 & 5 Standard 6 not relevant for this service. QUALITY IN THIS OUTCOME GROUP IS GOOD. THE JUDGEMENT HAS BEEN MADE USING AVAILABLE EVIDENCE INCLUDING A VISIT TO THE SERVICE. Residents are safeguarded by being well-informed of the home’s facilities and by receiving written documentation pertaining to their ‘terms and condition’s. The home’s pre-assessment process ensures that care needs are clearly identified. EVIDENCE: A Statement of Purpose and Service User Guide have been produced giving details of the facilities and services available within the home; these documents are contained within the ‘welcome pack’ that is available within the entrance hall to the home. All prospective residents are invited to visit the home, so as to have an opportunity to view the premises and the vacant room and to meet with staff and residents. Before moving into the home a pre-assessment of need is undertaken, when care needs are identified and the judgement made of the The Grange Care Home DS0000041005.V300717.R01.S.doc Version 5.2 Page 9 home’s capacity to meet these needs. During the visit documented evidence was seen of the pre-assessment undertaken for individual residents; supporting relatives and social services, as appropriate, are very much involved in this initial assessment process. On moving into the home a trial period is agreed with the resident, with a review of the placement at the end of this period; each resident is given a written copy of the ‘terms and conditions’ of their stay, with the Fees charged being included within this document; evidence was seen during the visit of this document, this being kept by the resident within their own room. The Grange Care Home DS0000041005.V300717.R01.S.doc Version 5.2 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 & 10 QUALITY IN THIS OUTCOME GROUP IS GOOD. THE JUDGEMENT HAS BEEN MADE USING AVAILABLE EVIDENCE INCLUDING A VISIT TO THE SERVICE. The residents are well supported through the home’s care planning process and by receiving support from staff who are well trained, with a good awareness of respect and privacy issues. Residents are protected through the home’s medication procedures and training of staff. EVIDENCE: The management have given much focus to reviewing and developing the care planning process; care planning documentation is now more detailed, with risk assessments having been developed to clearly identify the daily support required by the individual resident. Care needs are regularly monitored and reviewed, with the ‘Key worker’ being very much involved in this process, producing a monthly report on the care needs of the resident. Care planning records also include ‘client handling risk assessment’, a record of accidents/incidents and a record of visits by the GP and other health professionals. The Grange Care Home DS0000041005.V300717.R01.S.doc Version 5.2 Page 11 A written ‘life history’ of the resident is seen as being important (if this is able to be obtained), so as to gain a greater understanding of the individual and the appropriate support required. In discussion with residents they praised the staff for their attentiveness and expressed that they felt well supported and ‘listened to’; they said that their privacy and choices were always respected and that support received was always carried out in a friendly and respectful manner. A relative spoken to said that she was very satisfied with the care provided and commented that the management and staff were very approachable and friendly and respectful in their manner when giving support. During the visit it was noted that medication was being stored securely, with medication administration sheets seen to be signed up to date; any handwritten information included on the sheets is now countersigned so as prevent errors. The manager, working closely with the deputy manager, is responsible for ordering, checking on delivery and identifying ‘returns’ to the pharmacy, with records in place to this effect. The manager confirmed that all staff complete a ‘safe handling of medication’ course, prior to having the responsibility of giving medication to residents; evidence was seen of the details of the course being undertaken by staff, organised with an external training agency. The Grange Care Home DS0000041005.V300717.R01.S.doc Version 5.2 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 & 15 QUALITY IN THIS OUTCOME GROUP IS GOOD. THE JUDGEMENT HAS BEEN MADE USING AVAILABLE EVIDENCE INCLUDING A VISIT TO THE SERVICE. Residents benefit from living in an environment where they have opportunity to be involved in a range of activities and where their choices are encouraged and respected. EVIDENCE: Residents spoken to said they liked to join in activities arranged at the home and particularly commented on how much they enjoyed playing bingo and the entertainment that is arranged. One resident commented on how much she enjoyed going to a club held at a local church and also valued the opportunity to partake in Holy Communion during the visits of a local Priest to the home. During the visit residents were seen to be using their own room as well as the communal areas of the home. Residents said that they did not feel restricted in any way and said that they are encouraged by staff to make choices in how they spend their time; one resident said how much she liked spending time in The Grange Care Home DS0000041005.V300717.R01.S.doc Version 5.2 Page 13 her room involved in her own choice of personal activities, however she said she likes to join the other residents in the dining room for some mealtimes. Another resident said that she prefers to have most of her meals within her own room, however so as to mix with other residents she normally goes to the dining room for one of the day’s meals. Residents said that the food was generally good, they were satisfied with the menu and their requests were always taken into account; they confirmed that there was always a choice of food at each mealtime. Relatives and friends are welcomed at the home and this was evidenced during the visit; a relative spoken to said that she always was made to feel very welcome on arrival, with refreshments offered; she said there was no restrictions on visiting times or length of time she stayed. A resident also commented on an occasion when a relative visited, having travelled a long distance by bicycle to the home; on arrival he was offered refreshments by staff which included substantial food following his long journey. On touring the home positive interaction was noted between relatives visiting and the staff and this is an area that has undoubtedly been fostered by the current management. Both residents and relatives particularly commented on how helpful they have found the manager and staff and how they can easily approach them to discuss any worries or issues that may arise. The Grange Care Home DS0000041005.V300717.R01.S.doc Version 5.2 Page 14 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16 & 18 QUALITY IN THIS OUTCOME GROUP IS GOOD. THE JUDGEMENT HAS BEEN MADE USING AVAILABLE EVIDENCE INCLUDING A VISIT TO THE SERVICE. Residents are protected by the home’s complaints procedure and by being supported by staff who have received training/guidance in Adult Protection. EVIDENCE: The home’s complaints procedure is included within the written information given to residents on admission, including the written ‘terms & conditions’. Residents said that they knew how to make a complaint and would always talk to the manager or deputy first; a relative said that the management were very approachable and said that she had every confidence that they would address a concern that was raised. The management have produced guidance for staff in regards to Adult Protection and as part of the ongoing training programme in place staff have attended courses specifically relating to AP. Evidence was gained from discussion with the manager, staff and residents that there is a good awareness amongst the staff team of AP issues, this being demonstrated in daily practice in the support of residents. The Grange Care Home DS0000041005.V300717.R01.S.doc Version 5.2 Page 15 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, 20, 23, 24, 25 & 26 QUALITY IN THIS OUTCOME GROUP IS ADEQUATE. THE JUDGEMENT HAS BEEN MADE USING AVAILABLE EVIDENCE INCLUDING A VISIT TO THE SERVICE. Residents benefit from living in an environment which is clean, comfortable and well - maintained and where there is commitment by management for improvements as currently being carried out. EVIDENCE: The home offers residents a comfortable and ‘welcoming’ environment, where encouragement has been given for residents to personalise their own room and to make this very much their ‘own space’. The home is currently in the process of being extended; building works include the addition of 8 bedrooms, an extension to the dining area and a ‘quiet room’ being created. Disruption to residents has been kept to a minimum; the main disruption, for a short period, has been work on the dining area; however residents spoken to said that they have not been unduly troubled by this and The Grange Care Home DS0000041005.V300717.R01.S.doc Version 5.2 Page 16 were looking forward to generally having more space on completion of the works. The sluicing facility within the home is to be relocated as part of the building work programme. On touring the home it was noted to be kept to a good standard of cleanliness; areas adjacent to the building works have been cordoned off for Health & Safety. Radiator covers have been installed within the home for the safety of residents. Residents bedrooms were seen to be very comfortable, with many items of the resident’s own personal possessions within the room. Communal areas are nicely furnished and offer a homely environment, however there has been some minimal effects to this with the current building works; residents were seen to be using the communal areas as well as their own room during the visit. Residents spoken to said they were very comfortable at the home and said that it was always clean with no unpleasant odours. The garden area at the front of the premises is well maintained; the rear garden area is to be ‘tidied up’ and landscaped once the building works are completed. The Grange Care Home DS0000041005.V300717.R01.S.doc Version 5.2 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): 27, 28, 29 & 30 QUALITY IN THIS OUTCOME GROUP IS GOOD. THE JUDGEMENT HAS BEEN MADE USING AVAILABLE EVIDENCE INCLUDING A VISIT TO THE SERVICE. Residents are supported by staff who are well trained and have a skill mix to meet the needs of residents. Residents are safeguarded by the home’s recruitment procedure. EVIDENCE: On viewing a selection of staff files the home’s robust recruitment procedure was demonstrated; applicants are asked to complete an application form and provide proof of identity, written references are followed up and a CRB/POVA check undertaken. On commencing their employment the new member of staff will undertake a period of Induction training, which is linked to Skills for Care; mandatory training is undertaken as soon as possible after starting employment. The management have produced a ‘training matrix’ for ease of recording and identifying training needs of the staff team; training undertaken by staff includes Mandatory courses and a range of training relating to care practice. The Grange Care Home DS0000041005.V300717.R01.S.doc Version 5.2 Page 18 A number of staff have now undertaken or are planning to commence NVQ training; five staff have completed at Level 2, two staff have completed at Level 3 and three staff will be commencing Level 2 study in August 06. In addition the deputy manager is undertaking study at Level 4. In discussion with residents and staff it was evident that there is a good understanding of residents individual needs; residents said they were well supported and spoke very favourably of the manager and the staff team. A relative said that she was very pleased with the standard of care provided within the home and felt the resident’s needs had been identified and appropriate support given. The Grange Care Home DS0000041005.V300717.R01.S.doc Version 5.2 Page 19 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): 31, 32, 33, 35, 36 & 38 QUALITY IN THIS OUTCOME GROUP IS GOOD. THE JUDGEMENT HAS BEEN MADE USING AVAILABLE EVIDENCE INCLUDING A VISIT TO THE SERVICE. Residents are safeguarded by living in a home which is well managed and where staff are well supported and supervised. EVIDENCE: Feedback from residents both during the visit and from surveys received praised highly the manager and the staff team; residents commented that the home offered a very relaxed environment where staff respected choices made and were always willing to offer support on request in a variety of different ways. The Grange Care Home DS0000041005.V300717.R01.S.doc Version 5.2 Page 20 The atmosphere within the home was noted to be relaxed and friendly with positive interaction seen between the staff and residents; staff were noted to be very respectful and ‘caring’ towards residents in the process of offering support and in conversation. Staff are well supported by management, with a process of regular one to one supervision and annual appraisal in place. The manager in her role works very closely with the deputy manager, sharing responsibilities of daily management; feedback from residents and relatives spoke highly of how supportive they found the management and how they felt they could always approach them to discuss any worry or issue that may arise. The manager has undertaken relevant training for her role within the home. The manager is very much involved in the daily life of the home and as part of offering care to the resident, building positive relationships with the relatives is seen as an important component of the service; this was observed directly during the visit with relatives visiting at the time. Attention has been given to ensuring the home is kept safe through Health & Safety awareness and Fire Safety training undertaken by staff; Fire Safety records viewed during the visit demonstrated that the Fire Alarm system is checked weekly. The home keeps some finances on behalf of residents for safekeeping; systems are in place for recording of all money transactions, with receipts kept for money spent on behalf of the resident (chiropody, Hairdressing etc.). Evidence gained during this visit demonstrated the commitment that has been given by management to addressing the requirements made during the last Inspection of the home; also there was clear evidence of a reflective approach in offering the service, to ensure that good standards of care are maintained. Residents meetings are arranged at regular intervals, from which feedback on the service is obtained; the management have also devised as part of Quality Assurance measures, a questionnaire form, which is given to residents/relatives. Evidence was seen of the responses received and how these had been collated for further action to be taken as necessary. The Proprietor makes regular visits to the home and submits Reg. 26 reports to the Commission. The Grange Care Home DS0000041005.V300717.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 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 3 3 3 3 x HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 x 18 3 3 3 x x 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 3 3 3 x 3 3 x 3 The Grange Care Home DS0000041005.V300717.R01.S.doc Version 5.2 Page 22 Are there any outstanding requirements from the last inspection? Yes 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. Refer to Standard Good Practice Recommendations The Grange Care Home DS0000041005.V300717.R01.S.doc Version 5.2 Page 23 Commission for Social Care Inspection Kent and Medway Area Office 11th Floor International House Dover Place Ashford Kent TN23 1HU 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 Care Home DS0000041005.V300717.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. 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. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!