Inspecting for better lives Random inspection report
Care homes for older people
Name: Address: The Grange Care Home Keighley Road Colne Lancashire BB8 0QG The quality rating for this care home is: The rating was made on: three star excellent service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. This is a report of a random inspection of this care home. A random inspection is a short, focussed inspection. Details of how to get other inspection reports for this care home, including the last key inspection report, can be found on the last page of this report. Lead inspector: Marie Matthews Date: 0 5 1 2 2 0 0 8 Information about the care home
Name of care home: Address: The Grange Care Home Keighley Road Colne Lancashire BB8 0QG 01282866054 01282866054 the.grange.colne@fshc.co.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Alliance Care (Dales Homes) Limited (wholly owned subsidiary of Four Seasons Healthcare Limited) care home 40 Type of registration: Number of places registered: Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 old age, not falling within any other category physical disability 0 4 Over 65 36 0 Conditions of registration: The home is registered for a maximum of 40 service users to include: Up to 40 service users who require nursing or personal care. Up to 36 service users who fall into the category of OP. Up to 4 service users who fall into the category of PD. Date of last inspection Brief description of the care home The Grange Care Home is a converted and extended Victorian house, which provides accommodation for up to forty people who require nursing or personal care. The current registration includes thirty-six places for older people and four places for younger people with a physical disability. The home was converted from the original house and has had additional accommodation added. The home is situated in a quiet Care Homes for Older People Page 2 of 11 residential area on the outskirts of Colne close to shops and on a main road bus route. There is car parking in the grounds of the home. Lawned areas with mature trees surround the home and are easily accessible to those residents who need to use a wheelchair. There are thirty single rooms and five shared rooms. Eighteen of the single rooms and three of the shared have en-suite toilets and hand wash basins. Two shared bedrooms have an en-suite bathroom. There is a passenger lift between floors. There are various communal areas. The Grange Care Home is part of the Four Seasons Health Care Group but registered to Alliance Care (Dales Homes) Ltd. Information about the services offered by the home is provided in the form of a service user guide and is available, with a summary of the most recent inspection report, to existing and prospective residents and their relatives. On the day of the key inspection the weekly fees ranged from £346.00 to £675.00. Items not covered by the fee are newspapers, toiletries, hairdressing, private chiropody and contributions to some outings and activities. Care Homes for Older People Page 3 of 11 What we found:
We last inspected this service on 17th April 2007. The home was randomly selected for a visit to look at whether they were still providing excellent outcomes for the people who lived there. The visit lasted approximately four hours and involved a tour of the home, looking at various records and speaking with the manager, one nursing staff and four residents. We also looked at the information from the annual service review of 8th April 2008 and information sent to us from other people. We looked at the information that was given to people. The information was clear and detailed and would help them to decide whether the home was the right place for them. However not all residents had been given a copy of their terms and conditions or contract with the home; this was needed to keep them informed of their rights and obligations whilst living in the home. We looked at a residents records including the information collected before their admission to The Grange and the current care plan. The care plans were clear and gave us some good information about how people were looked after; the care plans had been reviewed by staff to ensure they reflected current care needs. Residents and their relatives had been involved in decisions about care; this ensured they received the care they needed and wanted. We looked at how medicines were stored and looked at a sample of the medicine records. We found that medicines had been managed safely and that staff had been given training to help them with safe practice. However the records for one of the controlled drugs (medicines that can be misused) were incorrect and it was clear that staff had not followed the safe procedures; failure to follow procedures could result in misuse or mishandling of medicines. The manager was asked to look into this. We looked at how residents were treated by staff and whether their privacy and dignity was respected. Staff were seen responding to people in a friendly but respectful way. Residents said staff were nice and helpful and lovely. We looked at what activities were available for residents. Records showed us there were plenty of suitable activities and entertainments available; some residents said they preferred to stay in their rooms and that this was respected. Both staff and residents said the routines were flexible and they were given choices about how they could spend their day; one resident said I can do what I want. The meals were varied and nutritious and residents said they were given choices. Comments about the food included the food is nice there is always a choice, the food is bland and the food is nice. Residents were involved in changes to the menu; this would help to provide them with meals that they liked. There were still some gaps in the records of food served; this meant that it was not clear that everyone had been given a nutritious diet. We looked at how the home dealt with any complaints and concerns; the records showed us that the home had responded to any concerns or complaints properly. The also monitored any complaints which shows us that they take them seriously and use Care Homes for Older People Page 4 of 11 the information to help them to improve the service. Residents knew who to speak to if they were unhappy; one resident said the manager would listen and sort it out and the manager always asks me if everything is ok. There were clear procedures to help staff to recognise and respond to any reports or signs of abuse or neglect. The contact numbers for the local agencies that abuse or neglect should be reported to were not with the procedures; this was discussed with the manager as staff would need this information to rpotect residents from harm. It was noted that not all staff had been given training that would help them to recognise and respond properly to abuse of neglect; the manager said further training was being planned to resolve this. We went on a tour of the home and found it to be well maintained, clean, safe and comfortable. Residents said they liked their rooms and had brought in personal items to help to enhance the homely feel. The home was equipped with specialised aids and equipment to maintain residents comfort and to help them maintain their health and independence where possible. One resident said it is always lovely and clean. The home still did not have a sluicing machine that would properly disinfect commode pans; it was again strongly recommended that a sluicing machine was fitted to reduce the risk of any cross infection. We looked at the staffing rotas to check whether there were enough staff on duty to look after residents properly. The rotas showed there were sufficient staff to meet residents needs and residents confirmed this. One resident said I just press the button and staff come to help me. Records showed that new staff had not been allowed to look after residents until all the required checks were in place; this would protect residents from being looked after by unsuitable people. New and existing staff were given training that would give them the skills and knowledge to meet residents needs. We noticed that there were some gaps in the provision of training for some staff although the manager told us this was being sorted out. The manager responsible for the day to day running of the home was not yet registered with the Commission for Social Care Inspection although the application pack was being completed. The manager was a registered nurse with experience in the care sector and was due to commence on a recognised management course; this would support her in her management role. The home encouraged people to air their views and opinions about whether their needs and expectations were being met. Regular meetings were held and people were asked to complete anonymous surveys to help to improve the service. The home had achieved the Investors In People award which looks at the systems in place to develop staff and manage the home. There were also very good systems in place that checked whether staff were following procedures and whether people were looked after properly. We looked at the way in which the home looked after residents money; the records showed that residents money was safe and protected. Care Homes for Older People Page 5 of 11 What the care home does well: What they could do better:
All residents should be given a copy of the terms and conditions or contract; this would ensure they were aware of their rights and obligations whilst living at The Grange. Staff should always follow medication procedures particularly with the management of controlled drugs (medicines that can be misused). The records should accurately show the number of medicines available in the home and how residents medicines have been disposed of; this would prevent any risk of misuse or mishandling. The procedure should reflect that prescriptions were checked prior to prescribing and the dates of opening were recorded on medicines; this would reduce the risk of errors. A clear record of the meals served should be mainatined; this would help to show that all residents had been given a nutritious and varied diet. The home should ensure all staff were provided with training to help them to recognise Care Homes for Older People Page 6 of 11 and respond appropriately to any signs of abuse or neglect; this would ensure that residents were protected from harm and would improve staff skills and knowledge. The home should be fitted with a sluicing machine that would clean and disinfect soiled commode pans; this would help to protect staff and residents from the risk of cross infection. If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 2. Care Homes for Older People Page 7 of 11 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These requirements were set at the last inspection. They may not have been looked at during this inspection, as a random inspection is short and focussed. The registered person must take the necessary action to comply with these requirements within the timescales set.
No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 8 of 11 Requirements and recommendations from this inspection
Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours.
No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set.
No. Standard Regulation Requirement Timescale for action 1 9 13 The controlled drugs register 22/12/2008 must be an accurate record of the amount of medicines stored in the home. This will make sure medicines can be accounted for and prevent misuse or mishandling. Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service.
No. Refer to Standard Good Practice Recommendations 1 2 All residents should be provided with a copy of the terms and conditions or contract; this would ensure they are aware of their rights and obligations whilst staying at the home. The date of opening should be recorded on medicines; this will reduce the risk of error and help to monitor whether medicines have been managed safely. The procedure should reflect that the prescriptions are seen by staff at the home prior to dispensing; this will reduce the risk of error and misuse. The record of meals served should be completed in full; this will help to determine that all residents have been provided with a healthy and nutritious diet. 2 9 3 9 4 15 Care Homes for Older People Page 9 of 11 5 16 The contact numbers of local agencies should be stored with the safeguarding procedures; this will ensure staff have clear information to help them to respond appropriately to any signs or suspicions of abuse or neglect. All staff should be provided with safeguarding training to help them to recognise and respond apropriately to reports of abuse or neglect. The handyman should date when a request for a repair has been completed; this will help to identify a prompt response. The home should have a sluicing disinfector machine installed to reduce the risk of cross infection. 5o care staff should have a recognised qualification in care; this will ensure staff have the skills and experience to meet residents needs. The manager should be registered with the Commission for Social Care Inspection; this will identify a responsible and competent person who is registered to manage the home. 6 16 7 19 8 9 26 28 10 31 Care Homes for Older People Page 10 of 11 Reader Information
Document Purpose: Author: Audience: Further copies from: Inspection Report CSCI General Public 0870 240 7535 (telephone order line) Our duty to regulate social care services is set out in the Care Standards Act 2000. Copies of the National Minimum Standards –Care Homes for Older People can be found at www.dh.gov.uk or got from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop Helpline: 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 We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2008) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. Care Homes for Older People Page 11 of 11 - 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!
