Inspection on 05/09/05 for The Grange Care Home

This inspection was carried out on 5th September 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. 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 Home 17/09/07

The Grange Care Home 28/06/06

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 Penny McMullan Announced 05/09/05 at 10:00am 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 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 H56-H05 S41005 The Grange V239036 050905 Stage 4.doc Version 1.40 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 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 thegrangecarehome@tiscali.co.uk Ashwood Court Healthcare Limited Registered Care Home 20 Category(ies) of Old Age registration, with number of places The Grange Care Home H56-H05 S41005 The Grange V239036 050905 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 14/4/05 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 Grange Care Home H56-H05 S41005 The Grange V239036 050905 Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an announced inspection, which took place over one day. Most of the time was spent with the service users/relatives and the rest of the time was spent in the office talking to the proposed Registered Manager and staff. The Manager, Mrs Carol Weeks has applied to the Commission to become the Registered Manager. There was a joint additional visit made to the home by the Inspector and Adult Protection Co-Ordinator with regard to two complaints made to the Commission on 9 June 2005. The investigation was carried out throughout the day and was not taken forward as an Adult Protection issue. There were some areas of the complaints that were upheld and the home has complied with the seven requirements made from this visit. The additional visit letter is available on request to members of the public or other enquirers. Eight relatives and five resident comment cards were received and overall the feedback was complimentary to the care services provided and staff. Ten residents were spoken to, one relative and five members of staff. Residents were spoken to in their individual bedrooms, the lounge and dining room. What the service does well: Residents said that the home does everything well and the staff have a good relationship with them. They said the food was fine and varied and they could choose alternatives if they did not like what was on the menu. Staff demonstrated their skills by promoting choice and independence. Staff said that they work well as a team to meet the service users needs. The Grange Care Home H56-H05 S41005 The Grange V239036 050905 Stage 4.doc Version 1.40 Page 6 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 Grange Care Home H56-H05 S41005 The Grange V239036 050905 Stage 4.doc Version 1.40 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 Standards Statutory Requirements Identified During the Inspection The Grange Care Home H56-H05 S41005 The Grange V239036 050905 Stage 4.doc Version 1.40 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 standard(s) 3,6, (Standard 6 does not apply to this home) Arrangements are in place to carry out a detailed assessment of needs of service users prior to admission to the home to ensure that all care needs will be met. EVIDENCE: The home has implemented an assessment process, which covers all areas of health and social needs. This form is completed prior to admission to the home. The Grange Care Home H56-H05 S41005 The Grange V239036 050905 Stage 4.doc Version 1.40 Page 9 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 standard(s) 7,8,9,10 The home has developed the care plans, however there is a lack of information of how to meet the residents’ objectives. The lack of detail in risk assessments potentially puts residents at risk of not having their health and social care needs met. The lack of checking written information on medicine administration sheets is required to minimise the risk of recording errors in medication. Personal care is offered in a way protect residents privacy and dignity and promote independence EVIDENCE: Resident care plans have improved and developed since the last inspection. Further information is required to provide more detail of how to meet the residents’ objectives and how to minimise the risk in the risk assessments. Accidents/incident information is not being recorded consistently to ensure that health care needs are monitored. A requirement has been made in this report. The home is supported by the District Nurse, Continence Nurse and access specialist services through the GP. Residents said there are able to visit their own GP or arrange home visits. The Grange Care Home H56-H05 S41005 The Grange V239036 050905 Stage 4.doc Version 1.40 Page 10 Written information in the medication administration sheets is required to be countersigned to minimise the risk of error. Mar sheets were up to date and in good order. The deputy Manager audits the sheets on a two weekly basis. Residents said that the staff respect their privacy and dignity and are very sensitive when providing personal care. The Grange Care Home H56-H05 S41005 The Grange V239036 050905 Stage 4.doc Version 1.40 Page 11 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 standard(s) 12,13,14,15 The home endeavours to provide activities to meet the needs of the service users. Visitors are welcomed by the home and family contact is encouraged. Service users are supported to exercise choice over their lives. The home provides a well balanced nutritional diet and the overall provision of meals is of a good standard. Service users confirmed choice and variety of meals and special diets are catered for. EVIDENCE: Residents confirmed that activities take place in the home: playing cards, scrabble and bingo. Some residents go to a local club, music exercise sessions are held fortnightly. Residents have also been taken out to lunch and to the local shops during the summer period. Residents said that they are able to choose if they wish to join in the activities. Visitors are frequent and relatives said that the home was always welcoming. Residents said that they choose where to see their visitors either in the privacy of their own room, the lounge and in the seating area in the porch. Residents said that they had their personal possessions in their rooms and some were aware of their records but did not express a wish to view them. The Grange Care Home H56-H05 S41005 The Grange V239036 050905 Stage 4.doc Version 1.40 Page 12 Residents said that the food was good and the home provided a well balanced diet. The cook informs them what is for lunch and tea the next day and they are able to choose and request alternatives if they wish to. Residents said that there was always enough to eat and that the food was well presented. The lunch was unhurried and relaxed and one member of staff supported one resident to eat her dinner in a sensitive dignified manner. The Grange Care Home H56-H05 S41005 The Grange V239036 050905 Stage 4.doc Version 1.40 Page 13 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 standard(s) 16,18 The home has ensured that everyone is aware of how to raise concerns or complaints and the procedure is on display in the home for all services users, relatives and visitors to access if required. The home is continuing to provide all staff with adult abuse training to ensure staff has a clear understanding of protection of vulnerable services users. EVIDENCE: There were two complaints in June, which were investigated with the Adult Protection Co Ordinator. The investigation was completed and not raised as an adult protection alert. There were some issues of the complaint that were upheld and the home has addressed these issues and complied to the requirements issued in the additional visit report dated 9 June 2005. All of the residents spoken to said they would complain if they needed to but there was nothing to complain about. The home has an adult protection and whistle blowing policy in place and staff are aware of adult protection issues. The home is accessing ongoing training for all staff. The Grange Care Home H56-H05 S41005 The Grange V239036 050905 Stage 4.doc Version 1.40 Page 14 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 standard(s) 19, 25,26 The home is well maintained and decorated to a good standard providing service users with an attractive and homely place to live. Radiator covers have been installed in the home to minimise the risk to residents. There are polices and procedures in place for the control of infection, however the separation of the sluicing facility is recommend to reduce the risk of infection. EVIDENCE: Residents said that the home is well decorated and kept tidy including the gardens. Routine maintenance is carried out on regular basis and there are no outstanding issues from the last Environmental Health visit. The Grange Care Home H56-H05 S41005 The Grange V239036 050905 Stage 4.doc Version 1.40 Page 15 Two rooms have been redecorated since the last inspection and liquid soap dispensers have been installed in the residents’ bedrooms. The home has had two new fire doors on the immersion heater cupboards fitted. There are 12 en suite bedrooms and adequate toilet and bathing facilities to meet the needs of the service users. The sluicing facility is located in the bathroom on the first floor and the home needs to review this situation, as the sluicing facility should be located separately from bathing facilities. The home has completed the implementation of radiator guards and the home is clean and tidy. Residents said that the home is always clean and free from offensive odours. The Grange Care Home H56-H05 S41005 The Grange V239036 050905 Stage 4.doc Version 1.40 Page 16 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 considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27,29,30 The staff have a good understanding of resident care needs. This is evident from the positive relationships, which have been formed between the staff and residents. Arrangements are in place to ensure that residents are supported and protected by the home’s recruitment policies and procedures. Mandatory training for staff is now being provided and the induction programme is being reviewed to ensure the programme is linked to the Skills for Care specification. EVIDENCE: The home is currently adequately staffed and residents said there is always enough staff on duty. Residents also said that the staff is responsive to their calls. Staff spoken to say they worked well as a team and demonstrated their knowledge of meeting the residents’ needs. There is only one part time vacancy and the staff retention has been good since the last inspection. Staff files contained two written references, CRB and POVA checks. Staff demonstrated their awareness of the recruitment policies and procedures. Terms and conditions for staff are also in place. The proposed Registered Manager is attending an Assessor/training course to provide moving and handling training to the staff in the home. Mandatory The Grange Care Home H56-H05 S41005 The Grange V239036 050905 Stage 4.doc Version 1.40 Page 17 training is being provided and is ongoing for all staff. Staff spoken to were aware of the recruitment requirements, two written references, and CRB/POVA checks. The induction programme is linked to Skills for Care. The Grange Care Home H56-H05 S41005 The Grange V239036 050905 Stage 4.doc Version 1.40 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 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 33,35,38 The system for service user consultation is good and relatives and other stakeholders are included in the survey. The home has implemented an effective financial system to support residents with their finances. There are policies, procedures and systems in place to ensure the safety of the home. The lack of tracking accidents/incidents through to the daily record sheets potentially puts residents health care needs at risk. EVIDENCE: Residents are spoken to on a daily basis by the Deputy Manager to ensure they are happy with the care being provided. Residents said that meetings have occurred in the home where they can discuss issues such as the food. The proposed Registered Manager stated that the Registered Provider has carried out a quality assurance survey. This information was sent directly to the head The Grange Care Home H56-H05 S41005 The Grange V239036 050905 Stage 4.doc Version 1.40 Page 19 office and there was no evidence of this at the time of the inspection. The home needs to forward a copy of the summary to the Commission. A requirement has been made in this report. The majority of residents are supported with their financial requirements by the home. Receipts are provided for all transactions and there are some service users who are able to manage their own finances. The home has secure facilities for safe storage of all valuables, which are recorded appropriately. The home has completed the recommendations outlined in the last fire risk assessment. The fire book was up to date and in good order. Mandatory training is being provided and existing staff are being updated. Accidents/incidents are being completed in the accident book however the tracking of the information is not consistent to ensure the ongoing monitoring of health care needs. A requirement has been issued in this report. All of the necessary checks are in place to comply with health and safety regulations and environmental risk assessments have been implemented. Risk assessments are also in place and in some case require further detail to provide a safe practice of work. This is a requirement in this report. Induction training is taking place and is linked to Skills for Care. The Grange Care Home H56-H05 S41005 The Grange V239036 050905 Stage 4.doc Version 1.40 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score x x 3 x x N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 2 9 2 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION 3 x 2 x x x x 3 STAFFING Standard No Score 27 3 28 x 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x 3 x x 2 x 3 x x 2 The Grange Care Home H56-H05 S41005 The Grange V239036 050905 Stage 4.doc Version 1.40 Page 21 No Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard 7,8,38 Regulation 12,13,15 Requirement To provide further information in residents care plan of how to meet the objectives To provide detailed information in risk assessments to minimise the risk to residents and staff To consistently record accidents/incidents in the daily contact sheets to ensure that the health care needs of residents are monitored To countersign written information on Medical Administration Sheets To provide the Commission with a summary of the Quality Assurance Timescale for action 31/10/05 2. 3. 9 33 13 24 31/10/05 31/10/05 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. Refer to Standard 21 Good Practice Recommendations The sluicing facility is located in the bathroom on the first floor and the home needs to review this situation, as the sluicing facility should be located separately from bathing facilities. H56-H05 S41005 The Grange V239036 050905 Stage 4.doc Version 1.40 Page 22 The Grange Care Home The Grange Care Home H56-H05 S41005 The Grange V239036 050905 Stage 4.doc Version 1.40 Page 23 Commission for Social Care Inspection 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 H56-H05 S41005 The Grange V239036 050905 Stage 4.doc Version 1.40 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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