Inspection on 25/10/05 for The Grange Centre

This inspection was carried out on 25th October 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 Centre 08/12/06

The Grange Centre 23/08/05

The Grange Centre 18/11/04

The Grange Centre 11/05/04

Similar services:

Insight - Eastchurch

Southfields

Thorndene

Sutton Lodge Nursing Home

Magenta

Seabourne House

33 St John`s Church Road

Dovedale Court

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

CARE HOME ADULTS 18-65 Grange Centre (The) Rectory Lane Bookham Surrey KT23 4DZ Lead Inspector Helen Dickens Unannounced Inspection 25th October 2005 13:00 Grange Centre (The) DS0000013657.V261174.R01.S.doc Version 5.0 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 Grange Centre (The) DS0000013657.V261174.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 Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Grange Centre (The) DS0000013657.V261174.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Grange Centre (The) Address Rectory Lane Bookham Surrey KT23 4DZ 01372 452608 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) The Grange Centre Mrs Jeanette Thompson Care Home 20 Category(ies) of Learning disability (20), Learning disability over registration, with number 65 years of age (4), Physical disability (20), of places Physical disability over 65 years of age (4), Sensory impairment (20), Sensory Impairment over 65 years of age (4) Grange Centre (The) DS0000013657.V261174.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. 4. Condition One The Home may be accommodate up to 4 residents within the categories LD(E), PD(E) and SI(E) Condition Two The age/age range of the persons to be accommodated will be: 20 65 YEARS, with up to 4 OVER 65 years Condition Three It is a condition of registration that those services currently provided in the Main House of the Grange Centre will cease as from 15/11/04 Condition Four The services currently provided in the Main House of the Grange Centre will as from 15/11/04 be provided from the Gloucester Lodge site in the units referred to as the Willows, Maples and the Cedars 18th November 2004 Date of last inspection Brief Description of the Service: The Grange Centre is situated in its own expansive grounds on the outskirts of Bookham in Surrey. The service provides residential care for up to 20 residents. The main category of registration is for younger adults with learning disability, sensory impairment and physical disability. Up to four named residents may be over the age of 65. The accommodation is provided in three purpose built units each having single bedrooms, and a communal lounge/dining area and kitchen. Special bathing facilities are available. Activities and training facilities for residents are also available on site. There is ample car parking around the building. The National Minimum Standards for younger adults were used for this inspection and report. Grange Centre (The) DS0000013657.V261174.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place over 5 hours and was the second inspection to be undertaken in the Commission for Social Care Inspection year April 2005 to March 2006. The inspection was carried out by Helen Dickens, Lead Inspector for the service. Jeanette Thompson represented the establishment. A full tour of the premises took place. The majority of residents were conversed with during this inspection, some whilst they were engaging in their craft and horticultural activities on other parts of the site. One member of staff, in addition to the manager, was interviewed. A variety of records and documents were examined including 3 resident’s care plans, two staff files, and a number of health and safety certificates. A quality audit consisting of questionnaires to residents was also used in writing this report. This report covers fewer standards than the last, as the majority of ‘key standards’ were inspected earlier in the year. This was a very positive inspection. The inspector would like to thank the residents, staff and the registered manager, for their time, assistance and hospitality. What the service does well: The Grange Centre provides a homely and pleasant environment which one resident said didn’t ‘seem like a care home at all.’ The quality of furnishings and fittings is high and the premises are clean and hygienic throughout. The resident’s satisfaction questionnaire shows the greatest level of satisfaction is with the home’s environment. Resident’s independence is well supported, and the on-site facilities for resident’s training and leisure activities are excellent. The life skills and literacy department aims to equip residents with independent living skills. These activities are well resourced and added a great deal to the quality of life of residents at The Grange Centre. The facilities are open tenants who live in supported housing on other parts of the site, and to non-residents: this gives a greater social circle and more opportunities for friendships to develop. Care plans were also of a high standard with resident’s input (and signature) on every section, highlighting their involvement and agreement. This is covered in more detail later in the report. Grange Centre (The) DS0000013657.V261174.R01.S.doc Version 5.0 Page 6 Staff were observed to treat residents with consideration at all times and there was much evidence of resident’s autonomy, privacy and dignity being respected. 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. Grange Centre (The) DS0000013657.V261174.R01.S.doc Version 5.0 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Grange Centre (The) DS0000013657.V261174.R01.S.doc Version 5.0 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1,2,4 and 5 Prospective residents can be confident that the information available to them will equip them to make an informed decision about moving into The Grange Centre. Pre-entry assessments are thorough and fully involve the potential resident. Each resident has a contract with the home. EVIDENCE: The statement of purpose and service user guide sets out in detail the facilities and services available. Information about the home generally, residents individual accommodation and work and training activities, are all clearly set out. Pre-admission assessments are thorough at this home and every aspect of resident’s needs and wishes explored. Prospective residents can come for a day or part of a day to ‘test drive’ the home as well as the training and work placements. However, there is also an assessment room at the home and prospective residents can move in for a ‘residential’ assessment to see if the home can meet the persons needs. This gives the resident a better opportunity to try out the facilities, and mix with other residents. The resident’s files examined all had copies of contracts between the home and each resident. The inspector recommended that room numbers, or other identifying information be inserted, so residents can be confident of their right to occupy a particular room or rooms during their stay at the home. Grange Centre (The) DS0000013657.V261174.R01.S.doc Version 5.0 Page 9 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6 Resident’s can be confident that their assessed and changing needs, and their personal goals, are reflected in their individual plans. EVIDENCE: Three care plans were sampled and found to be well done. They contained a detailed record of each resident’s disabilities and health needs, personal care needs and family and social relationships. Risk assessments were appropriate and reviewed in a timely fashion. Resident’s reviews were thorough and showed the input from the resident and their family. Particular attention was paid to healthy eating, exercise, and the self-administration of medication. There was a thorough coverage of the communication needs of each resident and the plans themselves were in formats which had been tailored to each resident’s communication needs. Each section had a statement signed by the resident to say they had been involved in drawing up that section of their plan, and were in agreement with its contents. The home has a structured programme of training and work available for residents and each plan sets out the goals and aspirations for each resident with regard to these activities, as well as for other social and leisure pursuits. Grange Centre (The) DS0000013657.V261174.R01.S.doc Version 5.0 Page 10 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 11, 12, 14 and 15 Residents at The Grange Centre have very good opportunities for personal development and are supported to participate in age, peer and culturally appropriate activities. Personal and family relationships are encouraged. EVIDENCE: The life skills department at this home offers opportunities for residents to improve their daily living skills in a number of ways. The tutor said all trainees start with developing their social skills as this enables them to participate more fully in other activities. Other topics included money and maths, healthy eating, travelling and getting about, and personal appearance. The ‘literacy’ department encourages residents to learn or improve their reading, writing and creative writing abilities and therefore continue with their education once they come to live at this home. The work experience department aims to find suitable voluntary and paid work placements for tenants in the sheltered housing and residents at the care home. Some recent successful placements for tenants have included working at a charity shop, and in a local school. They are working towards offering Grange Centre (The) DS0000013657.V261174.R01.S.doc Version 5.0 Page 11 similar opportunities for residents. Currently residents help with some community functions, with support from staff. Most residents, except those who are retired, choose to work either in the onsite creative textiles centre, or on one the horticultural projects. During their afternoon tea-break, residents were pleased to show the inspector creative textile commissions they were working on, as well as the ‘shop’ where these items were sold. Other residents showed the inspector some of the work being done in the walled garden attached to the horticultural centre. They also pointed out that they have a shop selling the organic produce grown at The Grange Centre. On the day of the unannounced inspection those residents participating in the life skills class had been cooking in the training kitchen, making pumpkin bread for the coming Halloween celebrations. The tutor said that all trainees who are interested take the food awareness course. In addition to the above, residents engaged in a diverse range of social and leisure opportunities, including on-site activities, such as aqua-aerobics in their own swimming pool, and ballroom dancing where they had a wheelchair and non-wheelchair version. There is a ballroom in the main house for the use of residents and the coming Halloween party was to be held there. Retired residents had their own interests and activities which they pursued. Bird feeding was popular and one resident noted that there were 16 different bird species visiting the numerous bird feeders which she kept topped up outside her window. Another kept cats which obviously brought a great deal of pleasure not just to her, but to many of the other residents. One resident was getting her ‘Count Dracula’ outfit ready for the Halloween party when the inspector visited her in her room. Outside activities included belonging to various church, community and ‘hobby’ groups. One resident is in a local band and reputed to be a very good musician, and other residents take part in the ‘Guildford Games’. Resident’s were encouraged to keep family and friendship contacts and the registered manager gave a number of examples of how residents were being supported to do this. Staff enable residents to access information and advice on issues relevant to personal relationships. Grange Centre (The) DS0000013657.V261174.R01.S.doc Version 5.0 Page 12 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 21 Residents at this home can be confident that their needs in relation to ageing, illness, and death will be sensitively supported and managed by The Grange Centre. EVIDENCE: As well as having suitable policies and procedures on these topics, this home demonstrates that it can cater for all age groups well. The retired residents speak very well of this establishment, and two have lived here for over half a century. Residents are not segregated by age and therefore each unit has a diverse age range with all the benefits that can bring. Resident’s wishes regarding their ageing and death are dealt with sensitively and detailed on their individual care plans. Staff are investigating undergoing bereavement training as they sometimes support residents whose elderly parents or relatives have died. The registered manager said there is always a lot of support when residents lose a friend or relative because everyone knows each other so well and rallies around if there has been a bereavement. Grange Centre (The) DS0000013657.V261174.R01.S.doc Version 5.0 Page 13 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 22 and 23 This home has systems in place to ensure residents concerns are taken seriously, and that they are protected from abuse. EVIDENCE: Following the last inspection the home is now making a note of even minor difficulties and dealing with them before they become ‘complaints’. Two issues had been raised and dealt with in a satisfactory manner. The home’s procedure for the protection of vulnerable adults works well and one issue which had been raised sine the last inspection was thoroughly investigated and the proper procedures followed. The latest copy of Surrey’s local multi-agency procedures was available in the home and accessible to staff. Grange Centre (The) DS0000013657.V261174.R01.S.doc Version 5.0 Page 14 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 24 The Grange Centre provides a homely, comfortable and safe environment for it’s residents. EVIDENCE: The Grange Centre is purpose built and offers a good standard of accommodation for residents. In the annual questionnaire, residents rated the quality of the environment very highly. When asked to comment on their satisfaction with the furniture and decoration, cleanliness, maintenance and repairs, and access, residents gave these the highest number of ‘very satisfied’ scores. The standard of the furnishings and decoration is high and residents told the inspector they believed the current manager was responsible for this. They said she was also responsible for the very ‘homely’ touches she had added such as the nice pictures and displays in the living room and hallways. One unit had had a panel removed under the kitchen sink to allow access for wheelchairs. The inspector suggested that a more decorative arrangement could be made. The registered manager and one of the residents agreed to organise for a curtain to be fitted. Grange Centre (The) DS0000013657.V261174.R01.S.doc Version 5.0 Page 15 There was also some slight staining on the carpet tiles in the ‘assessment’ bedroom which the inspector recommended should be either cleaned or changed. Grange Centre (The) DS0000013657.V261174.R01.S.doc Version 5.0 Page 16 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 34 The policies and procedures for recruitment at The Grange Centre are well organised and the necessary safeguards are in place to protect residents. EVIDENCE: This home follows safe recruitment practices and staff files examined showed a full employment history had been sought and two references had been taken up. All new staff had the proper criminal record investigations carried out and are checked against the list of those deemed unsuitable to work with vulnerable adults. Residents take part in recruitment and selection of staff and assist new staff to find their way around. On the day of the inspection one resident was giving a guided tour to someone who had come for an interview. All appointments are subject to a six month probationary period, and volunteers undergo the same vetting procedures as paid staff. Grange Centre (The) DS0000013657.V261174.R01.S.doc Version 5.0 Page 17 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 42 Health and safety is taken seriously at the Grange Centre and resident’s interests are safeguarded by the current policies, procedures and practices. EVIDENCE: The arrangements for health and safety matters at this home are advanced and in a number of areas they do particularly well. The arrangements for fire safety are good, with all staff carrying a ‘fire pager’ which alerts them to the fire alarm being activated in one of the buildings on site. Some staff live onsite and it is a condition of their tenancy that when they are at home, even if they are not on duty, they will respond to fire alerts. The alarm was activated in one block during the inspection and provided a demonstration of how well the system works. Residents followed the evacuation policy and staff on site were on hand immediately. The home has recently reviewed its procedures for protecting against legionella and the staff member responsible for health and safety was particularly knowledgeable on this subject. Unused shower heads were being flushed through on a weekly basis, and the policies covered the care of cisterns and Grange Centre (The) DS0000013657.V261174.R01.S.doc Version 5.0 Page 18 pipe work. The inspector recommended the legionella safety certificate be followed up as the company who had carried out the checks had written confirming that the home was legionella free, but the certificate had still not arrived. As well as a full time health and safety officer employed on site, The Grange Centre also employs a consultant to advise them on health and safety matters. Grange Centre (The) DS0000013657.V261174.R01.S.doc Version 5.0 Page 19 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score 3 3 X 4 3 Standard No 22 23 Score 3 3 ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score 4 X X X X Standard No 24 25 26 27 28 29 30 STAFFING Score 3 X X X X X X LIFESTYLES Standard No Score 11 3 12 4 13 X 14 3 15 3 16 X 17 Standard No 31 32 33 34 35 36 Score X X X 3 X X CONDUCT AND MANAGEMENT OF THE HOME X PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Grange Centre (The) Score X X X 3 Standard No 37 38 39 40 41 42 43 Score X X X X X 3 x DS0000013657.V261174.R01.S.doc Version 5.0 Page 20 No Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. 2. 3. 4. Refer to Standard YA5 YA24 YA24 YA42 Good Practice Recommendations The home should include a room number, or other method of identifying specific rooms, on each residents contract. The home should review the area under a sink where a panel has been removed and consider a more attractive arrangement. The assessment bedroom has slight staining on the carpet and this should either be cleaned, or the carpet replaced. In addition to the letter confirming the home is legionella free, the certificate should be followed up and made available for inspection. Grange Centre (The) DS0000013657.V261174.R01.S.doc Version 5.0 Page 21 Commission for Social Care Inspection Surrey Area Office The Wharf Abbey Mill Business Park Eashing Surrey GU7 2QN 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 Grange Centre (The) DS0000013657.V261174.R01.S.doc Version 5.0 Page 22 - 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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