Inspection on 22/03/07 for The Grange Nursing Home

This inspection was carried out on 22nd March 2007.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is (sorry - unknown). 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 Nursing Home 18/03/09

The Grange Nursing Home 27/01/06

The Grange Nursing Home 09/09/05

The Grange Nursing Home 09/12/04

The Grange Nursing Home 04/05/04

The Grange Nursing Home 03/03/03

Similar services:

Flint House

St Vincents

The Cotswold Home

Fairways

Newbeech House

Winton House

Treloar College

Rush Court

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

CARE HOMES FOR OLDER PEOPLE The Grange Nursing Home Vyne Road Sherborne St John Basingstoke Hampshire RG24 9HX Lead Inspector Marilyn Lewis Key Unannounced Inspection 22nd March 2007 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 Nursing Home DS0000012148.V329837.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 Nursing Home DS0000012148.V329837.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service The Grange Nursing Home Address Vyne Road Sherborne St John Basingstoke Hampshire RG24 9HX 01256 851191 01256 851121 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) Britaniascheme Limited Mrs Maureen Rowsell Care Home 25 Category(ies) of Old age, not falling within any other category registration, with number (25), Physical disability (6), Physical disability of places over 65 years of age (25) The Grange Nursing Home DS0000012148.V329837.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. A maximum of six service users may be accommodated at any one time in the PD category between the ages of 50-64 years. 27th January 2006 Date of last inspection Brief Description of the Service: The Grange Nursing Home provides accommodation for twenty-five residents over the age of 65 years who require nursing care and/or have physical disabilities. The home has a condition to their registration that they can accommodate six physically disabled residents between the ages of 50 and 65 years. The Grange is owned by Brittaniascheme Limited. The home is set in large gardens, in a semi rural location, in the village of Sherborne St John, Basingstoke, Hampshire. The property is a large converted farmhouse, with accommodation provided on two floors. There are twenty-three single rooms, one of which has en-suite facilities and one double room, plus two lounges and a separate dining room. The third floor is used as staff offices and rest room. Many of the rooms have pleasant views over the gardens and surrounding countryside. Information received from the registered manager on the 18th February 2007 stated that the current fees ranged from £548 to £661. The Grange Nursing Home DS0000012148.V329837.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This report represents a review of all the evidence and information gathered about the service since the previous inspection including a pre inspection questionnaire completed by the registered manager and a visit to the service. The unannounced visit took place on the 22nd March 2007. The inspector toured the home and met with five service users, the activities co-ordinator, two carers, two trained nurses, a cook, a visitor, the assistant manager and the registered manager. Records seen included care plans, medication records, complaints, accidents, staff recruitment and staff training. What the service does well: The home looked clean and welcoming. Residents said that staff were very caring and kind and they felt they were treated with respect at all times. During the visit good interaction was observed between the staff and the residents. The registered manager, Mrs Rowsell, runs the home well. Residents said that Mrs Rowsell was ‘easy to talk with’ and staff said that they received good support. Prospective residents and their relatives are given clear information about life at the home and are able to visit before making a decision about living there. A care needs assessment is undertaken for all prospective residents before they are offered a place at the home to ensure the home can meet their care needs. Residents are involved in their care planning and care plans seen had been reviewed monthly or more frequently if necessary. Visits by GPs and other health professionals were documented in the residents’ records and indicated that health care needs were being met. The home employs an activities co-ordinator who has developed a varied programme of suitable activities for residents. The residents said that they particularly enjoyed participating in quizzes and trips out to the shops and theatre. There are no restrictions on visitors to the home provided the resident wishes to receive them. A visitor spoken with said that staff were always friendly and welcoming when she visited her relative. The Grange Nursing Home DS0000012148.V329837.R01.S.doc Version 5.2 Page 6 Residents said that the food provided at the home was very good. The menus seen indicated that a choice of meals was offered for each meal and the lunches served on the day of the visit were well presented. Since the last inspection visit the conservatory extension to the lounge and another to the dining room have been completed. Residents said that they liked these new areas and the additional space gave the rooms a light airy feel. Residents said that they liked their own rooms and those seen contained many personal items. Residents and staff said that they felt there were sufficient staff on duty. A resident said that staff came quickly when she used her call alarm to ask for assistance. The home follows robust procedures for the recruitment of staff which includes obtaining two written references and carrying out Criminal Records Bureau (CRB) and Protection of Vulnerable Adult (POVA) checks to ensure staff are suitable to work with the residents. Staff said that they had good training opportunities and records seen confirmed that staff received the training required to do their jobs. A high percentage of care staff hold National Vocational Qualifications (NVQ) in care. Trained nurses said that they were able to attend training sessions in topics relevant to the resident needs to maintain their personal development programme. Staff also receive regular supervision and an annual appraisal so that they receive feedback on the individual performance. What has improved since the last inspection? Since the last inspection the format for care planning has been improved to give staff an ‘easy to follow’ document. Staff said that they found the new format much more user friendly. Some areas of the home including the corridors and stairwell have been redecorated and new carpets have been laid. Also a new cupboard has been purchased for the ‘home’ shop. The home produces a monthly newsletter for the residents giving news of any changes in the home, future activities and quizzes. Since the last inspection a monthly newsletter has been produced for staff which keeps them up to date with any changes such as reviewed procedures. The Grange Nursing Home DS0000012148.V329837.R01.S.doc Version 5.2 Page 7 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 summary of this inspection report can be made available in other formats on request. The Grange Nursing Home DS0000012148.V329837.R01.S.doc Version 5.2 Page 8 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection The Grange Nursing Home DS0000012148.V329837.R01.S.doc Version 5.2 Page 9 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. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 2, 3, 5 and 6 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Prospective residents and their relatives are provided with good information about life at The Grange, they are able to visit the home before making a decision about taking a place there and a given a written contract on admission. No one is admitted to the home without a care needs assessment to ensure the home can meet their care needs. The home does not provide intermediate care. EVIDENCE: The home has a Statement of Purpose and Service User Guide that give clear information about life at the home. Included with the documents are copies of past inspection reports, a leaflet on the prevention of abuse and a copy of the home’s latest newsletter the ‘Grapevyne’. The Grange Nursing Home DS0000012148.V329837.R01.S.doc Version 5.2 Page 10 A copy of a written contract giving the terms and conditions for residency at the home, is also provided. Copies of the Statement of Purpose and Service User Guide together with the additional information are placed available for relatives and visitors in the small quiet lounge on the first floor. Contracts seen that had been provided for residents gave details of what services were included in the fees and those available at additional cost such as hairdressing and dry cleaning. The registered manager said that residents were given a written contract on admission. Residents spoken with said that they were not really interested in their contracts as their relatives handled their financial affairs. The registered manager said that a care needs assessment was undertaken for all prospective residents before a place at the home was confirmed. The care assessments were completed by either the registered manager or the assistant manager. Assessments were seen for three residents who had been admitted to the home since the last inspection. The assessments covered all aspects of care needs including cultural and social needs and personal care. The assessments were detailed and included information from GPs and other health professionals and also, if the placement had been agreed by adult services, a report from the person’s care manager. The registered manager said that prospective residents were able to visit the home before making a decision to take a place there. However due to the frailty of some prospective residents their relatives visited on their behalf. A resident spoken with said that her relatives had visited and seen her room before she was admitted. The home does not provide intermediate care and therefore standard 6 is not applicable. The Grange Nursing Home DS0000012148.V329837.R01.S.doc Version 5.2 Page 11 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. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 and 10 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents are involved in their care planning and their health needs are being met. Residents feel they are treated with respect and their health is protected by staff adhering to the home’s clear procedures for dealing with medicines. EVIDENCE: Since the last inspection the format of the care plans has been improved and the documents give very clear information about the care needs of the residents and the support required to meet those needs. Carers spoken with said that they liked the new care plan layout as it made it easy to follow the plans. The care plans documented the residents’ preferences for participating in daily life activities such as what time they preferred to get up in the morning. Plans The Grange Nursing Home DS0000012148.V329837.R01.S.doc Version 5.2 Page 12 seen included those for mobility, nutrition, communication, management of pain, washing and dressing and oral care. The plans seen had been reviewed monthly and had been signed by the resident or when appropriate their relative. The care plans contained risk assessments including those for moving and handling, including the use of hoists, pressure care, falls and nutrition. Risk assessments had also been completed for the use of bed rails. Visits from GPs and other health professionals such as physiotherapists, were documented in the care plans. Records seen indicated that opticians visited the residents for a routine check and also as required. Records also documented that one resident had made visits to ophthalmic clinics. One resident said that if she wanted a visit from her GP she ‘only had to ask staff to arrange it’. The home has clear procedures for the handling of medicines. Medication records seen had been completed appropriately and medicines were stored safely. At the time of the visit no residents were prescribed controlled medicines. Also no one was self administering their own medicines but procedures were in place should future residents wish to do so. Medicines that required storage in a fridge were stored appropriately in the medicine fridge. Eye drop containers were dated on opening to ensure they were discarded when the expiry dated was reached. The temperature of the fridge was being monitored and recorded. Procedures were in place to record medicines brought into the home and for the disposal of medication not required. Information sheets on the medicines being administered at the home were readily available for staff. During the visit staff were observed to knock on doors and wait before entering rooms and they spoke with residents in a friendly, respectful manner. Residents spoken with said that staff were very kind and caring and they felt they were always treated with respect. The Grange Nursing Home DS0000012148.V329837.R01.S.doc Version 5.2 Page 13 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 and 15 Quality in this outcome area is, good. This judgement has been made using available evidence including a visit to this service. Residents are able to participate in a range of suitable activities, receive visitors as they wish and enjoy a choice of varied meals served in a relaxed atmosphere. EVIDENCE: The religious interests of the residents were recorded in their care plans. A local minister visits the home regularly and residents who wish to do so are able to attend a monthly communion service. Services are also held by members of the Salvation Army on alternate Sundays. The registered manager said that arrangements would be made for ministers of other denominations to visit on request and this was also documented in the home’s Statement of Purpose. The home employs a very enthusiastic activities co-ordinator who is responsible for the activities programme. The co-ordinator has attended a training course on therapeutic activities and is qualified to provide Reiki and massage. The Grange Nursing Home DS0000012148.V329837.R01.S.doc Version 5.2 Page 14 The activities programme includes quizzes and crosswords which the residents said that they enjoyed as they ‘made them think’, table games, bingo, and discussions on newspaper articles. Residents also said that they enjoyed visits from the ‘Pat a dog’ each week. The activities programme includes visits from musicians and on the day of the inspection visit a past member of staff was entertaining residents with a session of music played on an electric organ. Residents were involved in making their Easter bonnets for a party that was due to be held at Easter. The activities co-ordinator said that trips were organised for shopping and visits to local places of interest. The home used the local Dial a Ride scheme or taxis to transport residents on trips. During the visit the activities co-ordinator received confirmation that some residents and their carers were able to attend a picnic at the park at Windsor later in the year when they would have the opportunity to possibly meet members of the Royal Family. Residents said that their visitors could visit the home whenever they wished. A relative visiting at the time of the inspection visit said that staff were always friendly and welcoming when she came to the home. Residents were able to entertain their visitors in one of the lounges or in the privacy of their own room. Visitors were also able to take meals with the residents if prior notice was given. The home employs two cooks who work shifts so that a cook is on duty from breakfast to supper. The cook spoken with had information on the residents’ dietary needs and their likes and dislikes for food items. Menus seen indicated that a varied choice of meals was offered. The menu for lunch on the day of the visit was a choice of chicken pie or fish with carrots, cabbage and potatoes followed by spotted dick and custard, yoghurt, ice cream or fresh fruit. Egg salad was also available as an alternative meal. Fresh vegetables were used for the meals. All residents spoken with said that they enjoyed their meal. Residents added that the food provided was always good. The atmosphere in the dining room was relaxed. Staff were observed supporting residents who required assistance in a friendly caring manner. The Grange Nursing Home DS0000012148.V329837.R01.S.doc Version 5.2 Page 15 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents know that any complaints will be taken seriously and acted upon quickly and they are protected by staff awareness of the protection of vulnerable adults. EVIDENCE: The home has a complaints policy in place that indicates who will investigate the complaint and timescales for resolving the issue. The registered manager said that there had been no complaints received since the last inspection. Residents spoken with said that they would speak with the registered manager if they had any concerns or complaints as they felt she would look into the issue quickly. The residents added that they had never felt the need to make a complaint. The complaints procedures were included in the information given to residents on admission and a copy of the complaints procedure was also kept in the quiet lounge and was readily available to residents and visitors. Staff spoken with said that they had received training in the protection of vulnerable adults and records seen confirmed this. A notice was also on display reminding staff that another session of training for abuse awareness was due to take place later in the month. The Grange Nursing Home DS0000012148.V329837.R01.S.doc Version 5.2 Page 16 The home had procedures in place for the prevention of abuse including Hampshire County Council’s Protection of Vulnerable Adults and Whistle Blowing. Staff spoken with knew the procedures to follow should abuse be suspected. The Grange Nursing Home DS0000012148.V329837.R01.S.doc Version 5.2 Page 17 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. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 20, 21, 22, 23, 24, 25 and 26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The Grange provides a clean, safe and homely environment for all who live, work and visit there. EVIDENCE: The Grange is a detached property situated in a semi rural location in the village of Sherborne St John, on the outskirts of Basingstoke. The home provides accommodation over two floors with a third floor used for offices and a staff room. Since the last inspection the home has reduced its’ number of shared rooms to one and this has reduced the number of residents from 28 to 25. The Grange Nursing Home DS0000012148.V329837.R01.S.doc Version 5.2 Page 18 The home has a large lounge with conservatory on the ground floor and a small lounge used as a quiet lounge on the first floor. A separate dining room with conservatory is provided on the ground floor next to the kitchen. The conservatories have been completed since the last inspection and have greatly improved the communal areas. Residents spoken with said that they liked the new areas. One resident said that they particularly enjoyed sitting in the conservatory area of the lounge as it gave such good views of the surrounding countryside. The home has a programme of routine maintenance and redecoration. Since the last inspection some redecoration has taken place in the corridors and stairways and new carpet has also been laid in these areas. Residents are accommodated in twenty- three single rooms and one double room. One of the residents in the shared room said that she was quite happy sharing the room. Screens were provided to give privacy when required. Residents’ rooms seen looked clean and homely and contained many personal items such as pictures, ornaments and small pieces of furniture. All residents spoken with said that they liked their rooms and there were comments of ‘it’s comfortable’ and ‘I have all I want’. Many of the rooms have pleasant views over the garden and surrounding countryside. One resident said that she enjoyed sitting and watching the birds and other wildlife including deer that passed by. A call alarm system is in place throughout the home and during the visit it was noted that the call bells were accessible to residents. A resident said that a staff member came quickly if she pressed her call bell for assistance. The home has sufficient toilets and bathrooms and those seen looked clean and in good order. During the visit staff were seen to wear protective clothing including disposable aprons and gloves as needed. Since the last inspection a new cupboard has been purchased for the home’s shop. The cupboard stands next to the main lounge and displays items such as writing paper and toiletries that are available for residents to purchase. The gardens of the home are laid mainly to lawn with a patio area outside the lounge that has seating available for residents. The Grange Nursing Home DS0000012148.V329837.R01.S.doc Version 5.2 Page 19 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. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 and 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents’ needs are being met by the number and skill mix of staff on duty and they are protected by the home’s robust procedures for the recruitment of staff. Staff receive the training they require to do their jobs and the home has a high number of care staff who have obtained NVQ level 2 or above ensuring that the residents are in safe hands at all times. EVIDENCE: Staff spoken with said that they felt there were usually enough staff on duty and residents also said that there were sufficient staff. Since the last inspection there have been some changes in the home’s support team. The administrator has retired and new one has recently been recruited. The new administrator worked alongside the previous person for a month to get to know the residents and the responsibilities of the position. A new cook has also been appointed to work in partnership with the other cook. A new handyman was also recruited and began work in January 2007. Staff said that they were encouraged by the registered manager to attend training sessions and obtain qualifications. Sixteen of the twenty-two carers The Grange Nursing Home DS0000012148.V329837.R01.S.doc Version 5.2 Page 20 hold NVQ level 2 or above and another carer is due to start the course in April. This will give the home 77 of care staff who hold or be in the process of obtaining the qualification and will ensure the residents are in safe hands at all times. The assistant manager was in the process of completing the Registered Managers Award. The home has robust procedures in place for the recruitment of staff. Records seen for four staff members recently employed contained all the information required including a completed application form and two written references. Criminal Records Bureau (CRB) and Protection of Vulnerable Adult (POVA) checks had been completed prior to the staff members commencing work at the home to minimise the risk to the safety of the residents. Staff said there were good training opportunities with one commenting that there ‘was loads of training available’. Records seen indicated that staff received training in the mandatory subjects and also topics relevant to the service group such as Stroke care. Trained nurses said that they were able to access training to keep their personal development up to date. Sessions included End of life training, palliative care, catheterisation and dysphasia. The assistant manager and a senior nurse were trained to train staff in moving and handling. The Grange Nursing Home DS0000012148.V329837.R01.S.doc Version 5.2 Page 21 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. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 32, 33, 35, 36, 37 and 38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is well managed and run in the best interests of the residents. Resident’s financial interests are safeguarded by the home’s clear policies for handling money and they are supported by staff who receive regular supervision and who use safe working practices. EVIDENCE: The registered manager of the home Mrs Rowsell is a trained nurse who holds the Registered Managers Award and has many years experience in providing care in a residential setting. Mrs Rowsell attends training sessions with staff to keep her professional development up to date. The Grange Nursing Home DS0000012148.V329837.R01.S.doc Version 5.2 Page 22 Staff said that they received good support from the registered manager Rowsell and residents said that Mrs Rowsell was caring and ‘easy to talk with’. It was evident during the visit that Mrs Rowsell had a good rapport with residents, visitors and staff. Meetings are held to give residents and their relatives the opportunity to discuss the quality of care provided at the home. A resident said that she felt that she was always kept informed of any changes in the home and that the registered manager chatted with her on a daily basis. Residents and their relatives completed surveys in the form of questionnaires periodically and the information obtained was fed back through group and one to one meetings and also through the home’s monthly newsletter. The registered provider also undertakes visits to check on the quality of care being provided. Staff meetings are held on a regular basis and arrangements were in place for the assistant manager to take the lead in the next one due in April. Since the last inspection a newsletter for staff called the Grange Gazette has been developed and provides staff with news items such as updates on procedures, and training opportunities. The newsletter is given with the staffs’ monthly payslip. The home keeps small amounts of money for residents. The monies are kept in individual containers in a secure place. Records are kept of all transactions and records seen for two residents matched the amount held. Staff said that they received regular supervision and records seen confirmed this. Notes are kept of the meetings and also for the annual appraisals that take place annually. Records seen in the home are kept in very good order and are easy to follow and check. The registered manager is very methodical in her paperwork and policies and procedures seen had been reviewed regularly and were up to date. During the visit staff were observed to use safe working practices. Two staff members had trained in health and safety and there were notices on display around the home giving health and safety advice. Staff received training in health and safety issues including moving and handling, first aid, infection control and food hygiene. Records seen indicated that staff received training in fire safety and attended fire drills. Checks were completed on fire safety equipment. Hazardous substances such as cleaning fluids were stored safely and the home had information on the substances used in the home. The kitchen looked clean and in good order with food stored appropriately. The Grange Nursing Home DS0000012148.V329837.R01.S.doc Version 5.2 Page 23 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 x 3 N/A 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 3 3 3 3 3 3 STAFFING Standard No Score 27 3 28 4 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 4 4 4 x 3 3 3 3 The Grange Nursing Home DS0000012148.V329837.R01.S.doc Version 5.2 Page 24 Are there any outstanding requirements from the last inspection? NO STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 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 Nursing Home DS0000012148.V329837.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Hampshire Office 4th Floor Overline House Blechynden Terrace Southampton SO15 1GW National Enquiry Line: 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 © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI The Grange Nursing Home DS0000012148.V329837.R01.S.doc Version 5.2 Page 26 - 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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