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Inspection on 22/11/05 for The Grange Nursing Home

Also see our care home review for The Grange Nursing Home for more information

This inspection was carried out on 22nd November 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.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

The residents feel they are well looked after and respected by staff that know what they are doing, are caring and helpful. They also all feel safe and comfortable at the home. The staff team is well trained and able to meet the needs of the residents. The home invests much time and money on-going training programmes for staff to gain recognised national qualifications in care. This is so that staff have the necessary knowledge and tools to provide the best care possible for the residents. The home has investigated a recent complaint in a sensitive and thorough way following the home complaint procedure. The home has a good system in place for looking at the quality of the service they provide. This includes gaining the opinions of the residents, family and friends, health and social professionals. This helps them look at how to improve their service. The home is kept in good order and equipment throughout is maintained regularly to keep them in go working order.

What has improved since the last inspection?

There is an on going improvement and redecorating programme within the home that keeps the house looking fresh and bright. Since the last inspection, the home has redecorated some more bedrooms as part of the on-going redecoration programme. Since the last visit, the home has collected a sample of the outstanding staff signatures so that the home can easily identify who has given out the medicine.

CARE HOMES FOR OLDER PEOPLE The Grange Nursing Home 72 Upper Northam Road Hedge End Southampton Hampshire SO30 4EB Lead Inspector Isolina Reilly Unannounced Inspection 22nd November 2005 11:00 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 DS0000011449.V262270.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 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 DS0000011449.V262270.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service The Grange Nursing Home Address 72 Upper Northam Road Hedge End Southampton Hampshire SO30 4EB 01489 790177 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) Mrs Angela Louise Northover Mr Roy Clive Northover, Mrs Heather Northover Mrs Carolyn Sarah Ryves Care Home 43 Category(ies) of Old age, not falling within any other category registration, with number (43), Physical disability (8), Physical disability of places over 65 years of age (40), Terminally ill (8), Terminally ill over 65 years of age (40) The Grange Nursing Home DS0000011449.V262270.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. A maximum of 8 beds can be used at any one time for service users in the categories of PD or TI between the ages of 52 and 64 A maximum of 3 beds may be used at any one time for service users who are only in need of personal care 17th May 2005 Date of last inspection Brief Description of the Service: The Grange is a care home providing personal care and nursing care for forty-three service users over the age of 65 years. The home is registered to admit service users who are physically disabled and those who are terminally ill. There are conditions of registration, one being that the home may accommodate up to three service users at any one time who are in receipt of personal care only. The other condition is that no more than eight service users may be accommodated between the ages of 52-65 years. The Grange is owned by three partners and is a family business.The home is located in the suburbs of Southampton, and is in easy access to a motorway. The home is close to shops and other amenities, which service users, have access to if they choose. The home is a purpose built two-storey building that has been extended to provide more accommodation with en-suite facilities. The home has twenty-nine single rooms, twenty-four of which have en-suite facilities. The seven double rooms all have en-suite facilities and a passenger lift. The Grange has a large well -maintained garden, which is accessible to the service users. The Grange Nursing Home DS0000011449.V262270.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This is the second unannounced inspection for this service that took place over one day. The opportunity was taken to look around the home, view records, procedures and talk with residents and staff. The inspector also had the opportunity to observe the evening meal and interaction between residents and staff. The inspector was able to speak with several residents, relatives, registered nurses, carer, cleaners and kitchen staff were spoken with who stated that they felt the home provides an excellent service. A full summary of the home’s assessment against the key National Minimum Standards is available by reading this and this year’s previous inspection report of 17th May 2005. What the service does well: What has improved since the last inspection? There is an on going improvement and redecorating programme within the home that keeps the house looking fresh and bright. Since the last inspection, The Grange Nursing Home DS0000011449.V262270.R01.S.doc Version 5.0 Page 6 the home has redecorated some more bedrooms as part of the on-going redecoration programme. Since the last visit, the home has collected a sample of the outstanding staff signatures so that the home can easily identify who has given out the medicine. 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 Nursing Home DS0000011449.V262270.R01.S.doc Version 5.0 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection The Grange Nursing Home DS0000011449.V262270.R01.S.doc Version 5.0 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): The above key standards were assessed and met at the previous inspection on the 17th May 2005. EVIDENCE: The Grange Nursing Home DS0000011449.V262270.R01.S.doc Version 5.0 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 the following standard(s): The above key standards were assessed and met at the previous inspection on the 17th May 2005. Standard seven was exceed at the previous visit. EVIDENCE: The Grange Nursing Home DS0000011449.V262270.R01.S.doc Version 5.0 Page 10 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): The above key standards were assessed and met at the previous inspection on the 17th May 2005. EVIDENCE: The Grange Nursing Home DS0000011449.V262270.R01.S.doc Version 5.0 Page 11 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16 The home has a satisfactory complaints procedure that residents are able to use. EVIDENCE: The residents and staff spoken were aware of the home’s complaint procedure and how to make one if they wish. The home’s complaint procedure included the address for the Commission and that all complaints will be dealt with promptly within 28 days. The home has received one complaint since the last visit. The home appropriately implemented their complaints procedure and the records sampled were found to be satisfactory. The manager and deputy stated that as part of the complaint they looked at the homes practices with a view to implementing improvement if necessary. The Grange Nursing Home DS0000011449.V262270.R01.S.doc Version 5.0 Page 12 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19 and 26 The home presents as a clean, homely, comfortable and suitable environment for the residents. The standard of the décor within the home is good with evidence of on-going maintenance and improvements. EVIDENCE: On the tour the home was found to be clean, warm and no offensive odours were detected. The deputy explained that the decorating was on going. Further bedrooms have been redecorated since the last visit. It was noted that in bedroom 15 a hot pipe behind the bed travelling up the wall was hot to the touch. This was discussed with deputy manager who gave a verbal undertaking to ensure that the pipe is made safe as soon as possible. Currently this hot pipe presents a low risk to the resident within the room as they are immobile and being nursed in bed. The deputy stated she would The Grange Nursing Home DS0000011449.V262270.R01.S.doc Version 5.0 Page 13 check all the other bedrooms to see if there any further exposed hot pipes that may need making safe. During the tour of the home the inspector noticed that the communal hand sinks seen have liquid soap for washing hands and disposable paper towels. There were gloves and plastic aprons available in the laundry rooms, toilets and bathrooms. On arrival at the home the Environmental Health officer was leaving having completed an inspection of the home. The manager confirmed that the home had met the necessary standards on this visit. The Grange Nursing Home DS0000011449.V262270.R01.S.doc Version 5.0 Page 14 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 28 The home successfully supports staff to undertake appropriate qualifications within care that is relevant to this client group. Standards twenty-seven, twenty-eight and twenty-nine were assessed and met at the previous inspection on 17th May 2005. EVIDENCE: The inspector was able to sample staff training records and speak to staff regarding their qualifications. The staff spoken to stated that the home has been very supportive. Over fifty percent of carer staff have achieved or in the process of achieving National Vocations Qualification level 2 and/or 3 in Health and Social Care. The home checks all nurses employed qualifications and registration with the Nursing Midwifery Council on recruitment. Then registrations are checked six-monthly to ensure they have been renewed. The records sampled confirmed this. The staff spoken with have found the courses informative, increased their knowledge and assisted in the provision of care. The inspector was able to sample a detailed job description for support workers that outline their responsibilities and all have completed and organisation’s induction that gives them an understanding of the home’s ethos and attitude to care. The Grange Nursing Home DS0000011449.V262270.R01.S.doc Version 5.0 Page 15 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33 and 38 The home is run well by an experienced manager and skilled deputy. The home has an excellent system in place for self-monitoring, annual review and development. The residents’ health, safety and welfare are appropriately promoted by the home to ensure everyone is protected. Standard 35 was assessed and met at the previous inspection on 17th May 2005. EVIDENCE: The manager has many years experience in running the nursing home. This is evident in smooth running of the service and a staff team that was observed works well together. The manager undertakes regular updating training with the staff team and has a National Vocational Qualification Registered Manager’s Award and has recently completed a qualification as an assessor (A1). She maintains her nursing registration. The deputy manager has also completed The Grange Nursing Home DS0000011449.V262270.R01.S.doc Version 5.0 Page 16 her a National Vocational Qualification Registered Manager’s Award and an as an assessor (A1) qualification. She maintains her nursing registration. The staff spoken with confirmed that there is a clear line of authority within the home. The management is always looking for ways to improve the service and efficiency. The inspector was able to sample February 2005 quality audit findings that are informing the development of the home operating plan for 2006. The quality audit was found to be systematic, comprehensive including all aspects of the service and reviewed by an external company. The action plans reflected findings from the audit. The home has achieved ISO 9001 a recognised industry and business quality assurance standard. The residents, relatives, staff and management confirmed that they had been asked to complete questionnaire on how the home is run. These were sampled by the inspector and found to be positive in the care provided and attitude of staff. The home also sends out questionnaires to health and social care professionals. The inspector was able to sample a random selection of the questionnaires and found evidence where opinions had influenced practices. It was discussed that a summary of the findings and actions taken could be made available to residents and other interested parties. The staff spoken with also confirmed that they are regularly asked their opinion on how the home is performing and ideas are encouraged. This is done in various ways at the staff meetings that are minuted, supervisions and general informal chats with management. The inspector was able to seen the maintenance certificates for the home’s electrical and gas systems and appliances demonstrating that the home is maintained within good working order. The home has a system of testing the fire alarm weekly. The residents spoken with confirmed that the fire alarm is regularly tested to ensure that it is working. The inspector was able to view records that confirmed that the home has tested the fire alarm, undertaken visual checks of fire extinguishers, emergency lighting and smoke alarms. There were also recent maintenance certificates for all fire safety equipment within the home. The inspector was able to see the home’s file and risk assessments for the safe storage and use of chemicals that may be hazardous to health. The Grange Nursing Home DS0000011449.V262270.R01.S.doc Version 5.0 Page 17 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 X X X X X X HEALTH AND PERSONAL CARE Standard No Score 7 X 8 X 9 X 10 X 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 X 13 X 14 X 15 X COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 X 3 X X X X X X 3 STAFFING Standard No Score 27 X 28 3 29 X 30 X MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 4 X X X X 3 The Grange Nursing Home DS0000011449.V262270.R01.S.doc Version 5.0 Page 18 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. Refer to Standard Good Practice Recommendations The Grange Nursing Home DS0000011449.V262270.R01.S.doc Version 5.0 Page 19 Commission for Social Care Inspection Hampshire Office 4th Floor Overline House Blechynden Terrace Southampton SO15 1GW 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. 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