Inspection on 27/01/06 for The Grange Nursing Home

This inspection was carried out on 27th January 2006.

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 Nursing Home 18/03/09

The Grange Nursing Home 22/03/07

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 Unannounced Inspection 27th January 2006 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.V275355.R01.S.doc Version 5.1 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.V275355.R01.S.doc Version 5.1 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 28 Category(ies) of Old age, not falling within any other category registration, with number (28), Physical disability (6), Physical disability of places over 65 years of age (28) The Grange Nursing Home DS0000012148.V275355.R01.S.doc Version 5.1 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. 9th December 2005 Date of last inspection Brief Description of the Service: The Grange Nursing Home provides accommodation for twenty-seven 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-one single rooms, one of which has en-suite facilities and three double rooms, 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. The Grange Nursing Home DS0000012148.V275355.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place on the 27th January 2006. The inspector met with five residents, the activities co-ordinator, a carer, the administrator and the trained nurse in charge of the home for that shift. The registered manager was off duty and the deputy manager was due to commence her shift later in the day. Care plans were sampled for two residents and records were seen for medicines, staff training and supervision and the home’s policies and procedures were also assessed. This was the second unannounced inspection for the year 2005/2006. Information on the standards assessed at the first inspection can be found in the inspection report dated 9th September 2005. What the service does well: On the day of the inspection the home looked clean, homely and welcoming. Residents commented on the caring, respectful attitude of staff and said that it ‘was a lovely home’. Staff said that working at the home felt like being ‘part of a family’ and that the home had a ‘lovely atmosphere’. During the inspection visit there was a friendly relaxed atmosphere and good interaction was seen between staff and residents. Good care plans are in place and the residents felt they were treated with respect and were protected by the home’s clear procedures for dealing with medicines and the safe working practices operated in the home. The registered manager runs the home well and staff receive regular supervision and the training they require to do their jobs including health and safety, moving and handling, fire safety, food hygiene and infection control. Seven of the seventeen carers employed at the home hold National Vocational Qualification (NVQ) level 2 or above and staff said that they were encouraged and supported to attend training sessions. The Grange Nursing Home DS0000012148.V275355.R01.S.doc Version 5.1 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 Nursing Home DS0000012148.V275355.R01.S.doc Version 5.1 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 DS0000012148.V275355.R01.S.doc Version 5.1 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): EVIDENCE: These standards were met when assessed during the last inspection. Information can be found in the inspection report dated the 9th September 2005. The Grange Nursing Home DS0000012148.V275355.R01.S.doc Version 5.1 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): 7, 8, 9 and 10 Good care plans provide staff with all the information required to support the residents whose health needs are met and who are treated with respect and are protected by the home’s clear procedures for dealing with medicines. EVIDENCE: Care plans were seen for two residents. The plans were good and provided staff with all the information they required to fully support the residents. Plans were in place for all aspects of care needs including mobility, nutrition, continence, communication and pressure areas. Risk assessments had also been completed and were included in the plans. The residents’ likes and dislikes for daily activities were documented, for example, a care at night plan stated that the resident liked to use two soft pillows. The care plans seen indicated that the residents were involved in the review of the plans. Records seen indicated that the residents’ health care needs were being met. Visits from GPs were documented and it was evident that advice was sought as required. One resident spoken with during the inspection said that the GP was contacted on her behalf on request. Advice was also sought from district The Grange Nursing Home DS0000012148.V275355.R01.S.doc Version 5.1 Page 10 nurses and physiotherapists as necessary. Visits by a chiropodist were documented in one of the care plans and the home also has carers who have received training to provide foot care. One resident said that she visited her optician in the nearby town. The home has clear procedures in place for dealing with medicines. Medication records seen had been completed appropriately and records for controlled medicines matched the stock held. Only the trained nurses are able to administer the medication and the registered manager assess all nurses new to the home, before they are allowed to complete the medicine round alone. Records are kept of all medicines received into the home and for the disposal of unwanted medicines. During the inspection staff were seen to speak to residents in a friendly, caring manner. Two residents commented on the ‘lovely staff’ and said that they were always treated with respect and were given privacy as they wished. The Grange Nursing Home DS0000012148.V275355.R01.S.doc Version 5.1 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 the following standard(s): EVIDENCE: These standards were met when assessed during the last inspection. Information can be found in the inspection report dated 9th September 2005. During this inspection three residents commented on their enjoyment on the choice of food provided at the home. The Grange Nursing Home DS0000012148.V275355.R01.S.doc Version 5.1 Page 12 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 and 18 Residents are provided with clear information on making complaints and know that any complaints made will be taken seriously and they are protected by staff awareness of abuse issues. EVIDENCE: The home’s complaints procedures have been updated and provide information on how to make a complaint, who will investigate and timescales for the process. The document also states that complaints can be made through the commission at any time. Two residents spoken with were aware of the complaints procedures but said that they had no reason to complain. They also said that they felt any complaint or concern raised would be taken seriously and investigated. The home has procedures in place to be followed should abuse be suspected and information leaflets are available around the home. Records seen indicated that staff receive on going training in abuse awareness and two staff members spoken to said that they had received training and knew about the procedures for suspected abuse. The Grange Nursing Home DS0000012148.V275355.R01.S.doc Version 5.1 Page 13 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): EVIDENCE: These standards were met when assessed at the last inspection and information can be found in the inspection report dated the 9th September 2005. On the day of this inspection the home looked clean, homely and welcoming. Since the last inspection a conservatory has been erected alongside the large lounge on the ground floor and another has been built to enlarge the dining room. The conservatories make the areas much lighter and provide comfortable, pleasant, additional space. Two residents commented on the improvements saying that they ‘liked the new areas’. Further redecoration is due to take place on one of the stairways and new carpet is due to be laid in the corridor when the work has been completed. The Grange Nursing Home DS0000012148.V275355.R01.S.doc Version 5.1 Page 14 The administrator said that arrangements were being made to extend the patio area outside the lounge and conservatory to provide an improved seating area for residents. The Grange Nursing Home DS0000012148.V275355.R01.S.doc Version 5.1 Page 15 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): 27, 28 and 30 The number and skill mix of staff employed at the home meets residents’ needs and staff receive the training required to do their jobs. EVIDENCE: Staff rotas seen indicated that sufficient staff were on duty for each shift. The home employs the registered manager, a deputy manager, four trained nurses and seventeen carers. Another registered nurse has been recruited and is due to commence work at the home shortly and a bank of nine trained nurses and five carers provides staff as required. The home employs separate staff for administration, catering and domestic duties. A nurse and a carer spoken with during the inspection said that they felt sufficient staff were on duty and a resident said that staff came quickly when called. Seven of the seventeen carers hold NVQ level 2 or above. Records seen indicated that staff were receiving training in abuse awareness, moving and handling, continence care, infection control, wound care and food hygiene. Two staff members said that the registered manager encouraged them to attend training sessions. The Grange Nursing Home DS0000012148.V275355.R01.S.doc Version 5.1 Page 16 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, 32, 33, 36, 37 and 38 The registered manager runs the home in the best interests of the residents who benefit from the open door approach to management and the safe working practices operated at the home by staff who receive regular supervision. EVIDENCE: The registered manager, Mrs Rowsell, is a trained nurse, who holds the Registered Managers Award and who has many years experience in providing care in a residential setting. Two staff members spoken with commented on the support and encouragement they received from the manager. One carer said that the home had a ‘lovely atmosphere’ and a registered nurse said that working in the home was like being ‘part of a family’ and that Mrs Rowsell was a very good manager who treated staff and residents with care and sensitivity. The Grange Nursing Home DS0000012148.V275355.R01.S.doc Version 5.1 Page 17 Three residents also said that Mrs Rowsell was very caring and was always ready to listen to them. Meetings are held for residents and their relatives to voice their opinions on the care provided at the home. Two residents said that they were able to discuss any concerns or suggestions with the registered manager as they wished and that they had been kept up to date with progress when the major building work was taking place. Staff meetings are also held on a regular basis and records are kept and made available to all staff members so that those who had been unable to attend were made aware of the issues discussed. Staff receive regular supervision with the registered manager. New staff members meet on a monthly basis for three months and then supervision is held six times a year. Records seen for supervision indicated that care issues plus staff training and performance development were discussed during the meetings. A staff member said that the date for the supervision was agreed with her and she was given the opportunity to participate fully in the process, discussing issues she wished included as well as those on the agenda. The home has policies and procedures in place for all aspects of care provision including health and safety, the admission of residents, privacy and dignity, risk of falls, communication and the handling of residents’ finances. The documents seen had not been dated when reviewed. The registered manager contacted following the inspection stated that the documents were reviewed on an annual basis or more frequently if required and that she would ensure the review dates were added. Health and safety notices were displayed around the home and staff receive training in safe working practices including moving and handling, fire safety, food hygiene, first aid and infection control. During the inspection visit staff were observed using safe procedures including the use of a hoist when moving residents with poor mobility. At the time of the inspection the kitchen looked clean and in good order with food stored appropriately. The laundry room also looked to be tidy and clean. Hazardous substances such as cleaning fluids were stored securely. The Grange Nursing Home DS0000012148.V275355.R01.S.doc Version 5.1 Page 18 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 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 x 13 x 14 x 15 x COMPLAINTS AND PROTECTION Standard No Score 16 3 17 x 18 3 x x x x x x x x STAFFING Standard No Score 27 3 28 3 29 x 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 3 x x 3 3 3 The Grange Nursing Home DS0000012148.V275355.R01.S.doc Version 5.1 Page 19 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.V275355.R01.S.doc Version 5.1 Page 20 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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