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Inspection on 04/12/06 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 4th December 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.

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 home looked clean and welcoming and residents said that they liked living there. Residents spoken with said that the staff were very kind and caring and treated them with respect at all times. A visiting relative said that they `couldn`t fault the home at all`. The home provides prospective residents with clear information about life at the home and residents are 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 care assessment provides the basis for the individual care plans. Care plans sampled contained detailed information about the resident`s care needs and the actions required to meet those needs. A resident who had been involved in the regular review of their plans, said that the plans reflected their wishes. Records seen indicated that resident`s health care needs were being met, with visits by GPs and other health professionals document in their care plans. The home is involved in a pilot scheme for providing rehabilitation and six beds are dedicated to residents admitted for rehabilitation. Records for one of these residents indicated that staff at the home worked alongside a multi disciplinary team that included GPs, physiotherapists and occupational therapists, to provide the care. The home has clear procedures for dealing with medication and staff were seen to adhere to them when administering medicines. Medication records seen had been completed appropriately. Residents said that they were able to choose whether to participate in the varied programme of activities provided at the home. One resident said that they had enjoyed a recent craft session where they made bracelets and another said that they appreciated being able to choose when to join in but also to be able to spend time alone if they wished. All residents spoken with said that they enjoyed the food provided at the home. Meals served for lunch offered choice and were well presented. Residents were able to choose to take their meals in the dining room or in the privacy of their own room. Residents spoken with said that they liked their rooms and those seen contained many personal items such as pictures, ornaments and small items of furniture. Residents said that they felt any complaints would be taken seriously and acted upon quickly. All said that they had no reason to make a complaint. Staff had received training in the prevention of abuse and knew the procedures to follow should abuse be suspected. The deputy manager said that staffing levels were flexible to meet the changing level of care needs of the residents. Residents spoken with said that they felt there were sufficient staff on duty, as they did not have to wait long when they requested assistance. A high percentage of the care staff have obtained a National Vocational Qualification ( NVQ) level 2 or above. Staff said that they were encouraged to attend training sessions and records seen indicated that they are receiving the training required to meet the residents` care needs.The Grange Nursing HomeDS0000011449.V319547.R01.S.docVersion 5.2Page 7The home follows robust procedures when recruiting staff. Criminal Records Bureau (CRB) and Protection of Vulnerable Adults (POVA) checks are completed before staff commence work at the home to protect the safety of the residents. Residents said that they felt they were involved in the running of the home and were able to give their views on the quality of care provided through resident and relatives meetings and one to one talks with the registered manager or deputy.

What has improved since the last inspection?

At the time of the last inspection hot water pipes in one room were uncovered. Since then the pipes have been boxed in to protect the safety of the residents.

CARE HOMES FOR OLDER PEOPLE The Grange Nursing Home 72 Upper Northam Road Hedge End Southampton Hampshire SO30 4EB Lead Inspector Marilyn Lewis Unannounced Inspection 4th December 2006 09:30 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.V319547.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 DS0000011449.V319547.R01.S.doc Version 5.2 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.V319547.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. Service users in the categories of PD or TI can only be admitted between the ages of 52 and 64 22nd November 2005 Date of last inspection Brief Description of the Service: The Grange is a care home providing personal care and nursing care for fortythree 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. Information received on the 20th November 2006 from the registered manager of the home states that current fees range from £545 to £735 per week. The Grange Nursing Home DS0000011449.V319547.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place on the 4th December 2006. The inspector toured the home and met with nine of the thirty- eight residents, two visitors, a trained nurse, two carers, the activities coordinator, the chef and a rehabilitation assistant. The registered manager was not on duty and the deputy manager assisted with the inspection process. Information from previous inspections and information provided by the registered manager prior to the inspection was used during the inspection and the writing of this report. The service users at the home wish to be known as residents and their wishes are respected in the report. As part of this inspection, the quality of information given to people about the care home was looked at. People who use the services were also spoken to, to see if they could understand this information and how it helped them to make choices. The information included the Service User Guide (sometimes called a brochure or prospectus), Statement of Terms and Conditions (also known as Contracts of Care) and the complaints procedure. These findings will be used as part of a wider study that CSCI are carrying out about the information that people get about care homes for older people. This report will be published in May 2007. Further information on this can be found on our website www.csci.org.uk. What the service does well: The home looked clean and welcoming and residents said that they liked living there. Residents spoken with said that the staff were very kind and caring and treated them with respect at all times. A visiting relative said that they ‘couldn’t fault the home at all’. The home provides prospective residents with clear information about life at the home and residents are 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 Grange Nursing Home DS0000011449.V319547.R01.S.doc Version 5.2 Page 6 The care assessment provides the basis for the individual care plans. Care plans sampled contained detailed information about the resident’s care needs and the actions required to meet those needs. A resident who had been involved in the regular review of their plans, said that the plans reflected their wishes. Records seen indicated that resident’s health care needs were being met, with visits by GPs and other health professionals document in their care plans. The home is involved in a pilot scheme for providing rehabilitation and six beds are dedicated to residents admitted for rehabilitation. Records for one of these residents indicated that staff at the home worked alongside a multi disciplinary team that included GPs, physiotherapists and occupational therapists, to provide the care. The home has clear procedures for dealing with medication and staff were seen to adhere to them when administering medicines. Medication records seen had been completed appropriately. Residents said that they were able to choose whether to participate in the varied programme of activities provided at the home. One resident said that they had enjoyed a recent craft session where they made bracelets and another said that they appreciated being able to choose when to join in but also to be able to spend time alone if they wished. All residents spoken with said that they enjoyed the food provided at the home. Meals served for lunch offered choice and were well presented. Residents were able to choose to take their meals in the dining room or in the privacy of their own room. Residents spoken with said that they liked their rooms and those seen contained many personal items such as pictures, ornaments and small items of furniture. Residents said that they felt any complaints would be taken seriously and acted upon quickly. All said that they had no reason to make a complaint. Staff had received training in the prevention of abuse and knew the procedures to follow should abuse be suspected. The deputy manager said that staffing levels were flexible to meet the changing level of care needs of the residents. Residents spoken with said that they felt there were sufficient staff on duty, as they did not have to wait long when they requested assistance. A high percentage of the care staff have obtained a National Vocational Qualification ( NVQ) level 2 or above. Staff said that they were encouraged to attend training sessions and records seen indicated that they are receiving the training required to meet the residents’ care needs. The Grange Nursing Home DS0000011449.V319547.R01.S.doc Version 5.2 Page 7 The home follows robust procedures when recruiting staff. Criminal Records Bureau (CRB) and Protection of Vulnerable Adults (POVA) checks are completed before staff commence work at the home to protect the safety of the residents. Residents said that they felt they were involved in the running of the home and were able to give their views on the quality of care provided through resident and relatives meetings and one to one talks with the registered manager or deputy. 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 summary of this inspection report can be made available in other formats on request. The Grange Nursing Home DS0000011449.V319547.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 DS0000011449.V319547.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. No one is admitted to the home without a care needs assessment to ensure the home can meet their care needs. Prospective residents are provided with clear information about life at the home, are able to visit before making a decision about taking a place and are given a written contract on admission. The home’s staff work alongside a multi disciplinary team to ensure the care needs of residents admitted for rehabilitation are met. EVIDENCE: The home has a Statement of Purpose and Service User Guide that provide prospective residents with clear information about life at the home. The documents give details of the registered manager’s experience and qualifications and the organisational structure of the home. Comments are included from residents and relatives meetings. A copy of the documents is The Grange Nursing Home DS0000011449.V319547.R01.S.doc Version 5.2 Page 10 kept in each resident’s room and can be provided in large print or on tape should this be requested. Three residents spoken with said that they had been given a copy of the Statement of Purpose and Service User Guide before they moved into the home. One of the residents said that they had found the information helpful and the other two said that their relatives had read and discussed the documents with them. Each resident is provided with a written contract giving the terms and conditions for residency at the home. Contracts seen gave details of the services included in the fees and services available at additional cost such as hairdressing, chiropody, toiletries and newspapers. The three residents spoken with knew that they had contracts but said that they did not wish to be involved as their relatives managed their finances. The deputy manager said that a care needs assessment was undertaken for all prospective residents before a place was offered, to ensure the home can meet their care needs. The five assessments covered all aspects of care needs including personal and emotional care, mobility and medication. Three of the residents said that the registered manager had visited them to do the assessment. Two of the residents said that they had visited the home before they decided to take a place there and the third person said their relatives had visited on their behalf. The home is taking part in a pilot scheme and has six beds dedicated for residents who are admitted for rehabilitation. Multi disciplinary team assessments are undertaken for these residents before they are admitted for a specific time, usually up to six weeks but some for a short period only. The multi disciplinary team includes GPs, district nurses, occupational therapists, physiotherapists and rehabilitation assistants. An assessment seen for one resident admitted for rehabilitation confirmed the multi team working. The Grange Nursing Home DS0000011449.V319547.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, 9,10 and 11 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents felt that their care plans reflected their wishes, their health care needs are met, they are treated with respect and they are protected by staff adhering to the home’s clear procedures for dealing with medication. EVIDENCE: The deputy manager said that the care assessment formed the basis for the individual care plans. Care plans were sampled for five residents with varying levels of care needs. The care plans contained detailed information and included risk assessments for nutrition, moving and handling, pressure area care, communication and psychological well- being. Care plans seen showed evidence of regular review and involvement of residents. Three of the residents spoken with said that the plans had been discussed with them and they agreed they met their care needs. The Grange Nursing Home DS0000011449.V319547.R01.S.doc Version 5.2 Page 12 Records seen indicated that resident’s health care needs were being met. Visits by GPs were recorded and notes for one resident indicated that they were attending an eye clinic. Records for the resident admitted for rehabilitation contained information from the multi disciplinary team. One of the rehabilitation assistants said that they worked alongside the home’s carers so that regimes put in place such as simple physiotherapy exercises could be undertaken by the care staff when the rehabilitation assistants were not on duty. The home has clear procedures in place for dealing with medication. The trained nurse responsible for medicines at the time of the visit said that the trained nurses gave medication. However carers who have received training were able to administer medication alongside the trained nurse, with both signing the medication records. Medication records seen contained a photograph of the resident and had been completed appropriately. Controlled drugs were stored safely and two staff members, as required, had signed records seen for the administration of controlled drugs. Up to date information on medication used in the home was readily available for staff. All the residents spoken with said that staff were very caring and kind and treated them with respect at all times. Staff were seen to knock on doors and wait before entering rooms and spoke to residents in a friendly manner. The home has procedures in place for the care of the dying that indicate care is given sensitively, with relatives able to stay as they wish. Staff have received training in palliative care and bereavement. The Grange Nursing Home DS0000011449.V319547.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 exercise control over their lives, participate in a varied programme of activities, receive visitors as they wish and enjoy a choice of well presented meals served in a relaxed atmosphere. EVIDENCE: The home employs an activities coordinator who has responsibility for the activities programme. The coordinator has received training in providing activities for older persons and those with dementia. Activities offered included quizzes, crafts, poetry and music. Exercise sessions were held on alternate weeks and the activities coordinator said that it was hoped to increase these sessions to weekly. One resident said that she wasn’t able to join in all the activities but ‘did what she could’. Another resident said that he appreciated staff letting him make his own decisions as to whether to join in or not. Three other residents said that they enjoyed the afternoons when videos were showed. The activities coordinator said that some residents were frail and time was spent with them on a one to one basis chatting. The Grange Nursing Home DS0000011449.V319547.R01.S.doc Version 5.2 Page 14 A minister from a local church visits monthly to provide communion for those who wish to participate. Residents spoken with said that their visitors were able to visit as they wished and a visitor said that staff always made them feel welcome at the home. All residents spoken with said that they enjoyed the food provided at the home. The chef said that choices were offered for each meal and menus seen reflected this. On the day of the visit residents had a choice for lunch of lamb hotpot, sweet and sour chicken or omelette with various fillings, with broccoli, cauliflower, sautés potatoes, creamed potatoes, carrots and rice. One resident had chosen to have a salad. Puddings included lemon mousse; jam tart, yoghurt, jelly and ice cream. Meals served were well presented and residents were able to have more if they wished. Residents were able to choose to take their meals in the dining room or in the privacy of their own rooms. Staff were observed supporting residents who required assistance, in a friendly and relaxed manner. The Grange Nursing Home DS0000011449.V319547.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 feel that any complaints will be taken seriously and acted upon quickly and they are protected by staff awareness of the prevention of abuse. EVIDENCE: The home has a complaints procedure that indicates who will investigate the complaint and timescales for resolving the issue. Records seen indicated that all complaints were taken seriously and acted upon quickly. Three residents spoken with said that they knew the home had procedures for dealing with complaints but had never had to use them. All said that if they had any concerns they would discuss them with the registered manager whom they felt would act on the information. Three staff members spoken with were aware of the procedures to follow should abuse be suspected. Records seen indicated that staff had received training in the prevention of abuse and the home had procedures available for staff including Hampshire County Council’s Protection of Vulnerable Adults and Whistle Blowing. Records seen indicated that Criminal Records Bureau (CRB) and Protection of Vulnerable Adult (POVA) checks were completed for staff before they commenced work at the home to protect the safety of the residents. The Grange Nursing Home DS0000011449.V319547.R01.S.doc Version 5.2 Page 16 The Grange Nursing Home DS0000011449.V319547.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, 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 welcoming environment for all who live, work and visit there. EVIDENCE: The Grange is a large purpose built building situated in a residential area of Hedge End, Southampton. The home is close to local shops. Residents are accommodated in twenty- nine single rooms or share one of the seven double rooms. Twenty- four of the single and all of the double rooms have en-suite facilities. The home looked clean, welcoming and well maintained. Residents spoken with said that they liked their rooms. Rooms seen contained many personal items and one resident said that she liked having ‘her own things around her’. One of The Grange Nursing Home DS0000011449.V319547.R01.S.doc Version 5.2 Page 18 the residents who shared a room said that she liked to share and did not wish to move to a single room. Screens were provided in the double rooms to allow for privacy when required. All rooms are provided with lockable storage space and residents are able to have a key to their room door if they wish to do so. The home has a large lounge and dining room and there are also small sitting areas around the home where residents can sit quietly. One resident said that she liked to sit in on of the quiet area when entertaining her visitors. Stairs and passenger lifts provide access to each floor. The home has sufficient bathroom and toilet facilities and those seen looked clean and in good order. Specialist equipment such as hoists and pressure relieving mattresses was available and a staff member said that they had all the equipment required to provide the care for the residents. At the time of the last inspection hot water pipes were not covered. Since then the pipe work has been boxed in to protect the safety of the residents. The home has well maintained gardens that are accessible to residents. Chairs and tables were provided in the garden and one resident said that they enjoyed being out in the garden during good weather. The Grange Nursing Home DS0000011449.V319547.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 met by the skill mix and number of staff employed at the home and they are protected by the robust procedures used when recruiting staff. Staff receive the training they require to do their jobs. EVIDENCE: The home employs the registered manager, deputy manager, ten trained nurses and twenty-seven care staff. Separate staff are employed for administration, catering, domestic and laundry duties. The home also employs a maintenance man. At the time of the visit the deputy manager was on duty together with three trained nurses, nine carers and ancillary staff. Staff spoken with said that they felt there were sufficient staff on duty to provide the care for the residents. Three residents also said that they felt there were sufficient staff and added that they did not have to wait long when they requested assistance. The home has a high percentage of care staff, 81 , who hold a National Vocational Qualification (NVQ) level 2 or above. Staff spoken with said they had been encouraged to obtain qualifications. The home is officially recognised The Grange Nursing Home DS0000011449.V319547.R01.S.doc Version 5.2 Page 20 as a training centre for NVQ training, working alongside a local college. Both the registered manager and the deputy are NVQ assessors. The home has clear procedures for the recruitment of staff. Records seen for three staff members who had commenced employment in the home recently, indicated that the procedures were followed. The deputy manager said that no proof of identity was kept on file but records were kept of the information seen by the registered manager during the recruitment process. CRB and POVA checks had been completed before staff commenced work at the home to protect the safety of the residents. Two staff members spoken with said that they had many opportunities to attend training sessions and had received training in moving and handling, abuse awareness, infection control, dementia awareness, health and safety and first aid. A trained nurse said that she was able to attend training sessions to keep her professional development up to date as required by a trained nurse. Records seen indicated that staff also attended training in wound care, bereavement, risk assessment and medication. The Grange Nursing Home DS0000011449.V319547.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 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 run in the best interests of the residents who feel able to give their views on the quality of care provided. Residents are financial interests are safeguarded by the home’s clear procedures for handling money and they are protected by the supervision of staff and the safe working practices operated at the home. EVIDENCE: The registered manager of the home Mrs Carolyn Ryves, is a trained nurse who holds NVQ level 4 in management and the Registered Managers Award. Mrs Ryves is also an NVQ assessor and has been the manager of the home since 2001. The Grange Nursing Home DS0000011449.V319547.R01.S.doc Version 5.2 Page 22 The deputy manager is also a trained nurse holding the same qualifications. Staff spoken with said that the registered manager and the deputy manager were very supportive. Residents and visitors also said that they felt supported by the management team with one resident saying ‘ I can talk to them about anything’. Residents spoken with said that they felt involved with the running of the home, through group meetings with relatives and one to one discussions with the registered manager or deputy. A staff member said that they attended staff meetings where they were able to discuss the quality of care provided at the home. Records seen confirmed that the meetings took place and that feedback was given to residents, relatives and staff. The home does not hold any money for residents. Any costs incurred for services such as hairdressing and chiropody are invoiced to the resident or the person responsible for their finances. Staff members spoken with said that they received regular supervision that covered all aspects of their work and personal development. Records seen confirmed this. The records were only signed by the supervisor and should also be signed by the staff member being supervised to confirm they agree with the records. The registered manager and the deputy supervise the trained nurses who in turn supervise the care staff. Staff had received training in providing supervision for care staff. During the visit staff were observed to use safe working practices, using specialist equipment such as hoists when necessary and wearing disposable aprons and gloves as required to minimise the risk of cross infection. The home has policies and procedures relating to Health and Safety and information were displayed around the home. Records seen indicated that staff had received training in health and safety. Hazardous substances such as cleaning fluids were stored securely. The kitchen looked very clean and in good order with food stored appropriately. Records seen confirmed that staff preparing food had received training in food hygiene. Certificates and records seen indicated that regular servicing and maintenance took place for specialist equipment, lifts, call alarm system and utilities of gas, electric and water. The home has a fire risk assessment in place and records seen indicated that staff received fire safety training. The Grange Nursing Home DS0000011449.V319547.R01.S.doc Version 5.2 Page 23 The Grange Nursing Home DS0000011449.V319547.R01.S.doc Version 5.2 Page 24 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 3 HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 3 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 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 3 x 3 3 x 3 The Grange Nursing Home DS0000011449.V319547.R01.S.doc Version 5.2 Page 25 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 DS0000011449.V319547.R01.S.doc Version 5.2 Page 26 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 DS0000011449.V319547.R01.S.doc Version 5.2 Page 27 - 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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