Inspection on 09/09/05 for The Grange Nursing Home

This inspection was carried out on 9th September 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

The Grange Nursing Home 18/03/09

The Grange Nursing Home 22/03/07

The Grange Nursing Home 27/01/06

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 Hants RG24 9HX Lead Inspector Marilyn Lewis Unannounced 10:00 a.m. 9 September 2005 th 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 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 H54 S12148 The Grange St J v242660 090905.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service The Grange Nursing Home Address Vyne Road Sherborne St John Basingstoke Hants RG24 9HX Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) 01256 851191 01256 851121 Britaniascheme Ltd Mrs Maureen Rowsell CRH 28 Category(ies) of OP Old age PD Physical disability PD(E) Physical registration, with number disability - over 65 of places The Grange Nursing Home H54 S12148 The Grange St J v242660 090905.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: A maximum of 6 service users may be accommodated at any one time in the PD category between the ages of 50-64 years Date of last inspection 9th December 2004 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 H54 S12148 The Grange St J v242660 090905.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place on the 9th September 2005. On the day of the inspection the registered manager and deputy manager were not on duty and the administrator and the nursing director of the company, who was visiting the home, assisted with the inspection process. The inspector toured the home and met with eight residents, two visitors and three staff members. Three individual care plans were sampled and records seen for staff recruitment, medication, fire safety and fire drills, complaints and duty rotas. Service users at the home wish to be known as residents and this has been respected in this report. What the service does well: The home looked clean and welcoming and there was a relaxed atmosphere. Building work taking place to enlarge the lounge on the ground floor by adding a conservatory, meant that the residents were unable to use the large lounge for a short time while the conservatory was being erected and the room redecorated and refurbished. Residents spoken to said they were looking forward to the extra communal space. Prospective residents and their relatives are provided with clear information about life at the home and can visit before making a decision about taking a place there. No one is admitted without a full care needs assessment ensuring the home can fully meet their care needs. Good care plans and liaison with GPs and other health professionals, provide staff with the information they need to fully support the residents, who are treated with respect at all times. Residents are protected by the homes’ procedures for dealing with medicines. Residents are able to choose to participate in the wide range of activities on offer and are able to receive visits from relatives and friends as they wish. The Grange Nursing Home H54 S12148 The Grange St J v242660 090905.doc Version 1.40 Page 6 Residents are offered a choice of interesting, nutritious meals. Residents know that any complaints will be taken seriously and acted upon and are protected by the homes’ procedures to be followed should abuse be suspected. The home provides a clean, safe environment with specialist equipment, communal rooms, attractive gardens, sufficient bathroom and toilet facilities and suitable, personalised bedrooms. Residents are protected homes’ robust recruitment procedures. The registered manager has the qualifications and experience required to manage the home and offers staff support and encouragement. Residents’ financial interests are safeguarded by the homes’ clear finance procedures. Residents are protected by the homes robust recruitment procedures and safe working practices. What has improved since the last inspection? What they could do better: The complaints procedures contained in the service user guide need to clearly indicate that any complaints can be referred to the Commission at any time. Please contact the provider for advice of actions taken in response to this The Grange Nursing Home H54 S12148 The Grange St J v242660 090905.doc Version 1.40 Page 7 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 H54 S12148 The Grange St J v242660 090905.doc Version 1.40 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 Standards Statutory Requirements Identified During the Inspection The Grange Nursing Home H54 S12148 The Grange St J v242660 090905.doc Version 1.40 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 1, 2, 3, 4, 5 and 6 Residents and their relatives are provided with clear information about life at the home and are able to visit before making a decision about taking a place. No one is admitted to the home without a full needs assessment, ensuring the home can meet their care needs. EVIDENCE: The home has a statement of purpose and service user guide that provides prospective residents and their relatives with clear information about life at the home. The documents include the aims and objectives of the home, such as respecting and recognising the cultural needs of all individuals, the qualifications and experience of the registered manager and the criteria for admission. The information is provided in an easy to read format and a colour welcome brochure with photographs of the home, is also included. Each resident is given a written contract that provides the terms and conditions for living at the home. Details of the services included in the fees are noted and the services available at additional cost, such as hairdressing, newspapers and toiletries. The Grange Nursing Home H54 S12148 The Grange St J v242660 090905.doc Version 1.40 Page 10 A full needs assessment is undertaken by the registered manager for each prospective resident before a place at the home is offered. The assessment covers all aspects of care including communication, mobility, personal and social care needs. The past medical history and any hobbies and interests are included in the assessment. Relevant information from care managers and health professionals is included in the completed assessment report. Relatives are encouraged to participate in the assessment process. The registered manager is a trained nurse with many years experience in providing nursing care in a residential setting. Staff at the home receive training in all aspects of care provision. Three care plans seen indicated that advice is sought from GPs and health professionals, such as physiotherapists, as required. Prospective residents and their relatives are able to visit the home and meet staff and residents, before making a decision about taking a room there. The home does not provide intermediate care and therefore standard six does not apply. The Grange Nursing Home H54 S12148 The Grange St J v242660 090905.doc Version 1.40 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 7, 8, 9 and 10 Good care plans provide staff with the information they require to fully support the residents who are treated with respect and are protected by the homes’ clear procedures for dealing with medicines. EVIDENCE: The full care needs assessment forms the basis for the individual care plans. The information contained in the three care plans sampled was good and plans were provided for all care needs identified in the assessments, including nutrition, pressure area care and mobility. The plans contained risk assessments for manual handling and falls. Residents or their relatives had signed consent forms for the use of bed rails and for the ability to hold keys for their room. Records seen contained advice given by GPs and district nurses and one contained an exercise programme provided by a physiotherapist. One resident had visited an optician at a local clinic and dentists visit the home as required. Four of the carers in the home have been trained to provide foot care and chiropodists visit regularly. The Grange Nursing Home H54 S12148 The Grange St J v242660 090905.doc Version 1.40 Page 12 The home has procedures in place for dealing with medicines. Trained nurses are assessed by the registered manager before they are able to administer the medication alone. Medication records seen had been completed appropriately. Records seen for a controlled medicine matched the stock held. Up to date information on the medicines used at the home was available to staff. Three containers of a medicine were in the medicine cupboard but the resident was no longer prescribed the medication. One of the bottles had been opened and dated and was now past its’ date for use. During the inspection staff spoke to residents in a friendly, respectful manner and were seen to knock on doors and wait before entering rooms. Four residents spoken to said that staff were very caring and always treated them with respect. The Grange Nursing Home H54 S12148 The Grange St J v242660 090905.doc Version 1.40 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12, 13, 14 and 15 Residents are able to exercise control over their lives and can choose to participate in a wide range of suitable activities, receive visits from relatives and friends as they wish and enjoy a choice of nutritious meals. EVIDENCE: The home employs an activities co-ordinator who is responsible for providing a programme of activities for the residents. Activities included table games, bingo, quizzes, carpet bowls and current affairs discussions. A fete had been held in July and the funds raised were used to provide trips out for pub lunches and visits to the theatre and to cover the cost of visiting entertainers. Recent entertainers included a harpist and a guitarist. A local Silver Band and the Salvation Army visit regularly. Two residents commented on their enjoyment of an outing, the previous day, to Woking for a trip on a boat, with a picnic lunch provided by the home. A resident said that she appreciated ‘being able to join in when she wanted to but could spend time on her own as she wished’ Local ministers and priests visit the home and a communion service is held monthly for those who wish to attend. The homes’ statement of purpose says The Grange Nursing Home H54 S12148 The Grange St J v242660 090905.doc Version 1.40 Page 14 that ministers from any denomination will be contacted if requested by a resident. Visitors are welcome at the home at any time. Two people visiting at the time of the inspection said that they had been made to feel very welcome by staff. It was evident during the inspection visit that residents were able to exercise control over their lives. Many of the residents chose to take their lunch in the dining room but some preferred to eat in their room. Residents likes and dislikes for daily living activities were noted in their care plans, including the time they wished to get up and retire. Records were kept of the property residents brought into the home with them. Menus seen indicated that residents were offered a choice of nutritious meals. Lunch for the day was fish or pasty with chips or mashed potato and peas, or ham salad, followed by rice pudding or fruit salad. Supper that evening was a choice of bacon, egg and waffles, beans on toast or sandwiches. A staff member discussed the options with the residents and organised their preferred meals. The meals served at lunch were well presented and five residents in the dining room, said that the food provided was good, with one commenting ‘the food is always excellent’. The Grange Nursing Home H54 S12148 The Grange St J v242660 090905.doc Version 1.40 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 inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 16,17 and 18 Residents know that any complaints will be taken seriously and acted upon, have their legal rights protected and are safeguarded by the homes’ procedures for dealing with suspected abuse. EVIDENCE: The home has a complaints policy in place that indicates who will investigate the complaint and timescales for the process. The complaints records indicated that all complaints are taken seriously and investigated promptly. The complaints procedure contained in the service user guide did not clearly state that the Commission could be contacted at any time in the process. The nursing director arranged for this to be altered during the inspection visit. A resident spoken to about making a complaint, knew how to make one but did not feel there would be the need. Daily records seen for one resident recorded that the person had attended a local polling station to cast their vote during the general election held earlier in the year. Advice on advocacy services is sought from care managers or organisations such as Age Concern. The home has procedures in place to be followed should abuse be suspected and leaflets on abuse issues are available on the main notice board and in the Information folder on display in the small lounge. Two members of staff asked, knew about the homes’ procedures for suspected abuse and indicated that they would report any concerns. The Grange Nursing Home H54 S12148 The Grange St J v242660 090905.doc Version 1.40 Page 16 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 standard(s) 19, 20, 21, 22, 23, 24, 25 and 26 The provision of a safe, clean home with communal rooms that are being enlarged, attractive gardens, sufficient bathroom and toilet facilities, specialist equipment and personalised, suitable bedrooms gives a pleasant environment for all who live and work there. EVIDENCE: Building work is currently underway at the home to enlarge the communal area on the ground floor by adding a conservatory to the large lounge. The foundations have been laid and the conservatory is due to be erected in the next few days. Plans are also in place for a conservatory to be added to the dining room. It is not possible for residents to use the large lounge while the work is taking place and the room is being redecorated and refurbished once the conservatory has been completed. Residents are using the small lounge situated on the first floor, or spending time in their rooms. Those spoken to about the building work said that it had not caused any problems and that they were looking forward to the extra space when it was finished. The Grange Nursing Home H54 S12148 The Grange St J v242660 090905.doc Version 1.40 Page 17 Since the last inspection a room that had been a double room has been made into a single room. This has reduced the number of persons to be accommodated from twenty-eight to twenty-seven. Five other residents’ rooms have been redecorated and provided with new soft furnishings. All interior doors have been painted and magnetic closures have been fitted to the small lounge, nurses station and laundry room. The home employs a maintenance man for routine repair and redecoration of the home. On the day of the inspection the home looked clean and welcoming. All visitors to the home have to request entry by ringing the doorbell and are required to sign the visitor record book on entering and leaving the property. A passenger lift and two stairways allow residents access to the ground and first floor of the home where the bedrooms, lounges, dining room and bathroom/toilet facilities are situated. The top floor is accesses via a stairway and is used for administration. There is also a nurses rest room/training/meeting room on this floor. The home has sufficient bathroom and toilet facilities and on the day of the inspection they looked clean and in good order. Specialist equipment such as hoists is provided to assist residents with poor mobility and ramps and grab rails are fitted where required. A call alarm system is available in all rooms used by residents and at the time of the inspection alarm call bells were seen to be available and within reach of residents. Staff were seen to respond quickly to alarm calls. Residents’ rooms are suitable for their needs and those seen looked homely and contained many personal items such as photographs, ornaments and small items of furniture. Two residents in their rooms at the time of the Inspectors’ tour of the home, said that they liked their rooms very much and appreciated having their personal belongings around them. The laundry room is situated on the ground floor. When the laundry assistant is not in the room the door is kept shut. The room looked clean and laundry appeared to be being handled appropriately. Disposable gloves and aprons were readily available for staff. The Grange Nursing Home H54 S12148 The Grange St J v242660 090905.doc Version 1.40 Page 18 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 considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 29 Residents are protected by the homes’ robust recruitment procedures. EVIDENCE: Records were seen for three staff members who had recently been employed at the home. The records contained a suitable application form, two written references and proof of identity. Criminal Records Bureau and Protection of Vulnerable Adult checks had been completed for the three staff members. However records indicated that one of the staff members had commenced work at the home a few days prior to the checks being completed. The staff member was a laundry assistant who has minimal contact with residents and had come into the home for orientation. She was supervised throughout the visit. The Grange Nursing Home H54 S12148 The Grange St J v242660 090905.doc Version 1.40 Page 19 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 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31, 35 and 38 The registered manager has the qualifications and experience required to manage the home and residents are protected by the homes’ financial procedures and safe working practices. EVIDENCE: The registered manager is a trained nurse, who holds the Registered Managers Award and has experience in providing nursing care in a residential setting. She was the assistant manager of the home for two years before taking up the post of manager in 1991. Staff spoken to during the inspection said that Mrs Rowsell was very supportive and encouraged them to attend training sessions and gain qualifications. The home keeps small amounts of monies for residents at the home. The monies are kept individually and stored securely. Receipts are kept for transactions and records seen for three residents matched the balance held. The Grange Nursing Home H54 S12148 The Grange St J v242660 090905.doc Version 1.40 Page 20 During the tour of the home it was noted that hazardous substances such as cleaning fluids were stored securely and information was available for products used at the home. On the day of the inspection the kitchen looked clean and food was stored appropriately. The temperatures of the fridges and freezers were being monitored and recorded. Records seen indicated that staff received fire safety training and attended fire drills. Regular checks were made on fire safety equipment. The Grange Nursing Home H54 S12148 The Grange St J v242660 090905.doc Version 1.40 Page 21 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score 3 3 3 3 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 3 3 3 3 3 3 3 3 STAFFING Standard No Score 27 x 28 x 29 3 30 x MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 3 3 3 x x x 3 x x 3 The Grange Nursing Home H54 S12148 The Grange St J v242660 090905.doc Version 1.40 Page 22 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. 1. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard Good Practice Recommendations The Grange Nursing Home H54 S12148 The Grange St J v242660 090905.doc Version 1.40 Page 23 Commission for Social Care Inspection 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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