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Inspection on 16/06/05 for The Grange Nursing & Residential Home

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

This inspection was carried out on 16th June 2005.

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

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

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

What the care home does well

What has improved since the last inspection?

The requirements from the last inspections have been met. The home has had new furnishings, decor and equipment installed such as Kylies and hoists. The home has had structural works carried out such as a new roof.

What the care home could do better:

The management team must ensure that health and safety of residents and staff is not compromised, relating to the equipment kept in the bathroom, this should be stored securely and appropriately. The management team should regularly check the home to ensure that trailing cables and wires do not cause any risk to residents and staff at all times.

CARE HOMES FOR OLDER PEOPLE The Grange Nursing & Residential Home Smeeton Road Saddington Leicester LE8 0QT Lead Inspector Rajsheree Mistry Unannounced 16 June 2005, 9:50am 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 & Residential Home C51 C08 S60078 The Grange Nursing Residential Home V233272 140605 Stage 4 .doc Version 1.30 Page 3 SERVICE INFORMATION Name of service The Grange Nursing & Residential Home Address Smeeton Road Sadington Leicester LE8 0QT 0116 2402264 0116 2404420 None Mr Banesh Laximilall Bhatool 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) Mrs Stephanie Anne Reed Care Home 40 Category(ies) of OP Old age 65 Years and over 40 registration, with number PD Physical disability18 Years - 65 Years 12 of places PD(E) Physical dis - over 65 65 Years and over 40 The Grange Nursing & Residential Home C51 C08 S60078 The Grange Nursing Residential Home V233272 140605 Stage 4 .doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: No person under the age of 55yrs falling within category PD (physical Disability) may be admitted to the home. The home may admit the person of category PD (Physical Disability) named in registration variation application number V41794 dated 7th January 2003. Date of last inspection 12th January 2005 Brief Description of the Service: The Grange Nursing and Residential Home is registered to accommodate upto forty older people, within the categories of older persons and physical disability. The home is located in quiet village of Saddington, Leicestershire, near to adjoining the villages of Great Glen, Kibworth Beauchamp and Fleckney. The home benefits from a village setting in pleasant surroundings. Car parking facilities are available to the rear of the home. The home is approximately 12 miles from Leicester Cuty centre and accessible by car. The home is a large, traditional style house with bedrooms on two floors. The upper floor accessible by stairs, stair lift or the passenger lift located at the centre of the home. The home has 23 single rooms and 8 double rooms of which two rooms have ensuite facilities. There are two large comfortable lounges and the dining area is situated off the main lounge. The staff team consists of trained nurses and care staff providing nursing and personal care to residents. The Grange Nursing & Residential Home C51 C08 S60078 The Grange Nursing Residential Home V233272 140605 Stage 4 .doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced inspection that took place from 9.50am on 16th June 2005 and lasted for 6 hours. The method of inspection consisted of a tour of the home, communal areas, three residents’ rooms and examination of the health and safety records for the home. Four residents were spoken with and observed, specifically to look at their lifestyle at the home and how their care needs were met. Individual plans of care and relevant care records were examined. Comments from residents were all very positive. Staff on duty talked about the provision of care and support in the home and were also observed how they delivered the care needs of the residents. Residents were observed engaging with the staff and health care professionals and going about their daily activities and routines. Towards the latter part of the inspection visit, time was spent with the Registered Provider and Senior Nurse in Charge, discussing some of the findings, information received and observations made. What the service does well: What has improved since the last inspection? The requirements from the last inspections have been met. The home has had new furnishings, decor and equipment installed such as Kylies and hoists. The home has had structural works carried out such as a new roof. The Grange Nursing & Residential Home C51 C08 S60078 The Grange Nursing Residential Home V233272 140605 Stage 4 .doc Version 1.30 Page 6 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 & Residential Home C51 C08 S60078 The Grange Nursing Residential Home V233272 140605 Stage 4 .doc Version 1.30 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 Standards Statutory Requirements Identified During the Inspection The Grange Nursing & Residential Home C51 C08 S60078 The Grange Nursing Residential Home V233272 140605 Stage 4 .doc Version 1.30 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 standard(s) 1, 3 Residents’ needs are assessed and individually tailored to ensure that these will be met when they live at the home. EVIDENCE: There is a comprehensive Statement of Purpose and Service Users’ Guide available to prospective residents. The information is clear and has been updated to reflected changes in the home, which is made available to the prospective resident at the first meeting, prior to moving to the home. Four care files of residents tracked, contained assessments that had been completed by the home’s manager and the admission procedure. These files contained comprehensive information, including prescribed nursing care tasks to maintain the residents wellbeing and promote their independence. Areas covered in the risk assessments included mobility, self-care, continence, medication and interests amongst other headings. Residents are consulted about the care to be provided as part of the agreement. The Grange Nursing & Residential Home C51 C08 S60078 The Grange Nursing Residential Home V233272 140605 Stage 4 .doc Version 1.30 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 standard(s) 7, 9 Residents are well looked after having their choice of lifestyle, health and social care needs met. EVIDENCE: Four residents files examined were, of which two were examined together with the residents. The files contained detailed information about the residents’ life, choice of lifestyle, work, family and their tailored plan of care. The risk assessments are in place, which were reflected in the plan of care. These included moving and handling and the use of bed rails. Residents that spoke to the Inspector and records viewed, indicated that they are reviewed regularly in consultation with the resident. Residents’ personal care needs met are recorded in the daily records along with any nursing care needs met, such as the visit by the Community Nurse and the Chiropodist on the day of the inspection. Residents who spoke with the Inspector stated that their health care needs are fully met. Medication is stored in a locked cabinet in the office. Procedures for receiving, storage, administering and returns were examined along with the records with the medication for four residents and found accurate. Trained staff administers medication at all times. Residents spoken with said that they receive their medication on time. The Grange Nursing & Residential Home C51 C08 S60078 The Grange Nursing Residential Home V233272 140605 Stage 4 .doc Version 1.30 Page 10 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 13, 15 All residents are able to maintain contact with families and friends. The home offers a good choice of meals to suit any special dietary needs. EVIDENCE: Residents may receive visitors at any time and may have a meal. Residents maintain good links with family, friends and the local community. All residents spoken with stated that they are able to receive visitors at any reasonable time and often are taken out by family. Four residents showed the Inspector their rooms, of which one couple had a double room. There was sufficient furniture in their rooms to enable them to ensure privacy during visits. The meals are prepared on the premises by trained cook. The daily menu is displayed on the notice board in the lounge, indicating a choice of breakfast, lunch and evening meals. The home can accommodate any special dietary and cultural requirements. One resident is provided with a culturally appropriate Asian diet, which is reflected in the individual plan of care. Residents spoken with were satisfied with the choice meals and stated, meals are offered to their visiting relatives. Drinks and snacks are available throughout the day. The Grange Nursing & Residential Home C51 C08 S60078 The Grange Nursing Residential Home V233272 140605 Stage 4 .doc Version 1.30 Page 11 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 16, 18 The complaints policy and procedures is robust, clear and accessible to all. Residents feel able to complain and are protected from abuse. EVIDENCE: The home’s complaints procedure is displayed on the notice board in the main reception and included in the service user guide, which is given to all residents. Residents spoken with were aware of whom to contact and speak with should they have any concerns. The summary of complaints log folder was viewed by the Inspector and found accessible and up to date. Residents spoken with felt they were safe and protected. The home’s manager has recently updated the policy and procedure on the protection of vulnerable adult from abuse and staff have received training recently. Three staff spoken with had a good understanding the procedure to follow in accordance with adult protection issues and whistle blowing. The Grange Nursing & Residential Home C51 C08 S60078 The Grange Nursing Residential Home V233272 140605 Stage 4 .doc Version 1.30 Page 12 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 19, 22, 26 Residents live in a safe, homely and well-maintained environment that is kept clean and tidy. EVIDENCE: The home is well maintained and pleasantly decorated. The premises are fully accessible having a stair lift to the first floor and a passenger lift. The home has two large lounges and a dining room that looks out on to the garden. All four residents who spoke with the inspector stated that they liked their rooms. One resident who was resting in bed said she has a special mattress to prevent sores occurring. During the tour of the home the Inspector noted that specialist equipment was available such as Kylies and hoists. The Inspector was shown all three rooms and they were pleasant, well appointed and personalised with furniture, belongings and décor. All bedrooms, bath/shower and toilet facilities are fitted with a nurse call bell system. Staff were observed responding to the nurse call bells promptly. The home was clean and tidy on the day of the inspection. The Grange Nursing & Residential Home C51 C08 S60078 The Grange Nursing Residential Home V233272 140605 Stage 4 .doc Version 1.30 Page 13 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) 27, 29, 30 Residents’ needs are met by trained staff that are sufficient in number and competent. EVIDENCE: The staffing structure is set out in the home’s statement of purpose. The staff rota for the day was examined was reflective of the staff on duty including the arrangements made to cover staff sickness. Observations made during the inspection indicated that the staff were responding to residents needs and promptly. The management team has a robust recruitment procedure. Two staff files were examined that demonstrated the procedures being followed and appropriate checks in place, including nursing qualifications and PIN numbers. The training records contained evidence of the training undertaken in addition to the induction training which includes health and safety, medication, food hygiene, adult protection, care practice, challenging behaviour. The home’s manager maintains a staff-training matrix used to match key workers with residents and to ensure staff receive timely refresher training. On the day of the inspection staff from college were visiting to register eight staff to commence the National Vocational Qualification level 2. The Grange Nursing & Residential Home C51 C08 S60078 The Grange Nursing Residential Home V233272 140605 Stage 4 .doc Version 1.30 Page 14 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) 37, 38 The health, safety and welfare of residents and staff are well promoted and protected. EVIDENCE: The home’s policies and procedures are annually reviewed and staff are informed through the staff meetings and one-to-one supervision meetings. Staff can access the home’s policies and procedures that are located in the staff areas and offices. During the tour of the home fire exits were clearly marked and were not obstructed. Notices are displayed throughout the home to draw attention to health and safety. Bedrooms were spacious to accommodate equipment used by residents. Risk assessments were in place for residents requiring the use of a hoist or using wheelchairs, walking aids, and pressure relieving equipment. Radiator guards identified as a requirement at the last inspection have been installed to the high-risk radiators. The programme to install the remainder of The Grange Nursing & Residential Home C51 C08 S60078 The Grange Nursing Residential Home V233272 140605 Stage 4 .doc Version 1.30 Page 15 the radiator guards in ongoing. One bathroom viewed on the first floor was also being used to store equipment inappropriately and unsafely. The Fire Officer inspected the home in January 2005 and deemed the home to be safe. Records of tests to fire safety equipment, lighting and alarms were in good order and health and safety issues were well documented. There is a programme of maintenance and testing of all equipment in the home and a sample viewed found records were up to date. It was observed that a cable for charging the stand-aid was trailing across the corridor on the first floor, which causes a potential risk to residents and staff that was raised with the Senior Nurse on duty. The Grange Nursing & Residential Home C51 C08 S60078 The Grange Nursing Residential Home V233272 140605 Stage 4 .doc Version 1.30 Page 16 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 x 3 x x N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 x 9 3 10 x 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 x 13 3 14 x 15 3 COMPLAINTS AND PROTECTION 3 x x 3 x x x 3 STAFFING Standard No Score 27 3 28 x 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x 3 x x x x x x 3 2 The Grange Nursing & Residential Home C51 C08 S60078 The Grange Nursing Residential Home V233272 140605 Stage 4 .doc Version 1.30 Page 17 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 OP38 Regulation 13(4)(b) Requirement The Registered Provider must ensure that equipment found in the bathroom is stored appropriately and securely without posing risk to residents and staff. Timescale for action Immediate and ongoing 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 OP38 Good Practice Recommendations The Registered Provider should regularly check the home to ensure that trailing cables or wires do not cause risks to residents and staff at all times. The Grange Nursing & Residential Home C51 C08 S60078 The Grange Nursing Residential Home V233272 140605 Stage 4 .doc Version 1.30 Page 18 Commission for Social Care Inspection First Floor Newland House Campbell Square Northampton NN1 3EB 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. Extracts may not be used or reproduced without the express permission of CSCI The Grange Nursing & Residential Home C51 C08 S60078 The Grange Nursing Residential Home V233272 140605 Stage 4 .doc Version 1.30 Page 19 - 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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