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Inspection on 25/05/06 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 25th May 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. 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 found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

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

Residents` needs are assessed prior to admission to the home. Care plans are comprehensive and most are regularly reviewed.

What has improved since the last inspection?

The home has received registration for an extra fourteen beds.

What the care home could do better:

Standards of care have fallen since the last inspection. Residents reported that staff are caring and dedicated however morale is low and the home is poorly managed. The registered manager resigned her post recently and evidence found supported that nurses were expected to fulfil all management duties including rosters, supervision, and mentoring of new staff whilst being counted into the staff numbers. Minimal support or time had been allowed to update care plans and it was reported that care plans are being updated after shifts have finished.The registered provider must appoint a manager as soon as possible to ensure that the home is run with the best interests of residents in mind. Staffing levels must reflect the needs of the residents. Staff must be provided with training which is relevant to categories of residents accommodated and staff should be regularly supervised and monitored by a senior member of staff to ensure that their practice is safe and appropriate. New staff should have a period of supernumerary induction before commencement of work and directly caring for residents. Due regard should be given to staffs ability to communicate with residents prior to appointment. Staff, residents` and stakeholders must be given the opportunity to express concerns and views about the home and have the confidence that timely action will be taken and without fear of notice being served. Senior staff must be given the time, staff and resources to ensure that outcomes for residents are positive. Residents and staff must be given the opportunity to raise concerns and views without fear of reprisal from the owner.

CARE HOMES FOR OLDER PEOPLE The Grange Nursing & Residential Home Smeeton Road Saddington Leicester Leicestershire LE8 0QT Lead Inspector Mrs Gillian Adkin Unannounced Inspection 25th May 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 & Residential Home DS0000060078.V296379.R02.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 & Residential Home DS0000060078.V296379.R02.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service The Grange Nursing & Residential Home Address Smeeton Road Saddington Leicester Leicestershire LE8 0QT 0116 2402264 0116 2404888 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) Mr Banesh Laxmilall Bhatoolall ** Post Vacant *** Care Home 52 Category(ies) of Old age, not falling within any other category registration, with number (52), Physical disability (12), Physical disability of places over 65 years of age (52) The Grange Nursing & Residential Home DS0000060078.V296379.R02.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. No person under the age of 55 falling within category PD (physical Disability) may be admitted to the home. 4th January 2006 Date of last inspection Brief Description of the Service: The Grange Nursing and Residential Home is registered to accommodate up to forty older people, within the categories of older persons and physical disability. The home is located in the village of Saddington, Leicestershire and is approximately 12 miles from Leicester City centre. It is accessible by public transport. Car parking is available at the home. The home is a large, traditional style house with bedrooms on two floors. The upper floor is accessible by stairs, stair lift or the passenger lift located at the centre of the home. The home has 38 single rooms and 7 double rooms of which two rooms have en-suite facilities. The home can accommodate up to 52 persons. There are two large comfortable lounges and the dining area is situated off the main lounge. Outside the home are large gardens, which are mainly laid to lawn. The staff team consists of trained nurses and care staff providing nursing and personal care to residents. The manager post is currently vacant. The home has recently been extended to include a further 14 bedrooms which are situated in the old coach house. The new rooms were unoccupied at time of inspection. It was not possible to ascertain the range of fees charged on this occasion. Contact provider for details. The Grange Nursing & Residential Home DS0000060078.V296379.R02.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced inspection conducted by two inspectors following a notification of concern received by the Commission. Concerns raised included: The owners approach, health and safety of persons living in the home, staff group, the environment and training. The primary method of inspection used was ‘case tracking’ which involved selecting four residents and tracking the care they receive through review of their records, discussions with them and with the care staff and observations of care practices. A plan was made prior to the visit in which available information from the previous inspection report and service history was summarised. A number of sources were explored for information to substantiate or not the concerns raised. These also included telephone conversations with a number of persons associated with the home. This inspection indicated mainly poor outcomes for residents. A number of requirements and recommendations were made. What the service does well: What has improved since the last inspection? What they could do better: Standards of care have fallen since the last inspection. Residents reported that staff are caring and dedicated however morale is low and the home is poorly managed. The registered manager resigned her post recently and evidence found supported that nurses were expected to fulfil all management duties including rosters, supervision, and mentoring of new staff whilst being counted into the staff numbers. Minimal support or time had been allowed to update care plans and it was reported that care plans are being updated after shifts have finished. The Grange Nursing & Residential Home DS0000060078.V296379.R02.S.doc Version 5.2 Page 6 The registered provider must appoint a manager as soon as possible to ensure that the home is run with the best interests of residents in mind. Staffing levels must reflect the needs of the residents. Staff must be provided with training which is relevant to categories of residents accommodated and staff should be regularly supervised and monitored by a senior member of staff to ensure that their practice is safe and appropriate. New staff should have a period of supernumerary induction before commencement of work and directly caring for residents. Due regard should be given to staffs ability to communicate with residents prior to appointment. Staff, residents’ and stakeholders must be given the opportunity to express concerns and views about the home and have the confidence that timely action will be taken and without fear of notice being served. Senior staff must be given the time, staff and resources to ensure that outcomes for residents are positive. Residents and staff must be given the opportunity to raise concerns and views without fear of reprisal from the owner. 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 DS0000060078.V296379.R02.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection The Grange Nursing & Residential Home DS0000060078.V296379.R02.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1,2,3 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Residents are not given relevant information prior to admission. Residents’ needs are assessed in order to inform the care planning process. EVIDENCE: Residents who spoke with the inspectors stated that they had not had a statement of purpose (information about the home) one also stated that they had not been involved in the assessment process. Files tracked did not contain contracts or terms and conditions. Useful assessment records were present in all files tracked. Information received from the registered provider after the inspection indicated that information about the home is given during the assessment of prospective residents. The Grange Nursing & Residential Home DS0000060078.V296379.R02.S.doc Version 5.2 Page 9 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,9,10,11 Quality in this outcome area is poor. This judgement has been made using available evidence including a visit to this service. Residents’ health and personal care needs are not consistently or fully met. They are protected by the home’s medication procedure. EVIDENCE: Care plans were inconsistent; some were comprehensive and had been reviewed while others lacked essential information such as weight charts for residents at high risk of pressure sores and specific information on specific conditions for which residents were being treated. One resident who was identified in their assessment as being at high risk of developing a pressure sore had not been referred to a dietician, however she had been prescribed nutritional supplements by the General Practitioner. Residents stated that their health needs are met but staff expressed frustration that they are not able to fully meet their clinical needs. Examples were given of residents who require two staff for moving and handling. This is not currently possible as there is not sufficient staff. New staff were observed The Grange Nursing & Residential Home DS0000060078.V296379.R02.S.doc Version 5.2 Page 10 handling residents on their first day of employment and before training had been given. An incident had been recorded where staff had been found attempting to move a resident without the hoist, this had resulted in the person in charge having to remind staff about the appropriate use of equipment and performing safe moving and handling manoeuvres. Residents spoke very positively about the nursing and care staff. They said that they were treated with respect and dignity and were afforded privacy where appropriate. Residents accomodated during this inspection totalled 28 (14 nursing and 14 residential). Dependency levels were recorded by nurses as 11 Medium 14 High 1 Very High and 2 Low.Most residents required at least one- two members of staff to provide care and assist with mobility. Records regarding residents’ wishes in the event of their death were inconsistent or absent. The care plan of a resident with palliative care needs was inspected, it had no care plan in place to address any end of life decisions. Discussion with a registered nurse about current good practice guidelines indicated limited knowledge. Discussion with nursing staff identified that there were a limited number of qualified staff and time available to ensure plans were updated and reflective of how the home were managing needs. Medication processes were observed and it was found to be stored and administered appropriately. Although some gaps were noted in administration sheets overall medication was well managed. The Grange Nursing & Residential Home DS0000060078.V296379.R02.S.doc Version 5.2 Page 11 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,14,15 Quality in this outcome area is poor. This judgement has been made using available evidence including a visit to this service. Residents do not experience a lifestyle, which meets with their preferences and recreational or cultural needs. Meals provided are not always of a sufficiently good quality to satisfy the preferences and requirements of residents’. EVIDENCE: There was little evidence of activities being provided at the home. On the day of the inspection most residents spent their time watching TV. Those that spoke with the inspectors stated that not much goes on. This was confirmed in residents’ daily records. Staff stated the owner provides six activities per year and the comforts fund pays for another six. Files tracked did contain useful information regarding their religious and cultural needs. Discussions with a number of relatives highlighted that they were concerned that their relatives could not access the gardens at all and never went out. One relative said their relative had told them that they were “bored” and another informed their relative that they were “lonely” Relatives also commented on the lack of time available to staff to provide activities or one to one time for conversation. The Grange Nursing & Residential Home DS0000060078.V296379.R02.S.doc Version 5.2 Page 12 Staff commented on the additional time it took them to respond to requests for attention from residents due to time taken to explain to new staff with language difficulties. Residents stated that they are enabled to maintain contact with family and friends. This was also evident when reading care plans and daily records. Some residents spoken with stated that they are able to make choices where appropriate. Care plans contained some information regarding communication to enable staff to support residents in making choices. Discussions with people associated with the home said that a number of staff were unable to understand residents requests due to language difficulties and two residents’ stated that they have been placed in difficult positions when staff simply “do not understand” their instructions, they both commented on how polite and respectful they were however. When residents were asked about the food the responses included ‘OK’, ‘Alright’, ‘Bland’ and ‘a bloody mess’ “not appropriate” A resident complained to the owner about the food. Evidence obtained during the inspection indicated that specific needs in terms of choice and individual requirements regarding meals provided were not always met and that support with meals was not always offered to those residents’ requiring it. Menus were seen on display in the home during the inspection. No evidence was found to suggest that the views of residents’ or their representatives are sought about the quality of food provided. The Grange Nursing & Residential Home DS0000060078.V296379.R02.S.doc Version 5.2 Page 13 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16,18 Quality in this outcome area is poor. This judgement has been made using available evidence including a visit to this service. Residents do not feel able to complain or are confident that they will be listened to. Recruitment procedures are thorough and protect service users, however staff have not received training relating to adult protection. EVIDENCE: The Commission received four complaints between January 11th and March 13th 2006, in relation to provision of nursing care, quality of staff, and communication in the home, general cleanliness and poor moving and handling practices. One of the complaints was not upheld, two partially upheld and one unresolved. During this inspection one resident informed the inspectors that they did not feel able to raise concerns with the home’s owner. They stated that it would be a ‘waste of time’. The inspectors examined minutes of a management meeting in which the owner stated that he would ‘dismiss without compunction’ any staff found criticising the home to residents’ relatives who then go on to make complaints against the home. Complaints about food recently made resulted in the residents being offered the opportunity to find alternative accommodation. This was repeated during discussion with a relative who had also been given this option in the past. The Grange Nursing & Residential Home DS0000060078.V296379.R02.S.doc Version 5.2 Page 14 A resident spoken with informed the inspector that they had not met the owner yet and would refer any complaints to her son to deal with. A second resident didn’t know anything about the complaints procedure and also said they would inform a relative. A training matrix was displayed on the notice board in the main office and some certificates were seen in staff files. No training of staff had taken place at the home since November 2005 except moving and handling training, which happened in February 2006 inspectors were informed that this was due to a lack of time. All staff files seen contained relevant documents to indicate that residents are protected by the home’s recruitment procedure. Concerns raised with the Commission about the manner in which some staff assisted residents’ was explored by inspectors and also the competency of certain senior staff who because of language and communication issues were allegedly unable to use the telephone. A specific member of staff was identified to inspectors who upon discussion appeared to be able to communicate adequately. The Grange Nursing & Residential Home DS0000060078.V296379.R02.S.doc Version 5.2 Page 15 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19,26 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Areas of the home require attention to make it safe; generally the building is clean and well maintained. EVIDENCE: Inspectors received a conducted tour of the building including the new extension block. The home was clean and generally tidy on the day of the inspection. The inspectors spoke with the domestic on duty who stated that domestic cover is provided every day from eight am until two pm. Residents reported that the home is usually tidy and clean but staff who spoke with the inspectors said they felt that the general upkeep of the home had deteriorated. In the extension it was noted that two carpets were poorly fitted, one window had a broken pane of glass and another had a broken seal. Various items such as furniture and sundries were stored in an area off the corridor near the lift, which could constitute a fire hazard and the owner was advised to either remove the items or update the fire risk assessment. The Grange Nursing & Residential Home DS0000060078.V296379.R02.S.doc Version 5.2 Page 16 The owner stated that all plug sockets and television points were in working order and although it had been indicated (in concerns raised) that furniture and fittings had been delivered to the home which might not have been new or wholly appropriate, no evidence was found to support this allegation. The new extension was not occupied and the owner showed the inspectors the staff kitchenette and bathroom, which is also sited, in the new extension above resident’s rooms. The inspectors were invited to open the fire door, which was fully accessible from the inside; this opens onto the garden area. It was suggested that consideration be given to the provision of a ramp at this door to ensure that staff are able to move residents in wheelchairs easily in the event of a fire and to access the gardens. The Grange Nursing & Residential Home DS0000060078.V296379.R02.S.doc Version 5.2 Page 17 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27,28,29,30 Quality in this outcome area is poor. This judgement has been made using available evidence including a visit to this service. There are insufficient staff and a number are not well trained enough to meet residents’ basic needs. EVIDENCE: Examination of the rota and conversation with residents’ and staff indicated that there was insufficient staff to meet residents’ basic needs. A conversation with a relative confirmed this; it was indicated that regularly specific resident’s are left in bed particularly at weekends and it has been noted that residents are left waiting a long time for drinks or to use the toilet. One resident described how they had to point to the light to make the new staff member aware that they needed it “turning on” after their curtains were closed. Staff rotas seen indicated that staff were included in the regular staff numbers from day one despite not receiving formal induction prior to this. A resident spoken with said “ Staff are always dashing about I don’t think there is enough staff” Another person said “ staff are brilliant but slowly disappearing, they only stay for short periods” Staff files inspected indicated that the induction process in one instance had been completed and signed off in one day. Staff rosters seen indicated that some staff are working long hours and long stretches. Inspectors identified that two night shifts were not covered for the The Grange Nursing & Residential Home DS0000060078.V296379.R02.S.doc Version 5.2 Page 18 following weekend. Internal staff subsequently covered these. The registered nurse on duty stated that he had tried to cover the shifts without success. The inspectors asked that they be notified when the shifts are covered. A fax was received the day after the inspection notifying that internal staff had covered them. A number of staff are employed through recruitment agencies and start work with no formal induction or training. A member of staff who spoke with the inspectors had started work the day of the inspection with no induction and no obvious supervisor. The registered nurse confirmed that he should have been supervising her on her first day but had no time, as he was the only nurse on the floor that day and was attending to nursing duties. Staff files indicated that appropriate references and Criminal Records Bureau checks or equivalent are obtained prior to employment. New staff are required to start work as soon as they arrive and to work long hours. Staff are recruited from recruitment agencies based overseas and residents stated that often they struggle to make their needs known in English. A relative who spoke with the inspectors stated that they had observed communication difficulties with some overseas staff. Staff share accommodation with other staff employed at the home and live in accommodation above the new extension in staff quarters. No residents were occupying this area. No training or supervision of staff had taken place at the home since November 2005 except moving and handling training, which happened in February 2006, inspectors were informed that this was due to a lack of time. Inspectors were informed that it would be unbeneficial to provide supervision, as staff were unable to understand the process due to language difficulties. The inspectors observed staff attempting to hoist a resident who was strapped into her wheelchair, an incident record and a conversation with a resident indicated that staff were lifting residents without the use of any hoist equipment. An example of poor moving and handling practise was witnessed at the last inspection resulting in a requirement being made. Evidence was gathered from a variety of sources including complaints made to indicate that the comprehension and understanding of some staff might impact on how moving and handling manoeuvres are undertaken. Further information was found to suggest that two staff had been reprimanded after moving a resident inappropriately. This had been documented. The Grange Nursing & Residential Home DS0000060078.V296379.R02.S.doc Version 5.2 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 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31,33,38 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The home is not being well run; although senior staff are running the home they do not have the support necessary to ensure that outcomes for residents are always good. EVIDENCE: There is currently no registered manager at the home. Senior staff stated that they feel unsupported and requests for more staff and other resources are ignored. Furthermore a number of staff informed inspectors that they felt unable to air their views with the owner or make complaints due to his unprofessional and unreasonable responses. This information was supported through conversation with others. A number of staff and several residents and relatives said they felt unable to talk to the owner and two people said they “avoided him when he was in the home” wherever possible one said they had had “run ins with him in the past” The Grange Nursing & Residential Home DS0000060078.V296379.R02.S.doc Version 5.2 Page 20 The provider is not monitoring the home by carrying out regular visits to ensure compliance with Regulations (Regulation 26). This includes monthly visits to the home and formal interviews with staff, residents and visitors and report being formalised and a copy sent to the Commission for Social Care Inspection Furthermore no evidence was found to suggest that quality assurance monitoring is being carried out. Written evidence, observation and conversations with staff and residents indicated that moving and handling is not being routinely carried out appropriately. Records regarding health and safety are inadequate. Concerns had been raised indicating that the owner is delivering fire lectures himself. The inspectors did not clarify this point with him during this inspection and no documentary evidence was seen to support this allegation. The Grange Nursing & Residential Home DS0000060078.V296379.R02.S.doc Version 5.2 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 Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 2 2 3 X X X HEALTH AND PERSONAL CARE Standard No Score 7 1 8 1 9 2 10 3 11 2 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 3 15 1 COMPLAINTS AND PROTECTION Standard No Score 16 1 17 X 18 3 2 X X X X X X 3 STAFFING Standard No Score 27 1 28 2 29 2 30 1 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 1 X 2 X X X X 2 The Grange Nursing & Residential Home DS0000060078.V296379.R02.S.doc Version 5.2 Page 22 Are there any outstanding requirements from the last inspection? Yes 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 OP8 Regulation 13(5) Requirement Service users safety must be maintained and promoted by the adoption of correct moving and handling procedures. Residents’ healthcare needs must be recorded and met. Complaints made under the complaints procedure must be fully investigated. An urgent review of staff numbers to take place to ensure that sufficient staff are employed to meet residents’ needs. Timescale for action 30/06/06 2. 3. 4. OP8 OP16 OP27 12 22(3) 18 30/06/06 30/06/06 30/06/06 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 OP1 Good Practice Recommendations Residents should be given a statement of purpose prior to moving into the home. DS0000060078.V296379.R02.S.doc Version 5.2 Page 23 The Grange Nursing & Residential Home 2. 3. 4. 5. 6. 7. 8. 9. 10. 11 12 OP2 OP7 OP9 OP11 OP12 OP19 OP28 OP29 OP30 OP31 OP32 13 14 OP33 OP20 Residents should be given a contract or statement of terms and conditions and a copy is kept on their file. A consistent approach should be adopted to care planning and all plans regularly reviewed. A system should be adopted to ensure that all medication records are checked for missing signatures, the gaps to be rectified soon as discovered. Residents’ needs in the event of their death should be recorded. Residents/advocates should be consulted on the current activity arrangements to establish whether their needs are being met. The fire risk assessment should be updated to include the new extension. An audit should be undertaken of staff qualifications to ensure that at least half are qualified to NVQ 2 or above. New recruits should receive a comprehensive induction prior to starting work. A programme of training for all staff should be implemented with a system for monitoring to ensure staff are using the skills they are given. A manager should be appointed and application to CSCI submitted for registration. The registered person should make arrangements to enable staff to inform the registered person and the Commission of their views about any matter relating to the conduct of the home insofar as it may affect the health or welfare of residents. The view of residents and others should be obtained regularly to ensure the service provided is suitable to meeting their needs. The exterior of the home including the garden area is to be made suitable in order to allow residents to sit outside; this includes those persons who are wheelchair users. The Grange Nursing & Residential Home DS0000060078.V296379.R02.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Leicester Office The Pavilions, 5 Smith Way Grove Park Enderby Leicester LE19 1SX 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 DS0000060078.V296379.R02.S.doc Version 5.2 Page 25 - 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. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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