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Inspection on 31/10/06 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 31st October 2006.

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

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

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

What the care home does well

Residents live in a well maintained home that is clean and brightly lit. The atmosphere and the ambience of the home is relaxed and welcoming. Staff were seen carrying out their daily tasks in a calm manner and without rushing. Residents are involved in making sure staff know what help they need, know about their preferences of meals, routines and interests, such as reading the newspapers or doing the crosswords. Residents receive a good choice of meals and special dietary meals to suit, which are prepared at the home. The residents are offered a range of social and leisure activities and interests both within the home and outside including a church service and can chose to participate.Residents and their relative`s comments, views and opinions are valued and acted upon. Visitors are welcome at the home at any time. All the residents have a named staff known as a `key worker` who are responsible for making sure all aspects of their care and living arrangements are provided. Staff demonstrated a good attitude towards caring for the residents as individual people, who are important. Residents` individual rights and dignity is promoted in the way staff responds. Staff showed they had sound knowledge, practice and provided the clinical treatment that is required.

What has improved since the last inspection?

Since the last inspection, the Grange Nursing & Residential Home has made improvements to address issues identified at last inspection. Additionally, the following improvements and changes have taken place at the home: Appointment of an Acting Manager; Magnetic door holders, which are automatically activated in case of fire; New second passenger lift has been installed; Decoration to the main lounges creating a more spacious feel to the home; `Comment book` and staff photographs with their names and job titles displayed in the improved reception area; Activities Organiser 3 days per week; "Relatives and Representative Survey" have been sent out and responses are due; `Residents / Relatives` meeting are held monthly and recorded; Two pressure-relieving mattresses have been purchased for residents.

What the care home could do better:

This was a positive inspection of the service overall, indicating the residents received good quality of care in home. Residents looked relaxed, moved around the home freely, without restrictions, and received prompt support from staff. The findings of the inspection visit were shared with the Registered Person and the Acting Manager throughout the inspection and concluded at the end of the inspection and were well received.

CARE HOMES FOR OLDER PEOPLE The Grange Nursing & Residential Home Smeeton Road Saddington Leicester Leicestershire LE8 0QT Lead Inspector Rajshree Mistry & Thea Richards Unannounced Inspection 09:00 31 October 2006 st 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.V317418.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. The Grange Nursing & Residential Home DS0000060078.V317418.R01.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.V317418.R01.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. 25th May 2006 Date of last inspection Brief Description of the Service: The Grange Nursing and Residential Home is registered to accommodate up to fifty-two 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 or private transport and there is car parking 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 lifts. The home has 38 single rooms and 7 double rooms. Bathrooms and toilet facilities are located close to the bedrooms and the communal areas. There are two large comfortable lounges and the dining area is situated off the main lounge. All areas of the home are accessible to people using mobility support, aids and equipment. Information about the service is provided to prospective and current residents in the ‘service user guide’. The monthly fees are £300 to £550,which was provided by the Registered Person. There are additional charges for hairdresser, chiropodist and escort fees. The CSCI published inspection report is available at the home. The residents are informed of the findings of the CSCI inspection at the ‘Residents Meetings’ or individually. The Grange Nursing & Residential Home DS0000060078.V317418.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The Commission for Social Care Inspection inspected the Grange Nursing & Residential Home against the Care Standards Act 2000. This was the second key inspection of the Grange Nursing & Residential Home this year that was concluded with an unannounced visit to the home. The inspection method used was ‘Inspecting For Better Lives’, which is based on outcomes for the residents. Comment cards were received from all the residents who were sent the comment cards. Comment cards for General Practitioner’s and District Nurses were left with the Registered Person to give to them respectively. No responses were received from the General Practitioners or the District Nurses at the time of this inspection report being completed. The visit took place on 31st October 2006 from 9.00am and lasted 9 hours. During the course of the inspection, the Inspectors provided the Acting Manager and the Registered Person an overview of the ‘Inspecting for Better Lives’ presentation and answered questions. The method called ‘case tracking’ was used to determine the standard of care provided in the home surroundings. This involved identifying four residents with varying levels of care needs and looking at how these are being met by the staff at the Grange Nursing & Residential Home. Discussions held were residents themselves and other residents; speaking with staff providing the care and nursing tasks; checking records relating to their health and welfare; viewing their personal accommodation (with their consent) as well as communal living areas used. Observations made of how the care staff supported residents participate in the daily activities and decision-making. Checking record relating to the health and safety, staff records, training records and the minutes of the residents meetings and team meetings. What the service does well: Residents live in a well maintained home that is clean and brightly lit. The atmosphere and the ambience of the home is relaxed and welcoming. Staff were seen carrying out their daily tasks in a calm manner and without rushing. Residents are involved in making sure staff know what help they need, know about their preferences of meals, routines and interests, such as reading the newspapers or doing the crosswords. Residents receive a good choice of meals and special dietary meals to suit, which are prepared at the home. The residents are offered a range of social and leisure activities and interests both within the home and outside including a church service and can chose to participate. The Grange Nursing & Residential Home DS0000060078.V317418.R01.S.doc Version 5.2 Page 6 Residents and their relative’s comments, views and opinions are valued and acted upon. Visitors are welcome at the home at any time. All the residents have a named staff known as a ‘key worker’ who are responsible for making sure all aspects of their care and living arrangements are provided. Staff demonstrated a good attitude towards caring for the residents as individual people, who are important. Residents’ individual rights and dignity is promoted in the way staff responds. Staff showed they had sound knowledge, practice and provided the clinical treatment that is required. What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. The Grange Nursing & Residential Home DS0000060078.V317418.R01.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.V317418.R01.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. JUDGEMENT – we looked at outcomes for the following standard(s): 1 and 3. Standard 6 is not applicable. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The assessment process is thorough and involves the residents and/or their family, which ensures their individual care and nursing needs, are met. EVIDENCE: Since the last key inspection, the statement of purpose has been updated. The document sets out details of the type of care that will be provided at the home, the experience and qualifications of the Registered Person, Acting Manager and skills mix of the nursing and care staff group. The document also has the aims and objectives of the home and the key policies, procedures and the complaints procedure, indicating the management and guidance followed. The information is in an easy to read style. The Grange Nursing & Residential Home DS0000060078.V317418.R01.S.doc Version 5.2 Page 9 The Inspectors spoke with the residents who said they and/or their relatives visited the home before moving in. Residents said they were given information about the home and involved in the assessment process. Care records showed an assessment was undertaken identifying the individual care and nursing needs to be met. There was evidence to support that pre-admission assessment had been carried out by the home’s staff. The assessment also included details of the resident’s history affecting their wellbeing, health and the details of who will be meeting the health care needs such as the trained nurse, District Nurse, dietician or the General Practitioner. The care files also contained a copy of the social worker’s assessment of needs, which was part of the referral process. The home does not take emergency admissions or provide intermediate care. The Grange Nursing & Residential Home DS0000060078.V317418.R01.S.doc Version 5.2 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 and 10. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The residents are well cared for having their individual health and daily care needs met that promotes and maintains their independence and lifestyle. EVIDENCE: Residents said they had been asked about their daily routines, the amount of help needed on a daily basis. The care plans seen for the residents were individual, setting out the level assistance and accurately reflected the care and nursing needs of residents. There was clear guidance for staff to provide the care in a way that suited the resident. Residents care plans showed how measures were taken to minimise risks such as moving and handling, falls, special diets, nutrition, and communication. Residents receive health support from District Nurse’s, General Practitioners and records are kept of the visit and treatment given. The visiting chiropodist saw residents in private. The Grange Nursing & Residential Home DS0000060078.V317418.R01.S.doc Version 5.2 Page 11 All the residents have a named care staff responsible for their needs being met. The care staff ensure the resident’s bedroom, clothing are tidy and personal toiletries are available. The care staff reviews each aspect of the care needs with the resident, to ensure the care plans are up to date. The residents said how the staff help them on a daily basis with their personal, nursing care needs, making choices about how they chose to spend the day, to choosing their clothes and meals. Residents were seen throughout the day being treated by staff in a respectful manner and enjoying friendly conversation. Staff addressed residents by their preferred names. The staff described how they encourage residents to maintain as much independence as they are able, such as washing their face. Where residents shared a bedroom, a dividing curtain was seen in use, providing privacy for each resident. The Inspectors noted that call bells rang about three times and were promptly responded to by staff. The trained nurse demonstrated they had sound knowledge and followed current practice when caring for people at risk of developing pressure sores. Special equipment, including the two new pressure-relieving mattresses purchased are available to benefit the residents. The trained nurse said that residents needing continence products were supplied individually and supported by the supply seen in the resident’s bedroom. The Acting Manager was advised that the home’s staff would benefit from liaising with the link nurses for advice, information and training. The medication is stored securely, receipt and storage was checked and confirmed by the trained nurse. Currently medication is dispensed in named individual boxes or packaging stored in a medication trolley. The medication and records were checked for residents tracked, which were complete and accurate. Residents spoken with said they receive their medication on time and this was observed during breakfast and lunchtime. The Acting Manager said that a new contract with a Pharmacist had been arranged to start next month. The Pharmacist will supply individual medication in blistered packs for each resident. The contract will include training of staff, regular audit and equipment. The Grange Nursing & Residential Home DS0000060078.V317418.R01.S.doc Version 5.2 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 and 15. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The residents continue to make choices about daily living and are offered variety of meals, social and cultural activities of interests. EVIDENCE: Residents were seen receiving visitors throughout the day and evidenced by the comments made in the comment book in the new reception. Residents were seen meeting with their visitors in the lounge or in the privacy of their own rooms. Residents care plans viewed showed the involvement from family, and included preferences such as reading newspapers, talking books, crosswords and religious practice. The care plans showed the resident’s cultural needs and special diets such as diabetic or vegetarian meals, required. Residents were aware of their right to look at their care file at any time. The Grange Nursing & Residential Home DS0000060078.V317418.R01.S.doc Version 5.2 Page 13 The home has appointed an Activities Organiser who works three days a week. Activities are planned with the residents’ involvement. On the day of the inspection, the Activities Organiser was seen arranging ‘classical music’ in the music lounge. Residents were asked whether they wish to participate and were assisted into the music lounge. There was documentary evidence recorded in the ‘Entertainments and Activities’ book, which confirmed that residents enjoy a range of activities in the home. Residents were seen reading the daily newspaper, doing crosswords, watching television, listening to music, and speaking with staff and other residents. Residents were seen moving around without restrictions, choosing to sit in the lounge, at the dining table or going to their room. Church services are held on the first Monday of the month with a church group from the local community. Comment cards received from the residents indicated that activities are provided and residents can chose whether to attend. One resident said they enjoyed their birthday celebrations, “. . . a large cake with my name and balloons”. Meals are prepared at the home by the cook. Residents were heard being offered a choice of both main course and dessert - lamb casserole with mint dumplings or fish pie in cheese sauce with vegetables, followed with a selection of deserts, fruit and yoghurt. The meals were served at the table where residents sat, the dining room, lounge or in their bedrooms. The meals looked hot, aromatic, well balanced and appetising. Comments received included “couldn’t be better if she had cooked it herself”. The evidence seen and viewed on the day indicated residents were actively making daily choices about their daily routines, which was consistent with the records. The Grange Nursing & Residential Home DS0000060078.V317418.R01.S.doc Version 5.2 Page 14 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents are protected by a good and accessible complaint procedure and by staff trained in the adult protection procedures. EVIDENCE: Residents are informed of the home’s complaints procedure when the first visit the home and when they move to the home. Details of how to complain are in the home’s brochure. The complaints procedure is displayed on the notice board in the reception area and near the public telephone. Residents told the Inspectors they felt confident to complain to a member of staff, the Acting Manager or through their relatives. Comments received directly from residents and through the comment cards included; “received information about how to complain, but have no reason to complain”; “speak with . . . . ”; . . . . .’s son or daughter will inform the staff or management if they have a complaint”. The Grange Nursing & Residential Home has not received any new complaints since the last inspection. The new ‘comment book’ kept in reception contained comments from visiting relatives, such as general comments, compliments and specific concerns. There was evidence of the comment book being read by the Acting Manager and concerns being addressed promptly. The Commission received two complaints that were referred to the relevant agencies to address directly with the home. The Grange Nursing & Residential Home DS0000060078.V317418.R01.S.doc Version 5.2 Page 15 The trained nurse and care staff spoken with showed they had a good understanding of their responsibility and procedures to follow if they suspected abuse was happening. Staff were confident to whistle-blow poor and bad care practice. Staff files examined contained evidence to show that staff had received training in ‘safeguarding adults’ as part of the home’s induction training. The staff knew where to find the policies and procedures including the revised safeguarding adults procedure, which is held in the nurses’ station and main office. The Grange Nursing & Residential Home DS0000060078.V317418.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 20 and 26. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The residents’ benefit from having a clean, well-maintained and safe place to live, which individually and collectively meets the residents’ needs. EVIDENCE: The Inspectors arrived at the home at 9am and found the home was clean and tidy. The Acting Manager showed the Inspectors around the home, the lounges, dining room and bathrooms on the ground and first floor used by the residents. The reception area is welcoming. The main lounge and dining room has been re-decorated, which creates a lighter and airy feel. The seating is arranged into small groups to support residents who enjoy watching television, listening to music or talking with the other residents. The garden and the surrounding areas near the home are well maintained by the handy person. The Grange Nursing & Residential Home DS0000060078.V317418.R01.S.doc Version 5.2 Page 17 A new resident told the Inspector, “I was able to bring my favourite pictures and family photographs”. The Inspectors were given permission to see the bedrooms of three residents. The bedrooms were clean, comfortable with personal furnishings and showed what was important to the resident. Bathrooms and toilets were clean and had specialist equipment for the moving and handling of residents. Shared bedrooms appeared to have sufficient space and a dividing curtain for privacy. Residents felt they had sufficient space to move around in. The flooring in the bathroom on the first floor prompted a discussion with the Acting Manager regarding the visible thin cracks. Although at present the floor does not cause a risk of trips or falls to residents and staff, it was suggested that the floor is monitored and prompt action is taken when it becomes a risk. Observations made throughout the day showed domestic staff were carrying out cleaning duties of resident’s bedrooms, toilets and bathrooms. The care staff were seen collecting residents’ laundry and were able to describe the procedure to be followed for soiled clothes to avoid spreading infection such as MRSA or other communicable infections. Staff confirmed they have ample supply of protective clothing to avoid the spread of infection. Staff were observed wearing aprons and clothes throughout the day. The corridors throughout the home are brightly lit with handrails to support residents walking. Residents were seen walking around independently, using walking aids or wheelchairs. Residents said they now have the use of two lifts, which they use independently. The Grange Nursing & Residential Home DS0000060078.V317418.R01.S.doc Version 5.2 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 consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 and 30. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The resident’s care needs are met and their safety generally protected by the recruitment process and by having sufficient staff on duty. EVIDENCE: On arriving at the home staff were seen going about their duties in a calm and purposeful manner primarily focussing on the residents. The staff rota accurately reflected the staff on duty, including the ancillary staff and the staffing levels over 24 hours and the week. The home does not use agency staff and has maintained the staffing levels since the last inspection. The Acting Manager stated that there are trained nurses on duty at all times with additional clinical lead provided by the Registered Person who is registered nurse. The Registered Person and Acting Manager said they were in the process of recruiting to the post of ‘clinical lead’ for the nursing care provided. The Grange Nursing & Residential Home DS0000060078.V317418.R01.S.doc Version 5.2 Page 19 The care staff and trained nurse spoken with have been in post for a number of years. Three key-workers files were examined for the residents tracked. All the files contained evidence of written references and training. All staff complete the mandatory induction training over three days. One file contained a checklist at the front of the file, which allowed documents to be found easily. Two out of three files contained evidence of Criminal Records Bureau checks being carried out and induction completed. This was brought to the attention of the Registered Person and the Acting Manager. The Registered Person said Police checks are carried out for all staff including any overseas staff. This was confirmed with the evidence found in the file showing checks were carried out for staff from their country of origin. The Registered Person has subsequently sent the completed CRB for the named member of staff. Staff spoken with said they received training in health and safety, adult protection, infection control, dementia awareness, palliative care and basic principles of care as part of their induction training. Additionally, records examined and comments received from staff indicated that staff have recently received training in moving and handling. At present, the staff training records are held in two separate folders. However, the Acting Manager is in the process of maintaining a systematic and accurate record of the staff training and skill mix. All staff files contained records of the supervision meetings and staff meetings, which was consistent with the comments received from staff. The Acting Manager accepted comments regarding the supervision records to be detailed to demonstrate to topics discussed and ensure all staff are receive consistent and structured supervision. The Acting Manager said at present only two staff hold the recognised award in care known as NVQ level 2 and a further eleven staff have registered to start the following week. The Grange Nursing & Residential Home DS0000060078.V317418.R01.S.doc Version 5.2 Page 20 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35, 37 and 38. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents’ and staff’s health, safety and welfare are being promoted and protected through the home’s policies, procedures and management systems. EVIDENCE: The Acting Manager has been in post for seven weeks, having experience of working in and managing a care home. The Acting Manager is a moving and handling training trainer, has completed training in dementia awareness and is due to commence the Registered Manager’s Award and NVQ in care, level 4. The Registered Person provides the clinical supervision to the trained nurses. All the staff spoken with said there were clear lines of responsibility and accountability for all the staff. The Grange Nursing & Residential Home DS0000060078.V317418.R01.S.doc Version 5.2 Page 21 The daily task list sets out the specific responsibility and tasks for care staff for residents, such as attending appointments, assisting with bathing residents, working on the ground/first floor or serving meals. The Registered Person at present does not carry out monthly visits as he provides supervision on a daily basis. The Acting Manager has sent out to all residents and their relatives a ‘Residents & Relatives Survey’ questionnaire. The survey asked views about ‘the standard of care, cleanliness, improvements that could be made, are staff friendly and welcoming, is the care value for money and aware of how to complain’. The responses from the survey are being collated and presented in a report and action plan to address any issues that may arise or implement good suggestions. All the residents indicated they were asked about the care they received, the information in the care plans and felt confident to tell staff. Residents could choose to attend the ‘Residents & Relatives meeting’, which is held monthly. The minutes of the meeting viewed covered topics such as decoration, meals and menus and planning for Christmas. Resident’s have the use of lockable cabinets in their bedrooms. Residents said arrangements are in place for them to get access to their money to pay for the hairdresser or to go shopping. The residents finance records for the small amount of money held at the home are kept locked with their money, which is overseen by the Administrator at the home. Residents care files contained copies of the risk assessments carried out for mobility, transfers using a hoist, pressure area care and measures taken to avoid any risks of spreading infection. Care files were in good order and easy to follow. Residents said they felt safe both in the home and with the staff looking after them. The Pre-Inspection Questionnaire submitted prior to the CSCI before the site visit detailed the regular maintenance of health and safety systems within the home, including fire systems and equipment, environmental health visits, central heating systems and emergency call systems. All fire exits were clear of obstructions and clearly signposted. The Handy Person is responsible for repairing minor faults and regular testing. The fire drills, fire alarm testing records showed checks are carried out regularly. The accident book was up to date, detailing the incidents and the actions taken. The Grange Nursing & Residential Home DS0000060078.V317418.R01.S.doc Version 5.2 Page 22 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 The Grange Nursing & Residential Home DS0000060078.V317418.R01.S.doc Version 5.2 Page 23 CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 3 X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 3 X X X X X 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X 3 3 The Grange Nursing & Residential Home DS0000060078.V317418.R01.S.doc Version 5.2 Page 24 Are there any outstanding requirements from the last inspection? NO STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations The Grange Nursing & Residential Home DS0000060078.V317418.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Leicester Office The Pavilions, 5 Smith Way Grove Park Enderby Leicester LE19 1SX National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI The Grange Nursing & Residential Home DS0000060078.V317418.R01.S.doc Version 5.2 Page 26 - 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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