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Inspection on 27/11/05 for The Grange Residential Care Home

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

This inspection was carried out on 27th November 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 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

The home provides a well decorated, spacious, and comfortable environment, with a secure, well maintained and usable garden. Meals are varied, nutritious and well presented and residents` dietary needs, likes and dislikes are taken into consideration. The home maintains good links and relationships with families and friends, who are encouraged to visit and made welcome. Residents and a visitor commented on the helpfulness and sensitivity of staff and made comments such as "we only have to ask and it`s done". Staff are well supported and the turnover of staff is very low.

What has improved since the last inspection?

All residents now have a comprehensive pre-admission assessment and the care plans include photographs of residents. Medication procedures and the residents` individual medication have been reviewed and there is a programme of staff supervision and training.

What the care home could do better:

Whilst the following is unlikely to compromise the care or safety of the residents, the medication storage should be reviewed, a lock should be fitted to the door of the laundry room, a programme of fitting locks to bedroom doors should be planned and fixed screens should be provided in shared rooms..

CARE HOMES FOR OLDER PEOPLE The Grange Residential Care Home 2 The Street Kennington Ashford Kent TN24 9EX Lead Inspector Mrs Sue Gaskell Announced Inspection 24th November 2005 10:00 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 Residential Care Home DS0000023557.V257051.R01.S.doc Version 5.0 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 Residential Care Home DS0000023557.V257051.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service The Grange Residential Care Home Address 2 The Street Kennington Ashford Kent TN24 9EX 01634 270674 01634 270674 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 Malcolm Brown Friend Mrs Diane Kathleen Friend Mrs Karen Ann Whiting Care Home 29 Category(ies) of Old age, not falling within any other category registration, with number (29) of places The Grange Residential Care Home DS0000023557.V257051.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 7th July 2005 Brief Description of the Service: The Grange is a large detached listed double property, with a converted barn extension. It is registered to provide accommodation, personal care and support for up to 29 older persons. There is a spacious enclosed garden with mature trees, plants and landscaped features, including a safely fenced fish-filled pond. Accommodation is arranged on the ground and first floors: the third floor provides office and storage space as well as the owners’ private residence. There are 2 passenger lifts. The home has 21 single rooms and 4 double bedrooms. All have private washing facilities, and 7 rooms have ensuite facilities. Bedrooms are fitted with TV and telephone points as well as individual call alarms. The ground floor consists of a generous sized dining room, 2 separate spacious lounges (one of which also has a dining area), a large conservatory, kitchen and laundry. There is parking for several vehicles at the front/side of the home. Mrs Karen Whiting is the Registered Manager and is responsible for the day-today running of the home. The Grange Residential Care Home DS0000023557.V257051.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This announced inspection was carried out over approximately 6 hours. Prior to this inspection the home had submitted a pre-inspection questionnaire completed by the registered manager. The Inspector toured the building and inspected a number of records, policies and procedures. The Inspector spoke with 8 residents, and a relative of 1 resident. The registered owners, the registered manager, 2 carers and the cook also assisted with the inspection. What the service does well: 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 Grange Residential Care Home DS0000023557.V257051.R01.S.doc Version 5.0 Page 6 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 Residential Care Home DS0000023557.V257051.R01.S.doc Version 5.0 Page 7 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): 3 and 6 Prospective residents, and/or their representatives, are provided with the information they need in order to make a decision on whether the home will suit them. The health, emotional and social care needs of prospective residents are assessed prior to their admission to the home. EVIDENCE: Several residents, and a relative, told the inspector that they had received written information on the home and been able to visit the home for trial periods before making a decision about whether to move in. The individual records which are kept for each resident included a pre-admission assessment form carried out by the home with input from other health care professionals. The Grange Residential Care Home DS0000023557.V257051.R01.S.doc Version 5.0 Page 8 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 and 10 The care planning system is sufficiently detailed to ensure that all residents’ needs will be met. Whilst medication policies and procedures are sound, the storage is not ideal. Personal support is offered in a manner which respects residents’ rights to choice, respect and dignity. EVIDENCE: There are care plans in place for all residents, with reference to residents’ health, personal and social care needs, risk assessments and clear guidelines on how to minimise any risk. Whilst medication was seen to be generally appropriately recorded, the storage of medication has yet to be changed to meet the timescale referred to in the previous inspection reports. However the inspector was advised that an area has been identified and that this should be done shortly. The Grange Residential Care Home DS0000023557.V257051.R01.S.doc Version 5.0 Page 9 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 and 15 Residents’ experiences of life in the home meets and satisfies their needs and expectations and they are helped to exercise choice and control over their lives and daily activities. Residents are assisted with maintaining contact with their previous way of life, and their families and friends are made welcome. Residents’ tastes, choices and dietary needs are well catered for, with a varied selection of food and drinks available during the day and evening. EVIDENCE: All of the residents spoken to, and a relative who visits the home on a regular basis, confirmed that residents are frequently encouraged to say what they would like, in terms of personal care, activities, menus etc., and that any suggestions are acted upon. Residents and a visitor confirmed that visitors are always made welcome and offered hospitality. The meal served during the inspection was seen to be appetising and nutritious and residents confirmed that the food is generally of a very good standard. The Grange Residential Care Home DS0000023557.V257051.R01.S.doc Version 5.0 Page 10 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): The home’s complaints process is satisfactory and there is evidence to show that residents’, or others’ concerns are taken seriously and responded to appropriately. Staff have a good understanding of adult abuse issues and of the home’s procedures to protect residents from abuse. EVIDENCE: The home has a complaints form to record complaints, and records are made of day to day issues. Residents and relatives confirmed that they would feel comfortable in mentioning anything to the owners or manager and confident that any concerns would be resolved. The manager and other staff referred to procedures and ongoing training in adult protection and have showed a willingness to consult with other professionals on any issues which may affect residents’ well being. The Grange Residential Care Home DS0000023557.V257051.R01.S.doc Version 5.0 Page 11 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, 24 and 26 The home is very well decorated and maintained and residents live in comfortable surroundings. However, residents in shared rooms lack a permanent form of privacy and do not have the means of controlling who has access to their rooms. EVIDENCE: The corridors and some bedrooms have recently been re-decorated, and new curtains have been provided as part of an on-going programme of decoration. Whilst the accommodation is very comfortable, and residents do not appear to have an complaints, the only form of screening in shared rooms is still by portable folding screens. One resident has been provided with a key to her room but this is not lock is over a type which could prevent access in the event of an emergency. Other bedrooms have not been provided with a lock and whilst the inspector was informed that residents are asked whether they would like a lock fitted, the provision of locks prior to asking would enable residents to make a true choice. The Grange Residential Care Home DS0000023557.V257051.R01.S.doc Version 5.0 Page 12 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 and 30 Staffing levels are adequate and staff morale is high with a low turnover of staff. The procedures for the recruitment of staff are sound and offer protection for people living in the home. Staff are trained and competent. EVIDENCE: Staffing at the time of the inspection comprised the registered manager, 4 care staff and kitchen and domestic staff. The owners also take an active part in the running of the home. Recruitment, training and supervision records were inspected. The manager and staff confirmed that there is a good level of induction and further training and that all necessary checks on staff are undertaken prior to employment. All of the residents spoken to confirmed that day staff and night staff are kind, sensitive, helpful and cheerful. The Grange Residential Care Home DS0000023557.V257051.R01.S.doc Version 5.0 Page 13 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): 31,32, 33, 35 and 38 The residents benefit from a well managed home and the record keeping and health and safety systems are generally sufficient to safeguard residents’ welfare, rights and best interests. However there are some health and safety issues requiring attention. EVIDENCE: The registered manager said that does not intend to become qualified at this stage although she has attended a number of shorter courses on all necessary aspects of residents’ care. Staff referred to the high level of support provided by the owners and manager. The records showed that fire alarm systems are tested regularly and all maintenance certificates were up to date. However, the portable folding screens are still the only means of giving privacy in shared rooms, a lock on one bedroom door is of a type which might not be accessible in the event of an emergency and there was no lock on the laundry door. The Grange Residential Care Home DS0000023557.V257051.R01.S.doc Version 5.0 Page 14 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 X X 3 X X 3 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 3 18 3 3 X X X X 2 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 4 3 X 3 X X 2 The Grange Residential Care Home DS0000023557.V257051.R01.S.doc Version 5.0 Page 15 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 OP9 Regulation 13 Requirement Medication storage should be reviewed according to the timescale on previous inspection report. Some form of fixed screening should be provided in shared rooms. Risk assessments must be prepared around the use of portable folding screens. Bedroom door locks fitted must be of a type which enables access in the event of an emergency Laundry door should be lockable when not in use Timescale for action 31/03/06 2 3 OP24 OP38 16 13 31/03/06 31/01/06 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 OP24 Good Practice Recommendations Commence programme of fitting safe and appropriate locks on bedroom doors. The Grange Residential Care Home DS0000023557.V257051.R01.S.doc Version 5.0 Page 16 Commission for Social Care Inspection Kent and Medway Area Office 11th Floor International House Dover Place Ashford Kent TN23 1HU 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 Residential Care Home DS0000023557.V257051.R01.S.doc Version 5.0 Page 17 - 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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