Inspection on 23/06/05 for The Grange Residential Hotel

This inspection was carried out on 23rd June 2005.

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

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

Other inspections for this house

The Grange Residential Hotel 05/12/07

The Grange Residential Hotel 02/03/07

The Grange Residential Hotel 05/01/06

The Grange Residential Hotel 18/02/05

Similar services:

The Vicarage

Fairfields Country Rest Home

7 Hyde Road

5 Seafield Road

Poldhu

Queensmount

Trevaylor Manor

Didsbury Court Rest Home

Extracts from inspection reports are licensed from CQC, this page was updated on 09/07/2008.

CARE HOMES FOR OLDER PEOPLE The Grange Residential Hotel Townsend Hill Ipplepen Newton Abbot TQ12 5RT Lead Inspector Doug Endean Unannounced 23rd June 2005 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. The Grange Residential Hotel D54-D07 S61643 The Grange V234078 230605 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service The Grange Residential Hotel Address Townsend Hill, Ipplepen, Newton Abbot, Devon, TQ12 5RT Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) 01803 813656 suttonr@btconnect.com Ogwell Grange Ltd Victoria Jane Kay Care Home 17 Category(ies) of Old age, not falling within any other category registration, with number (17), Physical disability over 65 years of age of places (17) The Grange Residential Hotel D54-D07 S61643 The Grange V234078 230605 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: 1. Old age, not falling within any other category (OP) maximum 17. 2. Physical disability over 65 years of age (PD(E)) maximum 17. Date of last inspection 18/02/05 Brief Description of the Service: The Grange Residential Hotel is a grade two listed building on the edge of the small rural town of Ipplepen, which is just a few miles from the market town of Newton Abbot and the holiday area of Torbay, in the county of Devon. It is located about 150 yards from the town centre and near the shops and Doctors surgery. The home is a large detached property on two levels with a shaft lift servicing the first floor level. It has a good number of parking spaces at the front with level access to the front door. There is a large lounge on the ground floor and this is complimented by a large dining room with a small conservatory leading to the secure, attractive garden at the rear of the home. In all there are five single bedrooms on the ground floor and three double and six single bedrooms on the first floor. The home caters for men and woman over the age of retirement who may have a degree of physical disability and memory problem. The home came into the possession of its present owner in August 2004 who, with his Registered Manager and team of workers have made many positive changes to the building and the culture of the home. The Grange Residential Hotel D54-D07 S61643 The Grange V234078 230605 Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection took place during the early afternoon and lasted for two hours. In this time the inspector reviewed three of the clients files including their care plans, spoke to the manager and one staff member, toured the home and spoke to four clients. The files of three staff were also looked at during 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 Hotel D54-D07 S61643 The Grange V234078 230605 Stage 4.doc Version 1.30 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 Standards Statutory Requirements Identified During the Inspection The Grange Residential Hotel D54-D07 S61643 The Grange V234078 230605 Stage 4.doc Version 1.30 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 standard(s) 1 & 3. Standard 6 is not applicable. The home only admits clients to the home who have needs that they can meet. EVIDENCE: The service users guide has been reviewed and is now a complete and informative document. The inspector saw three complete pre admission assessments that provided them with information about the potential needs of new clients. The assessments did cover areas such as mobility, nutrition and memory. In addition to this information that was gathered by the manager there was information supplied by such individuals as the social worker/care manager and District Nurse involved with clients prior to being referred to the home. From this information the manager and cares had produced risk assessments and care plans. Where necessary the District Nurses have maintained contact with clients to review and meet nursing care needs such as wound dressing. The Grange Residential Hotel D54-D07 S61643 The Grange V234078 230605 Stage 4.doc Version 1.30 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 standard(s) 7, 8, 9 & 10. The health and personal care needs of the clients living at the home are being met by the care team helped by the visiting health care professionals. EVIDENCE: Three care plans were selected at random by the inspector and reviewed. They were well constructed and provided clear information about the client and plans to meet their assessed needs. There was also evidence that showed the care plans are reviewed regularly. A further review does take place on a weekly basis when the manager meets with the registered person and manager and head of maintenance from the sister home to discuss all aspects of the care of clients and running of the home. This did not take place during this inspection but the inspector has been a part of several of these meetings in the past. Where possible the clients are involved in the development of their care plans on a formal or informal basis. The clients are assisted or supervised in meeting their personal care needs and the inspector observed this happening during the inspection. The local general practitioners attend the home on a regular basis mainly when called upon by the staff to do so. The District Nurse visits as necessary, twice The Grange Residential Hotel D54-D07 S61643 The Grange V234078 230605 Stage 4.doc Version 1.30 Page 9 weekly at present, to provide nursing care where needed such as dressings. The chiropodist visits the home on a six weekly basis. There is evidence in staff files that shows that all the care staff have been trained by a external trainer from a major pharmaceutical provider in the handling and administration of medication. The storage of medication is satisfactory. The four clients who spoke to the inspector spoke highly of the care that they receive and the manner in which the staff treat them. Each of these people said they were happy living at the home and also liked the food that they were given. The Grange Residential Hotel D54-D07 S61643 The Grange V234078 230605 Stage 4.doc Version 1.30 Page 10 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12, 14 & 15. The home provides an atmosphere that invites the clients to be in control of their care, express their views, maintain their independence and make choices within safe parameters. EVIDENCE: The service provides many ways for the clients to have their social care needs met. The plans meet the needs of individuals and group of clients. One client was doing artwork during the inspection whilst another was enjoying a story via the talking books series. The individual wants; needs and desires of the Service Users are recorded as the home becomes aware of them. This information gathering commences on admission with the question “How can things in the residents life be improved” prompting information about hobbies and interests to be gathered and all activities that they become involved in are also recorded in the individual clients files. At the end of the inspection the manager took several clients out for a car ride that was planned to travel around the local area of Torbay. The home also has evidence of several social events that are attended by clients at the sister home that is just a short distance away. Each client has the choice of what they wear, how they decorate their own room, what they will eat and where they will eat it. Activities are offered and the records show that they are well attended out of choice. This was confirmed when the inspector spoke to individual clients during the inspection. The Grange Residential Hotel D54-D07 S61643 The Grange V234078 230605 Stage 4.doc Version 1.30 Page 11 The four clients spoken to by the inspector stated that the food provided is of a good or very good standard and the dining room is a comfortable area for the social occasion that meal times have become. Likes and dislikes are met with choices of meals being offered. The Grange Residential Hotel D54-D07 S61643 The Grange V234078 230605 Stage 4.doc Version 1.30 Page 12 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 16. The training methods adopted by the home does show that they consider the protection of their clients a high priority. The complaints procedure provides the clients with clear to follow to follow if they feel that their needs or rights are not being met. EVIDENCE: There is a complaints procedure displayed in the main entrance area that includes the time frame for an initial response to any complaint and the process the home will following in investigating a complaint. The procedure includes the address of the Ashburton office of the Commission for Social Care Inspection. This information is available to every Service User and their advocates. The manager has obtained the local authorities “ No Secrets “ video that is used along with the adult protection “A Practical Guide” to train staff in recognising abuse and how to report it. The manager told the inspector that staff meeting are also used as training events and issues of abuse are often discussed. The Grange Residential Hotel D54-D07 S61643 The Grange V234078 230605 Stage 4.doc Version 1.30 Page 13 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 19, 20, 21, 24 & 26. The home provides good accommodation that is well maintained and well located in a small rural town. EVIDENCE: The home is well located for shops, post office and the general practitioners surgery, being almost on the level to the centre of the small rural town centre that is just a short walk from the home. The home is well maintained by the in house Head of Maintenance who also looks after the sister home close by. The maintenance records and risk assessments are up to date and of a good standard. There is safe level access to an enclose rear garden from the dining room through the conservatory. This allows the clients to enjoy good weather without being far from shade if they want it. The inspector was shown the first floor bathroom where a new battery operated bath chair has been provided to increase the comfort and independence of the clients who now use this bath. The home also has a large The Grange Residential Hotel D54-D07 S61643 The Grange V234078 230605 Stage 4.doc Version 1.30 Page 14 wheel in shower room on this level. The majority of bedrooms have en-suite facilities. The communal rooms are all furnished comfortably making them look warm and homely in nature. Client’s bedrooms are individually decorated and furnished to meet their personal and care needs. All the clients bedrooms have door locks fitted and keys are supplied where the risk is acceptable. The staff each has a master key to allow entry in an emergency. With the fitting of a stair lift the clients have a choice of using this or the shaft lift to get to the first floor. The home was found to be clean and odour free during the tour undertaken by the inspector. The staff files show that the care staff has attended “Infection Control” training in Mach 2005. The Grange Residential Hotel D54-D07 S61643 The Grange V234078 230605 Stage 4.doc Version 1.30 Page 15 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27, 29 &30. The home is staffed by skilled individuals who have gone through a recruitment process that was only let down by a failure to keep copies of some documents. EVIDENCE: At the time of the inspection the home was staffed by the manager and two senior cares for fifteen clients. In addition there was also a cook, a general assistant and a cleaner on duty. The manager has her NVQ level 4 in care. The staff recruitment process had not been completed, as some of the staff records did not hold the level of information required of them by schedule 2. The evidence of a satisfactory criminal records bureau check showed that the missing items, such as a copy of a birth certificate, passport, and proof of home address must have been seen but were not copied to the individual staff files. Job descriptions, contracts of employment and references were seen in the sample of staff files looked at by the inspector. There is only a small turnover of staff at this home. The staff files also held proof of training that individuals had attended that are appropriate to the task they are involved in. Training included basic first aid, infection control, handling medication, manual handling, an introduction to risk assessment and NVQ training in care at levels 2,3,and 4. The Grange Residential Hotel D54-D07 S61643 The Grange V234078 230605 Stage 4.doc Version 1.30 Page 16 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31, 32, 33 & 38. The registered manager and management team run the home in the best interests of the clients making decisions on improvements to the home and training as the regular audit recognises the need. A good deal is done to improve the home as part of the business plan. EVIDENCE: The Registered Manager is well qualified and experienced and has evidence of the training she has completed to meet the national minimum standards. She also has good leadership qualities that are recognised by her staff and the clients each having complimented her about during this and the previous inspection. The evidence of a total culture change in the home is proof of her talents in managing this care home. There are clear lines of accountability within the management structure external to the home. The Grange Residential Hotel D54-D07 S61643 The Grange V234078 230605 Stage 4.doc Version 1.30 Page 17 Audit commences with the clients views being obtained from the point of admission onwards and evidence can be seen of this in the clients records of likes and dislikes. There views are constantly sought formally and informally. The management team meet weekly to discuss the care of the clients and the performance of the home and individuals in it. The meeting is recorded and this provides a good quality assurance trail. The clients records include risk assessments and evidence about how the home have reduced the risk such as by manual handling training for staff and the provision of a manual handling assessment and equipment. The establishment has been risk assessed by the Head of Maintenance and repairs or servicing of equipment has occurred with proof being provided by way of reports and invoices for such work as shaft lift services and the servicing of kitchen equipment. The staff have all been involved in hazard risk assessment training to enable them to help in providing information to make the work place safe form them and the clients who live in the home. The accident book provides evidence that the home records accidents, where they occur and what action they took to address the situation. The Grange Residential Hotel D54-D07 S61643 The Grange V234078 230605 Stage 4.doc Version 1.30 Page 18 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score 3 x 3 x x N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 4 13 x 14 4 15 3 COMPLAINTS AND PROTECTION 3 3 3 x x 3 x 3 STAFFING Standard No Score 27 3 28 x 29 2 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x x 3 4 3 x x x x 3 The Grange Residential Hotel D54-D07 S61643 The Grange V234078 230605 Stage 4.doc Version 1.30 Page 19 NO Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard 29 Regulation 19(4)(b)(i ) Requirement The registered person shall not allow a person to work in the home where they have regular contact with service usersunless they have obtained, in respect of that person, documents specified in paragraphs 1 to 7 of Schedule 2. There needs to be evidence in staff files that these documents have been obtained such as copies of birth certificates and passports where they are available. Timescale for action 31/08/05 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard Good Practice Recommendations The Grange Residential Hotel D54-D07 S61643 The Grange V234078 230605 Stage 4.doc Version 1.30 Page 20 Commission for Social Care Inspection Unit D1 Linhay Business Park Ashburton TQ13 7UP 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 Hotel D54-D07 S61643 The Grange V234078 230605 Stage 4.doc Version 1.30 Page 21 - 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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