Inspection on 21/04/05 for The Grange Rest Home

This inspection was carried out on 21st April 2005.

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.

Other inspections for this house

The Grange Rest Home 04/10/07

The Grange Rest Home 24/05/06

The Grange Rest Home 15/09/05

The Grange Rest Home 19/10/04

The Grange Rest Home 22/05/04

Similar services:

The Shelley

Springfield House

Sutton Lodge Nursing Home

St Helier`s Residential Hotel

St Joseph`s

Ridgemount

Wingham Court

Old Hastings House

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

CARE HOMES FOR OLDER PEOPLE The Grange Rest Home Ltd 11 Sackville Gardens Hove East Sussex BN3 4GJ Lead Inspector Jane Jewell 21st Unannounced April 2005 10:00 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 Rest Home Ltd Version 1.10 Page 3 SERVICE INFORMATION Name of service The Grange Rest Home Ltd Address 11 Sackville Gardens, Hove, East Sussex, BN3 4GJ 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) 01273 298746 The Grange Rest Home Ltd Mrs Suzanne Leahy Care home only (OP) 25 Category(ies) of Old age, not falling within any other category registration, with number (OP), (25) of places The Grange Rest Home Ltd Version 1.10 Page 4 SERVICE INFORMATION Conditions of registration: 1)The maximum number of residents to be accommodated is twenty five (25). 2)The residents accommodated must be older people aged over sixty five (65) years. Date of last inspection 19 October 2004 Brief Description of the Service: The Grange Rest Home is a privately owned residential care home for up to twenty six older people. The home has been owned by the current providers since 1989. The home is an extended Victorian house, which is located near Hove seafront and close to transport links. The home is presented on three levels, ground, first and second floors. A shaft lift provides access to all floors with the first floor being split levelled, with several steps leading to the accommodation. Service users accommodation consists of twenty-five single bedrooms, eleven with ensuite facilities. There is a shared dinning room, two lounges a conservatory and enclosed rear garden. The front garden is paved to provide off road parking. The homes literature states that its aims are that each resident feels at home in warm, friendly surroundings and that they are as independent as is possible. That residents will be treated as an individual and with respect and dignity. The Grange Rest Home Ltd Version 1.10 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced routine inspection, which took place between 11.50am and 6pm. On the day of the inspection there were twenty-two residents living at the home. The inspection involved a tour of the premises, examination of the homes records, discussion with management, consultation with four staff on duty, twenty residents and a relative. The focus of the inspection was on the quality of life for people who live at the home. In order that a balanced and thorough view of the home is obtained, this inspection report should to be read in conjunction with the previous inspection reports. The Inspector would like to thank the residents, staff and management for their hospitality and assistance during the inspection. What the service does well: What has improved since the last inspection? Many of the areas of concern noted during previous inspections have been addressed. Action is in place to ensure that those areas not yet fully met are done so in the near future. Investment in the homes environment has meant that the redecoration of the whole home is near completion, resulting in a pleasant, comfortable and safer environment in which to live. The Grange Rest Home Ltd Version 1.10 Page 6 Much progress has been made to improve the standard of record keeping and administration, which supports the homes good care practices. What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The full report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The Grange Rest Home Ltd Version 1.10 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Standards Statutory Requirements Identified During the Inspection The Grange Rest Home Ltd Version 1.10 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 1,3 and 4 Prospective residents are told informally about the services of the home and this has enabled them to make an informed choice about where to live. Residents are only accommodated if the home is satisfied that they can meet their needs. The staff have a good understanding of residents support needs, which was evident from the positive relationship, which have been formed between the staff and residents. EVIDENCE: The home’s Statement of Purpose and Service Users Guide have recently been finalised but not yet used as a part of the formal admissions process. Instead prospective residents and their representatives are told about services and the homes literature discussed. Now that these documents have been finalised the manager agreed to display them around the home and to provide copies to interested parties. Residents consulted all stated that they knew what they needed to know about life at the home and felt confident to ask if they did not. The Grange Rest Home Ltd Version 1.10 Page 9 Documents seen for recent admissions showed that residents are accommodated following an assessment of their needs. Information about their needs is gathered from a variety of sources including the resident, their representative and health care professionals. The needs assessment then forms the basis of their care plan. This helps ensure that staff were aware of the recorded needs of new residents. There is evidence that the home is meeting the needs of most residents. It was clear that where the home has concerns about meeting the needs of residents, additional support or advice is sought from health care professionals. All residents spoke positively about the care they received and felt that their needs were being addressed. The Grange Rest Home Ltd Version 1.10 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 7,8,9,10 and 11 Care planning continues to improve and there is a simple plan in place for all residents. Although information in plans are basic, staff remain knowledgeable about the individual care needs of residents. The health needs of residents are addressed by good multi disciplinary working taking place on a regular basis. Medication practices need further work to ensure safe systems are in place. EVIDENCE: New care planning documentation has been developed using templates from a management manual. Four individual plans of care were inspected. These comprised of many documents including needs assessments, personal information, daily notes and a plan of care and provided the basic information necessary to guide staff to meet the needs of residents. Not all care plans were being regularly reviewed and updated to reflect any changes in needs and preferences and therefore the manager has been required to address this. Very few residents consulted were aware of their care plan or felt that they had been actively involved in their development or review, despite care plans being signed by the individual. Some residents stated that they were not interested in being involved in their care plan where others wanted to know what was written about them. All stated however that they felt their care needs were being addressed by staff in ways that ensured that their privacy and dignity The Grange Rest Home Ltd Version 1.10 Page 11 was respected. The manager has been required to ensure that residents are consulted regarding the development and review of their care plan and are notified of any revision to the plan. Much good practice was observed by the inspector in the way that care was provided. In line with previous requirements personal risk assessments have been undertaken on each residents. These provide basic information on the risks faced and posed and the actions needed to manage identified risks. It was not always clear when these had been reviewed, as they were not all signed and dated. All residents consulted indicated the way in which there health needs were being met by the home. The home works closely with health care professionals including GP’s, District nurses, chiropodists, opticians and dentists to ensure residents receive the necessary health care intervention and support. Significant improvements have been made to the management of medication since previous inspections. However, further work is still needed to ensure that a safe system of medication administration is operated. One example was noted whereby the prescribed instructions were not clear, as changes had been made but had not been signed, dated and a written explanation provided. Therefore it was not clear whether the prescribed instructions were actually being followed. The manager was immediately required to clarify this with the residents GP. In addition there is a need to ensure that additional instructions are provided for staff on the administration of all “As required” medication. This is to ensure that staff are clear on the individual requirements for when these medications are prescribed. The manager and staff spoke of the support they had received in the past from Health Care professionals during the care of residents who were receiving palliative care. Many letters and cards expressing gratitude and thanks to the staff were seen which have been received from relatives following the death of their loved one. The Grange Rest Home Ltd Version 1.10 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12,13,14 and 15 Flexible routines are part of daily practice at the home. Residents find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests. Links with families are valued and supported by the home. Dietary needs are well catered for with a balanced and varied selection of food available that meets resident’s tastes and choices. EVIDENCE: Residents stated that there is flexibility in daily routines regarding meal times, going to bed, rising and bathing. Residents are encouraged to remain as independent as possible and maintain control over all aspects of their daily lives. During the inspection residents were observed to move around the home freely, choosing which rooms to be in and what level of company they wanted to enjoy. Many activities are organised at the home, those mentioned by residents include: bingo, board games, cards, movement to music and musical entertainers. In addition the home has a range of equipment suitable for inhouse entertainment, including books, audio equipment and an electric organ. All residents stated that they are suitably occupied with some residents enjoying going out by themselves. The Grange Rest Home Ltd Version 1.10 Page 13 A visitor told the Inspector how well staff treat them, especially in how they are given clear information and are made to feel welcome. Residents spoke of their visitors being able to visit at any time and were offered hot drinks. Some residents have a private telephone line in their bedroom and they spoke of how this enabled them to keep in regular contact with their relatives and friends. Residents have been enabled to keep pets in the home following agreement with the providers. The home now has a small dog and cat which residents were extremely fond of. The Inspector took lunch with residents and observed staff providing discrete attentiveness to those who needed assistance. The meal presented was appetising and plentiful. All but one residents consulted said how nice the meals were and how their individual preferences are catered for. One resident requested that staff rotate the serving of tables each day to prevent the same people waiting until last to be served. This was feed back to the manager who agreed to address this. Records of meal provided showed that a varied menu with individual preferences and specialist diets are catered for. Mealtimes remain an important social function of the home, with residents observed to enjoy interacting with one another in a relaxed atmosphere. The dining room is decorated and set to a high standard with much thought given to providing a comfortable and pleasant environment in which to eat and socialise. The Grange Rest Home Ltd Version 1.10 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 inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 16,17 and 18 The inspector judged that resident’s rights were upheld. The home operates in an open manner and has not had a formal complaint for several years. The homes practices are designed to protect residents from abuse. EVIDENCE: Much effort continues to be made to ensure that resident’s rights are protected including ensuring there is regular access to personal monies, where it is held by a relative. Many residents were looking forward to voting in the forthcoming elections and spoke of either voting via post or being supported to vote in person. The home has an accessible complaints procedure for residents, their representative and staff to follow should they be unhappy with any aspect of the service. There have been no record complaints. Residents felt confident that any complaints would be listened to, taken seriously and acted upon. In line with previous requirements adult protection procedures have been updated and includes a flow chart for staff to follow on how to report suspected abuse. Staff are due to undertake further training in adult protection shortly. The manager was previously required to also undertake this training and they reported that they are also due to undergo this in the near future. The Grange Rest Home Ltd Version 1.10 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 standard(s) 19,20,21,22,23,24 and 26 Residents live in a clean and homely environment with parts of it decorated and furnished to a very high standard. The home ensures that service users private accommodation is equipped to provide comfort and privacy and to meet the assessed needs of those people residing in the room. EVIDENCE: The home is well located in relation to the local community and amenities. Over the last couple of years the home has undergone a major investment into improving environmental standards. Areas that have been refurbished have been done to a very high standard creating a comfortable and homely environment in which to live. A few areas remain outstanding, which include the remaining bedrooms, top floor bathrooms and stairwells all of which are gradually being addressed. The Grange Rest Home Ltd Version 1.10 Page 16 Bedrooms were observed to have been individualised with residents. Bedrooms are provided with domestic style furniture and fittings, together with bedding, carpeting, curtains to a high standard. Bedroom doors have an appropriate lock fitted to enable residents to lock their rooms if desired. All bedrooms are currently used for single occupancy. Four bedrooms are below the recommended 10sq meters, however of these rooms occupied resident’s felt that they had sufficient space. One of these room is now used as a treatment room Communal space consists of a separate smoking and non smoking lounge, dinning room and conservatory. All are decorated and furnished to a high standard and are popular with residents. During parts of the day the conservatory was observed to be extremely hot and uncomfortable to sit in as there was not shading available. The manager agreed to address this through the fitting of blinds. There is a secure rear patio area with seating, tables and flowerbeds. Access is via a ramp with a handrail making it accessible to all residents. In line with previous requirements plans are in place to re-organise the cubicle ground floor toilets into a more suitable location and layout. This is involving some major building works and therefore additional time has been granted. There are currently four baths, one of which is an assisted bath and an additional assisted shower. It was previously recommended that further assisted facilities were made available. There are plans to also address this during the relocated of the ground floor toilets. There is sufficient number of toilets located around the home including eleven bedrooms that have ensuite facilities. There is a need to ensure that hand washing facilities are made available in a first floor toilet. The home provides a range of individual aids and adaptations to assist resident’s mobility and independence, including raised toilet seats, ramps and grab rails. A call system is fitted to all rooms and those checked were in working order and promptly answered by staff. Hot water is controlled by mixer values to prevent the risk of accidental scolding. One bath checked by the inspector delivered hot water above the recommended safe temperature. This was of particular concern as it had also been identified at previous inspection as unsafe. The manager immediately rectified this during the inspection. The manager has been required to ensure that regular recorded checks on hot water outlets are undertaken to ensure that hot water is delivered safety at all times. The home was found to be clean and free from offensive odours. The home employs sufficient domestic staff to ensure that standards of hygiene and cleanliness are maintained. Extensive laundry facilities are available in the basement. Residents stated that they were happy with the standards of laundering. The Grange Rest Home Ltd Version 1.10 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 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 and 30 The numbers and deployment of staff are sufficient to meet the aims, objectives of the home and the individual needs of service users. The staff group includes a core group who have worked at the home for many years. Their experiences, together with training indicates that they have a good level of competence and make a positive contribution to the quality of life of residents. EVIDENCE: All residents consulted spoke positively about staff at the home with particular reference to their caring attitude, gentleness, patience and understanding. Staffing levels at inspection was for two care staff, senior carer and manager to be on duty until 2pm. This is in addition to domestic staff and a cook. During the afternoon and evening there are two staff and a senior carer. During the night there are two staff on duty. All staff and residents consulted felt that there were enough staff on duty to meet the needs of residents. There is a stable core group of staff who have worked at the home for many years and who have considerable experience in working with older people. Staff spoke affectionately about residents and demonstrated a clear understanding of their role and responsibilities. Many residents commented on how important it was for them to have the same carers on duty and how this was central to their quality of life. The recruitment records reviewed showed that a good standard of recruitment practices were being followed including obtaining the necessary police checks The Grange Rest Home Ltd Version 1.10 Page 18 to safeguard residents. Three residents commented that the manager operated very high standards of staff selection, as the standard of staff recruited was always very good. The manager was previously required to implement a training and development programme which is linked to the homes aims, objectives, residents needs and individual care plans, this had not been completed at the time of inspection. Staff stated that they undergo compulsory training such as Moving and Handling, First Aid, food hygiene, adult protection and Fire. In addition newer members of staff have also undergone the TOPPS induction programme. As at previous inspections it remains difficult to assess what training staff have undertaken as training records need to be more systematically collated and recorded. This is so the manager has an easily identifiable written profile of training undertaken and outstanding for each member of staff in order to plan more effectively the training needs of staff. A number of residents are partially sighted and in order to ensure that these needs are properly identified and addressed, the home has been required for staff to undergo specialist training in visual impairment. The Grange Rest Home Ltd Version 1.10 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 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, 33, 37 and 38 The home is openly managed in the best interests of residents. The home continues to benefit from a well-established and motivated manager who is gradually developing a fuller range of administrative skills. Not all of the homes practice safeguarded residents from risks of potential scolding and infection control. EVIDENCE: The manager has many years experience in managing the home and demonstrated in depth practical knowledge of the daily running of a service for older people. They are currently in the process of completing an NVQ level 4 in care and management. Staff, residents and a visitor spoke positively about the management approach with particular reference to their openness, approachability and good role modelling. The manager readily accepts the difficulties they experience with the administration elements of managing a care home. Notwithstanding this significant progress have been made to improve standards of record keeping and general administration. The Grange Rest Home Ltd Version 1.10 Page 20 Although the provider visits the home they do not undertake the required monthly-recorded visits. This has been an outstanding requirement for some time and therefore the provider has been written to outside of the inspection process. In line with previous requirements a system for obtaining feedback from residents, families and others involved in their care, about the services provided and the performance of the home has recently been implemented. Completed feedback questionnaires seen all spoke positively about the home with particular reference to the choice of food and staffing. There is a policies and procedures manual which is readily available to staff and designed to guide them in their work with residents. Many of the policies previously required to be developed have now been implemented. Those that remain outstanding include: Maintaining confidentiality and the recruitment of staff. The development of these written polices will underpin the homes current good practice and further support the induction of new staff. Radiator guards are fitted to all but one radiator in the shower room. The guard had been obtained and was awaiting fitting. Some poor infection control practices were noted, this includes: • Not all communal toilets had liquid soap and disposable towels to wash hands in accordance with good infection control guidelines. • Appropriate protective clothing when serving food. • Full protective clothing when disposing of human waste. • Appropriate measures for disposing of protective clothing safely and hygienically. A record of accidents is kept and was seen to be up to date with no specific patterns identified. Systems to support fire safety are in place. Regular fire alarms, emergency lighting checks and fire drills were recorded and up to date. Service contracts are in place for the fire detection and fighting equipment. Acoustically activated door guards have been fitted to some fire doors to enable them to be left open for ease of movement around the home. However some doors not fitted with closures had been propped open using doorstops. The manager was immediately required to cease this practice. The manager was previously required to regularly review risk assessments for all safe working practice topics to ensure that risks are identified and managed. This had not yet been undertaken. The Grange Rest Home Ltd Version 1.10 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. Where there is no score against a standard it has not been looked at during this inspection. 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 2 x 3 3 x x HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 2 10 3 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION 2 3 2 3 3 3 3 2 STAFFING Standard No Score 27 3 28 x 29 3 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 3 2 2 x 3 x x x 2 2 The Grange Rest Home Ltd Version 1.10 Page 22 yes 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. 2. Standard 7 7 Regulation 15(2) (a&b) 15(2)(c) Requirement That care plans are reviewed at least once a month and recorded as having been reviewed. That unless it is unpractical to do so residents are consulted regarding the development and review of their care plan and are notified of any revision to the plan. That additional instructions are provided for staff on the administration of all “As required” medication, which make clear the individual requirements for when this medications was prescribed. That alterations made to medication administration record sheets are signed, dated and a written explanation provided for staff. That the manager undergoes training in Adult Protection guidelines. (Outstanding from inspection of 19/10/04). That the ground floor communal toilets are reorganised to preserve the dignity and privacy of service users. (Outstanding from inspection of 5/6/03). That a plan of re-decoration and Version 1.10 Timescale for action 30-05-05 30-05-05 3. 9 13(2) Immediate 4. 9 13(2) Immediate 5. 18 10(3) 30-05-05 6. 19 12(4)(a) 30-09-05 7. 19 23(2)(d) 30-09-05 Page 23 The Grange Rest Home Ltd 8. 9. 10. 20 21 30 13(4)(c) 13(3) 18(1)(i) 11. 12. 30 31 18(1)(c) 26 13. 38 13(4)(c) 14. 15. 38 38 13(3) 13(3) 16. 17. 18. 38 38 38 13(3) 13(4)(c) 23(4)(a) repair is provided which addresses the areas identified during the inspection. (Outstanding from inspection of 19/10/04). That shading is providing in the conservatory to prevent this area from becoming to hot. That suitable hand washing facilities are available in a first floor toilet. That a training and development programme is developed which is linked to the homes aims, objectives, service users needs and individual care plans. (Outstanding from inspection of 19/10/04). That staff receive specialist training in visual impairment. That records of visits by the Responsible individual are in accordance with the National Minimum Standard. (Outstanding from inspection of 5/6/03). That the risk assessment for all safe working practice topics be reviewed frequently and records significant findings. (Outstanding from inspection of 22/4/04). That liquid soap and disposable towels for hand washing is provided in communal toilets. That infection control policies are reviewed and updated to include guidance for staff the use of protective clothing and disposing of human waste. That adequate quantities of protective clothing be made readily available to staff. That regular recorded checks on hot water outlets are undertaken. That fire doors are not wedged open using none automatic fire door closure mechanism. Version 1.10 30-05-05 30-07-05 30-07-05 30-07-05 Immediate Immediate 30-05-05 30-05-05 Immediate Immediate Immediate The Grange Rest Home Ltd Page 24 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. 2. 3. Refer to Standard 21 29 30 Good Practice Recommendations That there is a ratio of one assisted bath to eight service users. (Outstanding from inspection of 22/4/04). That a policy on the recruitment of staff be developed. (Outstanding from inspection of 5/6/03). That staff training records are more systematically collated and recorded, so that a written profile of training undertaken and outstanding is easily identified. (Outstanding from inspection of 19/10/04). That procedures are developed on confidentiality of service users. (Outstanding from inspection of 5/6/03). 4. 37 The Grange Rest Home Ltd Version 1.10 Page 25 Commission for Social Care Inspection Ivy House, 3 Ivy Terrace Eastbourne East Sussex BN21 4QT 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 Rest Home Ltd Version 1.10 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. 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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