Inspection on 08/12/05 for The Grange Rest Home

This inspection was carried out on 8th December 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 12/11/09

The Grange Rest Home 08/01/07

The Grange Rest Home 07/07/05

The Grange Rest Home 31/01/05

The Grange Rest Home 30/09/04

The Grange Rest Home 11/03/04

The Grange Rest Home 16/02/00

Similar services:

Turret Villa Retirement Home

Moor House

Mendip House

Beaconsfield Court Care Home

Little Sisters Of The Poor

Manor House

Middleton Hall Ltd

Middlesbrough Intermediate Care Centre

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 37 Watershaugh Road Warkworth Morpeth Northumberland NE65 0TX Lead Inspector Mary Blake Unannounced Inspection 10:00 8 December 2005 th 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 DS0000040702.V252051.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. DS0000040702.V252051.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service The Grange Rest Home Address 37 Watershaugh Road Warkworth Morpeth Northumberland NE65 0TX 01665 711152 01665 513091 barbara.penrose@nortoncare.co.uk 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) Norton Care Limited Mrs Barbara Penrose Care Home 23 Category(ies) of Dementia - over 65 years of age (11), Mental registration, with number Disorder, excluding learning disability or of places dementia - over 65 years of age (3), Old age, not falling within any other category (9) DS0000040702.V252051.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 situated on the outskirts of the village of Warkworth with limited access to its services. Converted from a house to create a home that is registered to provide care for 23 older people, of which 11 may have dementia and 3 may have other mental health needs. The home is on two floors with passenger lift to all levels, there are a variety of aids and adaptation to allow residents to move freely around the home although in common with many residential homes located within converted buildings, the design and layout presents some limitations for residents with physical disabilities. All of the bedrooms are currently single occupancy and there are no ensuite facilities. There are communal bathrooms and toilet facilities situated around the home. There are sufficient communal lounges and dining areas. There is public car parking at the rear of the building. The home does not provide nursing care. DS0000040702.V252051.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection was unannounced, the second of the year and took place over one day. A full tour of the premises was carried out. Residents care records; staff recruitment files and additional statutory records were examined. Three staff and seven residents were spoken to. What the service does well: What has improved since the last inspection? The admission procedure and records are better detailed and give good information. Decoration and furnishings have continued to improve and the home looks more welcoming and homely. Individual care plans have continued to improve and it was apparent that staff were more involved in planning and evaluating care. DS0000040702.V252051.R01.S.doc Version 5.0 Page 6 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. DS0000040702.V252051.R01.S.doc Version 5.0 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 DS0000040702.V252051.R01.S.doc Version 5.0 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 3, The majority of residents move into the home having had their needs assessed and been assured how these will be met. Residents have the opportunity to visit the home prior to admission and generally satisfactory pre-admission assessments processes were in place in order to meet their needs. EVIDENCE: The statement of purpose, service user guide was not available and it was subsequently agreed with the Registered Manager that this would be forwarded to CSCI. Discussion with residents, senior staff and examination of records confirmed that their care needs had been assessed prior to admission. DS0000040702.V252051.R01.S.doc Version 5.0 Page 9 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8 & 10 In general the residents personal, health and social care needs are set out in their individual plan of care; however respite residents needs were not fully addressed nor set out within a plan. Residents felt that their privacy was respected and that staff treat them with respect. DS0000040702.V252051.R01.S.doc Version 5.0 Page 10 EVIDENCE: Individual residents plans of care were examined and have continued to improve. However it was noted that a recent respite admission had basic information and did not have a care plan. Residents are weighed regularly and nutritional risk assessments are now carried out and actions detailed within the care plans. A range of risk assessments is undertaken and there was now sufficient documentation in relation to falls risk assessment. Residents have regular access to other health services such as doctor, district nurse, psychiatric nurses, dentist, chiropodist and optician. An outstanding requirement in relation to medication training for night staff has been addressed, with staff reporting that secondary dispensing no longer takes place. Residents spoke of staff giving them privacy but also supporting their independence and that staff were respectful in their dealings with them. DS0000040702.V252051.R01.S.doc Version 5.0 Page 11 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12 & 13 Social care needs, recreation and stimulation are adequate. Residents are supported to maintain contact with family, friend and their local community. EVIDENCE: A number of residents were spoken to and everyone commented upon the improvements to the social activities on offer within the home. Residents spoke of making decisions about visitors and visitors were observed to see residents in private. DS0000040702.V252051.R01.S.doc Version 5.0 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 the following standard(s): 18 Residents are not always fully protected due to the shortfalls in the recruitment process. EVIDENCE: Examination of two staff recruitment files indicated that a suitable recruitment process is not completed (see section 29) DS0000040702.V252051.R01.S.doc Version 5.0 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 the following standard(s): 19,21,25 & 26 Residents live in generally well-maintained and comfortable surroundings however the home is not always safe. Residents do not have access to sufficient and comfortable bathrooms areas. The home is clean, pleasant and hygienic. DS0000040702.V252051.R01.S.doc Version 5.0 Page 14 EVIDENCE: Since the last inspection the home had continued to progress with the redecoration programme and residents and staff commented on the positive change. It was again noted that door wedges were inappropriately used throughout the home. Bathrooms again were not all being used and this must be reviewed. Communal toiletries were again evident. The water temperature of a bath was tested and was 49’C, again exceeding the safe temperature of 43’C. Records indicated that this has last been tested on 14/11/05. The hot water supply to the upstairs bathroom and hand basins was insufficient to enable residents to wash their hands or bath. Three toilet seats were found to be loose and unstable presenting a risk to residents. Am immediate requirement notice was issued for the proprietor to urgently address these health and safety matters. Further discussion with the Registered Manager indicated that these matters are being addressed. A tour of the building indicated that the home was very clean and free from offensive odours. DS0000040702.V252051.R01.S.doc Version 5.0 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 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): 27,29 Resident’s needs are met by the number and skill mix of staff at the home. Residents are not always fully protected by the homes recruitment practices. DS0000040702.V252051.R01.S.doc Version 5.0 Page 16 EVIDENCE: Discussions with the staff and examination of the staffing rotas/diaries confirmed that the home has remained consistently staffed, both during the day and night. The minimum numbers of care staff are 4 mornings 3 afternoons 3 evening and two during the night. It was noted that several rotas/records of staff on duty was available however it did not include the hours of ancillary staff such as the handy man. Managerial assessment of the night staff was reported, as currently being reviewed by the Manager but documentation of this was not available at this inspection. Examination of two staff recruitment files indicated that suitable application forms and references were obtained. CRB checks were not readily available and one staff had a check from previous employment, CRB checks are not transferable. There were not details of a staff file for the handyman. All residents spoken to said that staff were kind and considerate. DS0000040702.V252051.R01.S.doc Version 5.0 Page 17 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): 35, 37 & 38 Residents’ financial interests are safeguarded Record keeping & procedures do not always protect the welfare of residents. The health, safety and welfare of users and staff are not always promoted and protected. EVIDENCE: Examination of residents’ monies was satisfactory. It was evident from examination of records such as staff rota, staff files and care plans that these were not appropriately completed. DS0000040702.V252051.R01.S.doc Version 5.0 Page 18 The use of door wedges, loose toilet seats and residents having access to excessive hot water do not promote or safeguard the health, safety and welfare of the people using the service. It was difficult to examine accidents records with several accident books in operation. The inspector was unable to find the entry relating to a recent serious accident, although this had been reported to CSCI. The fire log was not up to date with the last test for alarms carried out on 28/11/05, with gaps for testing between the period of August and September. There was no evidence of checking of fire door maintenance and this was also highlight by the Fire Prevention officer on his visit of 30th November 2005. Records of fire drills indicated that only one fire drill had taken place though staff clearly stated this was not the case. A review of the testing and recording necessary to meet fire safety must be undertaken and the proprietor must specify how they intend to comply with the Fire Prevention officers report. DS0000040702.V252051.R01.S.doc Version 5.0 Page 19 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 N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 3 10 X 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 X COMPLAINTS AND PROTECTION Standard No Score 16 X 17 X 18 2 2 X 2 X X X 1 3 STAFFING Standard No Score 27 2 28 X 29 2 30 X MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score X X X X 3 X 2 1 DS0000040702.V252051.R01.S.doc Version 5.0 Page 20 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 OP27 Regulation 18(1)(a) Requirement To review managerial competence for night staff and maintain a record of this assessment. Outstanding as of 1st April 2005 & 1st September 2005 but currently being addressed. To remove communal toiletries and review this practice. Outstanding as of 1st March 2005 & 1st August 2005 To remove all door wedges outstanding as of 7th July 2005 Immediate requirement notice issued Water temperatures to baths must not exceed 43c, steps must be taken Outstanding as of 7th July 2005 Immediate requirement notice issued Sufficient hot water must be supplied to the upstairs bathroom and hand basins. Immediate requirement notice issued Loose toilet seats must be made safe Immediate requirement notice issued Care plans must be completed DS0000040702.V252051.R01.S.doc Timescale for action 01/01/06 2 OP21 12(4) 08/12/05 3 OP38 23,(4) 08/12/05 4 OP38OP25 13(4) 08/12/05 5 OP25 23 2 (j) 08/12/05 6 7 OP19 OP37OP7 23 2 (c) 17 1 (a) 08/12/05 12/12/05 Page 21 Version 5.0 8 9 OP37OP27 OP18OP29 17 2 schedule 4 19 for all residents All care and ancillary staff must be included within the staff rota. All staff must have up to date CRB clearances and appropriate recruitment documentation 12/12/05 01/01/06 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations DS0000040702.V252051.R01.S.doc Version 5.0 Page 22 Commission for Social Care Inspection Cramlington Area Office Northumbria House Manor Walks Cramlington Northumberland NE23 6UR 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 DS0000040702.V252051.R01.S.doc Version 5.0 Page 23 - 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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