Inspection on 17/10/06 for The Grove

This inspection was carried out on 17th October 2006.

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 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 Grove 21/05/09

The Grove 28/05/08

The Grove 19/06/07

The Grove 14/02/06

The Grove 19/07/05

Similar services:

Fairfields Country Rest Home

Poldhu

Queensmount

Trevaylor Manor

Didsbury Court Rest Home

Belma

Hunters Care Centre

Manor Lodge

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

CARE HOMES FOR OLDER PEOPLE The Grove 181 Charlestown Road St. Austell Cornwall PL25 3NP Lead Inspector Elaine Bruce Key Unannounced Inspection 17th October 2006 08:30 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 Grove DS0000063217.V308610.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. The Grove DS0000063217.V308610.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service The Grove Address 181 Charlestown Road St. Austell Cornwall PL25 3NP 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) 01726 76481 01726 67457 Venetian Healthcare Limited Mrs Kerry Ann Lewis Care Home 31 Category(ies) of Old age, not falling within any other category registration, with number (31) of places The Grove DS0000063217.V308610.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. Service users to include up to 31 adults of old age (OP) Total number of service users not to exceed a maximum of 31 Date of last inspection 14th February 2006 Brief Description of the Service: The Grove is registered for thirty one service users within the category of old age. A permanent respite bed is available at the home and day care is provided on a daily basis. The home stands within beautiful substantial grounds on the approach road to Charlestown harbour. Seating areas are provided in the grounds. There are sea views available from some of the bedrooms in the home. Parking is available in the grounds of the home. The communal accommodation consists of three spacious and comfortable lounges (one smoking lounge) and a very pleasant dining room with flowers on the tables and freshly laundered table linen. Bedrooms are available on the ground and first floor. Bedrooms to the first floor are served by the use of a shaft lift. Nineteen of the single bedrooms have en suite accommodation and all double bedrooms have an en suite facility. There are additional toilets and bathrooms to suit the care needs of the service users. The Grove DS0000063217.V308610.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The key unannounced inspection at The Grove took place on the 17th October 2006 over 8 hours. Service users and staff were spoken to during the course of the inspection. 18 service user comment cards were received at the CSCI prior to the inspection. The majority of these comment cards expressed satisfaction with the standard of care being delivered at the home. Three relatives/visitors comment cards were received at the CSCI, one of these raised concerns suggesting deteriorating standards at the home. During the course of the day eight service users were spoken to, to include two service users who were attending the home for the day. One visitor was also spoken to. The majority of the service users indicated that they were satisfied with the standard of care delivery at the home. Where there are some concerns these appear to be around deteriorating standards generally and as such whether the home is now value for money. A number of service users stated that “it is very expensive here”. Case tracking took place with 5 service users. The registered manager was on duty at the time of the inspection. The registered provider is presently on holiday. As well as long term care a permanent respite bed is available in the home allowing service users an opportunity to stay at the home on a short term basis. The range of fees at the home are from £360 to £596 per week. What the service does well: The home employs a full time activities co-ordinator and as such there is a lot happening at the home. Service users can play scrabble, dominoes, read poetry, enjoy trips out and just have one to one time talking if that is what they so wish. The gardens at the home are very attractive and well tended. Improvements have recently taken place to include the addition of a rose garden which has The Grove DS0000063217.V308610.R01.S.doc Version 5.2 Page 6 involved the service users. The service users are looking forward to the formal opening of these gardens. 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 Grove DS0000063217.V308610.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection The Grove DS0000063217.V308610.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1 and 3 The quality outcome in this area is adequate. The home’s statement of purpose and service user guide documentation as well as a brochure provide prospective service users with details of what the home provides helping an informed decision about admission to the home. The registered manager assesses all service users prior to admission to the home to ensure that the home will be able to meet their care needs. EVIDENCE: The Grove has developed a statement of purpose which sets out the aims and objectives of the home, and includes a service user guide which provides information about the service. In addition a brochure is provided with photographs of the home and the grounds. It is recommended that this brochure be updated with correct information to include the name of the current registered provider. It would also be appropriate for updated photographs to be included in this document. The Grove DS0000063217.V308610.R01.S.doc Version 5.2 Page 9 As recommended in the inspection report of the 14th February 2006 further information has been included in the service user guide on the criteria for admission to the home and further information has been included re the criteria for moving out of the home. The Grove consults the assessment information to see if they can meet the prospective service user needs before they make the decision to accept the application for admission and offer a placement. The registered manager assesses each potential service user before they are admitted to the home. In the absence of the manager another senior staff member would undertake the assessment. A permanent respite bed is available in the home allowing service users an opportunity to stay at the home on a short term basis. Clients also attend the home for day care. All admissions to the home are on a trial basis for the first month of the placement. The Grove DS0000063217.V308610.R01.S.doc Version 5.2 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,9 and 10 The quality outcome in this area is adequate. The service user’s health, personal and social care needs are being met by the staff and multidisciplinary staff as required. Medication is being administered correctly to the service users but one good practice recommendation is made as a result of this inspection. The majority of the service users are happy with the way that the staff deliver their care and respect their dignity. EVIDENCE: Each service user has a care plan in place which evidences the service user involvement in the care planning process. The care plan includes basic information necessary to plan the individual’s care and includes a risk assessment element. Evidence of updating information and changing actions appears on care plans. Evidence is generally in place of continual improvements to the system. Daily day and night records support the care The Grove DS0000063217.V308610.R01.S.doc Version 5.2 Page 11 planning documentation. A recommendation is made to continue to develop the important “life history” that is now in place for each service user. Some important information that is gathered at the pre admission assessment could be included into the life history information. The service users have access to health care services that meet their assessed needs both within the home and in the local community. The service users are able to choose their own general practitioner and all have access to dentists, opticians and other community services. A community nurse was attending 5 service users on the day of the inspection. The service users health is monitored and appropriate action taken. The home seeks professional advice on health care issues, acts upon it and generally is able to provide the aids and equipment recommended. There is evidence in the care plan of health care treatment and intervention, and a record of general health care information including weight monitoring, although it is noted that this has lapsed in some documentation. The home has a medication policy and procedure which is accessible to staff. Medication records are up to date for each service user, although there is no record of the receipt of the monthly medication. It is also noted that the date of receipt for controlled drugs is not consistently entered in the controlled drug register. There is evidence of some service users administering their own medication safely. The home has a training plan and intends to train it’s staff in health care to achieve accreditation. Staff are aware of the need to treat the service users with respect and to consider dignity when delivering personal care. A discussion took place with the staff and then manager around the frequency of bathing for the service users. Generally, documentation indicates that this is weekly, which for some of the service users is unsatisfactory. The manager indicated that this can be twice a week but the philosophy of choice appears to have got lost in this area. It is appropriate to review this situation at this time. The Grove DS0000063217.V308610.R01.S.doc Version 5.2 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,14 and 15 The quality outcome in this area is good. The home employs a full time activities co-ordinator to meet the social, religious and recreational needs and interests of the service users. The meals in the home are good with a very good range of choice offered except at breakfast where there are no cooked breakfasts available at this time. EVIDENCE: Sufficient staff resources are provided to allow time for service users’ activities and stimulation. The home operates a key worker system, which enables closer service user and staff relationships where likes, dislikes and needs are shared. An activities co-ordinator is employed by the home on a full time basis. She was spoken to during the course of the inspection. A number and variety of activities go on in the home to include special days, evenings and events. On the morning of the inspection the hairdresser was at the home and holy communion took place. On the afternoon of the inspection a poetry session took place. A lot of conversations with the service user took place around the changes in the gardens that have recently taken place. A rose The Grove DS0000063217.V308610.R01.S.doc Version 5.2 Page 13 garden has been established and a formal opening of the garden is to take place. All the activities available are displayed for the week for everyone to see. The activities co-ordinator keeps records of all the social activities. The home has developed a system for displaying information and bringing attention to community events and activities. Family and friends feel welcome and know that they can visit the home at any time. The design of the home provides seating areas within the communal areas of the home where the service users can entertain their visitors, in addition to the privacy of their own room. Daily records evidence when visitors have come to the home and all visitors to the home are encouraged to sign in the “visitors book” in the entrance of the home. The service users are encouraged to take responsibility for their own financial affairs and to user their money as they wish. Staff will support those service users who need help in financial matters. Food and mealtimes are treated as an occasion and something to be looked forward to. An experienced (head) cook is responsible for providing quality nutritional meals that meet the cultural and dietary needs of the service users. The meals provided at the home are rotated over a four week period. On the day of the inspection the main meal of the day was lamb steaks with spring greens and turnip. The alternative meal was fish or chicken. The service users are able to express their choices for all meals provided at the home on a menu choice form displayed on their meal table. A choice is made 24 hours in advance. It is noted that at this time there is no availability for a cooked breakfast should anyone want this and this should be reviewed. A satisfactory inspection of the kitchen was carried out by the district council environmental health officer on the 18th January 2006. The cook is qualified with an intermediate food hygiene certificate. The Grove DS0000063217.V308610.R01.S.doc Version 5.2 Page 14 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18 The quality outcome in this area is adequate. The home has a satisfactory complaints policy and procedure provided to the service users and their representatives in the service users guide. Staff require more training to ensure that they have the knowledge and understanding of adult protection issues to protect service users from abuse. EVIDENCE: The Grove has a complaints procedure that meets the national minimum standards and regulations. The complaints procedure is available in the home and all the service users have been provided with this information in the service user guide. A comments book is available to the service users in the dining room should they wish to make any comments negative or positive about the home. The home is keeping records of any complaints received as required by legislation. The policies and procedures regarding the protection of the service users require updating. The documentation requires expanding on information re when incidents need external input and who to refer the incident to. When the policy and procedure is amended it is appropriate for all staff to read this documentation again. It is also recommended that training takes place on adult protection which some staff have received but more should attend training where possible. The Grove DS0000063217.V308610.R01.S.doc Version 5.2 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 the following standard(s): 19,20,23 and 26 The quality outcome in this area is good. The Grove is a well maintained, very pleasant, safe and comfortable environment for the service users and the staff. EVIDENCE: The Grove is situated in a residential area within easy care access to the centre of St Austell. The home is well maintained externally and internally with a maintenance person and gardener employed. The grounds are particularly pleasant and have recently been improved with the addition of a rose garden. The grounds are available to the service users and are provided with a hand rail for easier access if required. Communal areas are very spacious and include a quiet lounge, larger lounge and dining room off. A smoking lounge is also available at the home. Bedrooms are available on the ground and first floor of the home. A shaft lift is available to the first floor of the home if required. Bedrooms can be The Grove DS0000063217.V308610.R01.S.doc Version 5.2 Page 16 individually personalised and some of the bedrooms have views out to sea. All of the bedrooms at the home are lockable. In total nineteen of the bedrooms have en-suite facilities, with fourteen of these having either a bath or a shower as well as a hand basin and toilet. It is noted that some of the bedrooms are rather dark and lighting should be reviewed in these rooms. The home was found to very clean on the day of the inspection with staff employed specifically for these duties and laundry duties. The Grove DS0000063217.V308610.R01.S.doc Version 5.2 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 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 The quality outcome in this area is adequate. Staffing levels should be reviewed to ensure that the care needs of the service users are being met at all times. The home recognises the importance of training, and delivers where possible a programme that meets any statutory requirements. There are still some areas that need attention. Recruitment procedures are satisfactory. EVIDENCE: The majority of the service users are very happy that the care they receive meets their needs. There are though some service users who suggest that there are limited opportunities for bathing for example which could be related to staffing levels. One relative comment card identified a lack of staff particularly at the week-ends. Consequently, staffing levels should be reviewed to ensure that the care needs of the service users are being met at all times. All the staff employed at the home are included in the staffing rota which rotates over a four week period. Team leaders are employed on all shifts and senior care staff are also employed. The different levels of staff wear different The Grove DS0000063217.V308610.R01.S.doc Version 5.2 Page 18 coloured uniforms and all have staff name badges. The home operates a key worker system. Two waking night staff members are employed by the home. Staff information re recruitment to include criminal records bureau checks, written references and fully completed application forms are satisfactory. The home follows equal opportunity recruitment procedures. The Grove recognises the importance of training, and delivers where possible a programme that meets any statutory requirements. There are still some areas which need attention. This includes adult protection training and first aid for example. Fire drill and moving and handling training is fully up to date. Over 50 of the staff have obtained an NVQ 2 and or NVQ 3 in care. Evidence is available in the staff files of induction training. The Grove DS0000063217.V308610.R01.S.doc Version 5.2 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 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): 31,33,35 and 38 The quality outcome in this area is adequate. Following this inspection it is appropriate for the registered manager and registered provider to review a number of aspects of the service delivery at The Grove to ensure that standards are not deteriorating. EVIDENCE: The registered manager is qualified to undertake her duties. She is supported in her duties by a full time administrator. The registered provider visits the home monthly (and more if required) and provides the Commission for Social Care Inspection with a report of his visits as required by legislation. As discussed with the manager and administrator it may be appropriate for the registered provider to visit the home more frequently at this time to spend some time with the service users. This time could be used to establish the concerns that some of them have about the home. It was also suggested that The Grove DS0000063217.V308610.R01.S.doc Version 5.2 Page 20 it may be a good time to undertake a quality assurance/monitoring review of the home following the inspection. The service users are very involved in the running of the home. They have their own meetings and committee. Minutes are available from these meetings. The service users have the opportunity to manage their own money if they wish, and facilities are provided to keep it safe. Where the home manages money on service users’ behalf a system is in place to record transactions and accounts for spending. Checks show that the records are up to date and correct. The home has developed a health and safety policy that meets health and safety requirements and legislation. There are plans for staff to receive health and safety training and 5 staff are presently receiving infection control training. Maintenance records for all equipment in the home are up to date as documented in the pre inspection questionnaire. The Grove DS0000063217.V308610.R01.S.doc Version 5.2 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. 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 2 x 3 x x x HEALTH AND PERSONAL CARE Standard No Score 7 3 8 2 9 2 10 2 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 x 18 2 4 3 x x 3 x x 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 x 3 x 3 x x 3 The Grove DS0000063217.V308610.R01.S.doc Version 5.2 Page 22 Are there any outstanding requirements from the last inspection? NO STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard OP1 Good Practice Recommendations To update the brochure for the home with recent photographs and correct information on the registered provider. To continue to develop the life history on each service user. To review the frequency of the providing baths to the service users. To regularly record weight monitoring of the service users. To record on the medication administration records the date that the medication is received into the home and who it is checked by. To give consideration to providing a cooked breakfast to those service users who may wish for this choice to be available. To update the adult protection policy and procedure and DS0000063217.V308610.R01.S.doc Version 5.2 Page 23 2. OP7 3. 4. 5. 6. OP8 OP9 OP15 OP18 The Grove 7. OP23 provide adult protection training to all staff. To review the lighting in some of the bedrooms at the home which are rather dark. The Grove DS0000063217.V308610.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection St Austell Office John Keay House Tregonissey Road St Austell Cornwall PL25 4AD 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 Grove DS0000063217.V308610.R01.S.doc Version 5.2 Page 25 - 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. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!