Inspection on 19/07/05 for The Grove

This inspection was carried out on 19th July 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 Grove 21/05/09

The Grove 28/05/08

The Grove 19/06/07

The Grove 17/10/06

The Grove 14/02/06

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 Unannounced 19 July 2005 08:15 a.m. 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 Grove D52_D04 S63217 The Grove V227853 190705 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service The Grove Address 181 Charlestown Road St. Austell Cornwall PL25 3NP 01726 76481 01726 67457 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) 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 D52_D04 S63217 The Grove V227853 190705 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: Two named persons (married couple) only below the agreed age range may be accommodated Date of last inspection 15th March 2005 Brief Description of the Service: The Grove is registered for thirty one service users within the category of old age. There is currently a variation of certificate in place to accommodate a married couple who are under 65 and over 60. 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 accomodation 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 D52_D04 S63217 The Grove V227853 190705 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 over seven hours and was carried out as an unannounced inspection. Service users and staff were spoken to during the course of the inspection. Care records, staff files and policies and procedures were inspected. All of the feed back (from the service users) in relation to the standard of care being delivered was very positive. The home has recently changed hands and this is the first inspection under the new ownership. The manager was on duty at the time of the inspection. What the service does well: What has improved since the last inspection? The medication administration has improved since the statutory requirement in the inspection report of the 15th March 2005. All staff who have medication administration responsibilities have now received accredited medication training. The Grove D52_D04 S63217 The Grove V227853 190705 Stage 4.doc Version 1.30 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. The Grove D52_D04 S63217 The Grove V227853 190705 Stage 4.doc Version 1.30 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 Grove D52_D04 S63217 The Grove V227853 190705 Stage 4.doc Version 1.30 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) 1,2,3,4 and 5 The homes statement of purpose and service user guide are good and provide service users and prospective service users with details of what the home provides enabling an informed decision about admission to the home. Service users are provided with a contract of care detailing the terms and conditions of their placement. 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. Visits to the home prior to admission are encouraged. EVIDENCE: A service user guide has been produced for all service users within the home. The service user guide is available in large print if required. Prior to admission potential service users receive a very detailed brochure. Service users and their relatives/representatives can also access the home’s website should they so wish. The Grove D52_D04 S63217 The Grove V227853 190705 Stage 4.doc Version 1.30 Page 9 The statement of purpose document is in place and the information that was required to be included from the inspection report of the 15th March 2005 is now in place. Each service user has a written detailed contract/statement of terms and conditions in place. The information in the contract includes details on occupancy, fees, rights and obligations in relation to the service users placement. Some amendments to the document around legislation were made immediately by the home’s administrator. Each service user is assessed prior to admission to the home by the registered manager. In the absence of the manager another senior staff member would undertake this assessment. The assessment document includes all information required to establish if the home can meet the care needs of the service users being admitted. This process is explained in the service user guide document. The home has in place an admission policy and procedure in place to guide staff on all new admissions to the home. Staff are receiving statutory and good practice training to enable them to meet the care needs of the service users being admitted to the home. All potential service users are encouraged to visit the home prior to admission. A permanent respite bed is available in the home allowing service users an opportunity to stay at the home on a short term basis. All admissions to the home are on a trial basis for the first month of the placement. Records are in place of all “enquiries” to the home. The Grove D52_D04 S63217 The Grove V227853 190705 Stage 4.doc Version 1.30 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 and 10 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. Service users were observed by the inspector to be treated with the utmost dignity and respect at all times. EVIDENCE: Each service user has a care plan in place that evidences the service users involvement in the care planning process. All the staff are involved in the care planning documentation recording. The care plans include a risk assessment and moving and handling assessment as well as in important life history. It is recommended that the care plans include more information when “risks” have been identified. The care plans are supplemented by day and night recording. Monthly reviews of the care plans are taking place. It is recommended that documentation is consistently completed around personal care delivery ie bathing. The health care needs of the service users are identified in the care planning documentation and the care plans evidence the involvement of health care The Grove D52_D04 S63217 The Grove V227853 190705 Stage 4.doc Version 1.30 Page 11 professionals as required. Each service user is registered with a general practitioner. Dietary information/needs are included in care planning and service users are being offered the opportunity of being weighed regularly. The home operates the monitored dosage medication system and all staff who have medication administration responsibilities have received accredited medication training. A medication policy and procedure is in place to guide staff and a good practice recommendation for the policy was dealt with immediately on the day of the inspection by the home’s administrator. All storage of controlled medication was found to be satisfactory on the day of the inspection and all medication administration records were found to be completed appropriately. Improvements are noted to the medication administration following the statutory requirement in the inspection report dated the 15th March 2005. Service users were observed by the inspector to be treated with the utmost dignity and respect by all the care staff and the service users spoken to during the course of the day expressed very positive comments about the kindness of the staff employed. Staff were also noted to be able to spend time talking with the service users which they stated that they enjoyed. The Grove D52_D04 S63217 The Grove V227853 190705 Stage 4.doc Version 1.30 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 The home employs a full time activities co-ordinator to meet the social, cultural, 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 at all meals. EVIDENCE: An activities co-ordinator is employed by the home on a full time basis. She was spoken to during the course of the inspection. She explained the variety of activities that go on in the home to include one to one time which can include anything the service user may wish to do. There are also many group activities. On the afternoon of the inspection a singer was performing to the service users. This event was spoken of highly by the service users. The activities co-ordinator keeps good records of all the social activities and care plans evidence that the social interests of the service users have been assessed. The activities that are available in the home are displayed for all to see for the whole week ahead. On the morning of the inspection communion was taking place and the hairdresser was also in the home. The Grove D52_D04 S63217 The Grove V227853 190705 Stage 4.doc Version 1.30 Page 13 Visitors are welcome to the home although documentation suggests that visiting at meal times should be avoided. 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. Service users are helped to exercise choice and control over their lives. They are encouraged to bring personal possessions into the home with them (this is evidenced by the very individual bedrooms at the home). The home actively encourages service users to continue with their interests. Care plans evidence that individual choices have been made around routines for going to bed for example. The cook was spoken to on the morning of the inspection. She explained and evidenced that the meals provided in the home are on a four weekly rota. On the day of the inspection the main meal of the day was liver and bacon with cauliflower (and sauce) and mixed vegetables. The sweet was fresh fruit salad or ice cream, yoghourt or fresh fruit. The alternative main course meals available on the day of the inspection were poached chicken or poached fish. Service users are able to express their choices for all meals provided at the home on a menu choice form displayed at their meal table. A choice is made 24 hours in advance and the range of choice available is very good. The service users are fully involved in the choices of the meals provided in the home and recent changes to the menu have taken place. The home employs a head chef who is qualified to the intermediate hygiene level and another cook who has a foundation certificate qualification. The requirements of the district council environmental health officer inspection have been met. The Grove D52_D04 S63217 The Grove V227853 190705 Stage 4.doc Version 1.30 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 and 18 The home has a satisfactory complaints procedure provided to the service users and their representatives in the service user guide. Staff are provided with adult protection training and documentation to ensure that they have the knowledge and understanding of adult protection issues to protect service users from abuse. EVIDENCE: The home has a complaints policy and procedure in place which all the service users have been provided with in their service user guide. A comments book is available to the service users in the dining room should they wish to make any comments negative and positive about the home. The home has a detailed adult protection policy and procedure in place which includes the “No Secrets” documentation and the local social services department protection procedures. A whistle blowing policy and procedure is also in place and staff are signing to say when they have read the policies. Some of the staff have attended the local social services adult protection training and more are due to attend. The Grove D52_D04 S63217 The Grove V227853 190705 Stage 4.doc Version 1.30 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) The environmental standards were not assessed at this inspection. EVIDENCE: The Grove D52_D04 S63217 The Grove V227853 190705 Stage 4.doc Version 1.30 Page 16 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 Staffing levels are appropriate to meet the needs of the service users in the home. Recruitment procedures are generally satisfactory but the home must ensure that at all times criminal records bureau checks for staff employed are in place. Staff training at the home is good. EVIDENCE: All 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 three senior carers are employed. The different levels of staff wear different coloured uniforms and all have staff name badges. Two waking night staff members are employed by the home. The service users spoken to during the course expressed very positive comments on the kindness of the staff employed. Staff information including criminal records bureau checks, references and all information required for recruiting staff is kept in good order by the home’s administrator. Staff complete application forms and two written references are taken. It was though noted on the day of the inspection that a new staff member on duty had not had a enhanced criminal records bureau check which is a requirement of correct recruitment procedures. The home provides all statutory training and a wide range of good practice training. All staff are regularly provided with fire drill training, manual handling training and senior staff undertake first aid training. All staff files are The Grove D52_D04 S63217 The Grove V227853 190705 Stage 4.doc Version 1.30 Page 17 well organised with good records and certificate evidence kept of all training provided. New staff members receive induction training which is based on recognised good practice. Two carers were observed to be discussing their NVQ training that they are presently undertaking. The Grove D52_D04 S63217 The Grove V227853 190705 Stage 4.doc Version 1.30 Page 18 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) 31,35 and 38 The new registered provider and manager are committed to maintaining the high standards at The Grove. Service users’ financial interests are safeguarded by the home’s good records. As far as is practicably possible the health, welfare and safety of the service users is promoted and protected. EVIDENCE: The registered manager was on duty on the day of the inspection. She is presently in the process of completing her NVQ 4 studies and hopes to obtain her registered managers award soon. The manager is supported in her duties by a full time experienced administrator. A change of ownership of the home has recently taken place and the new registered provider visits the home approximately twice a month. He is due to send reports of his visits to the home to The Commission for Social Care Inspection. The Grove D52_D04 S63217 The Grove V227853 190705 Stage 4.doc Version 1.30 Page 19 The service users are encouraged to control their own finances. If they do not wish to do so the home can help them. Full records are kept by the home’s administrator of all money held on behalf of the service users. Safe storage of all money held is provided by the home. The home’s administrator has health and safety responsibilities for The Grove. She explained the training matrix which evidences that staff receive health and safety training. Fire drill training is taking place as required by legislation to include three monthly training for night staff. A satisfactory fire inspection took place of the premises on the 12th January 2005. COSHH very detailed risk assessments are in place. All required health and safety risk assessments are in place as required. The Grove D52_D04 S63217 The Grove V227853 190705 Stage 4.doc Version 1.30 Page 20 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 3 3 3 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 4 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION x x x x x x x x 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 3 3 x x x 3 x x 3 The Grove D52_D04 S63217 The Grove V227853 190705 Stage 4.doc Version 1.30 Page 21 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 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. 2. Refer to Standard 7 29 Good Practice Recommendations To consistently record the delivery of personal care and include more information when risks to service users have been identified. To ensure that all staff members employed receive a criminal records bureau check. The Grove D52_D04 S63217 The Grove V227853 190705 Stage 4.doc Version 1.30 Page 22 Commission for Social Care Inspection 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 D52_D04 S63217 The Grove V227853 190705 Stage 4.doc Version 1.30 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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