Inspection on 18/01/06 for The Grove Residential Home

This inspection was carried out on 18th January 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 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 Grove Residential Home 02/05/07

The Grove Residential Home 08/05/06

The Grove Residential Home 08/09/05

The Grove Residential Home 21/03/05

The Grove Residential Home 18/01/05

Similar services:

Byars Care Home

St Marys Nursing Home

Bramble Lodge

Parkmanor Residential Home

Thornham Grove

Hunter`s Lodge

London Road Neurological and Specialist Care Unit

Carlton Care Home

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

CARE HOMES FOR OLDER PEOPLE The Grove Nursing Home 14 Church Road Skellingthorpe Lincoln Lincs LN6 5UW Lead Inspector Vanessa Gent Unannounced Inspection 18th January 2006 09:30 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 Nursing Home DS0000060330.V278361.R01.S.doc Version 5.1 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 Nursing Home DS0000060330.V278361.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service The Grove Nursing Home Address 14 Church Road Skellingthorpe Lincoln Lincs LN6 5UW 01902 737170 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) Guardian Care Homes (UK) Limited Care Home 25 Category(ies) of Old age, not falling within any other category registration, with number (25) of places The Grove Nursing Home DS0000060330.V278361.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. The home is registered to provide nursing and personal care for service users of both sexes whose primary needs fall within the following categories:Old Age, not falling within any other category (OP) (25) The maximum number of service users to be accommodated is 25 2. Date of last inspection 08/09/05 Brief Description of the Service: The Grove, which is owned by Guardian Care, is a two storey, Grade II listed country house, with a single storey extension, situated on the outskirts of Lincoln. Local facilities, including the parish church and village shops, are within walking distance of the home. The home is registered to provide personal and nursing care for up to twentyfive residents of both sexes over the age of 65 years. The residents are housed in thirteen single rooms, of which one is ensuite and six shared rooms. Communally, there is a large lounge, a dining room, two bathrooms, two shower-rooms and seven toilets. The home is pleasantly decorated throughout, with residents rooms containing their own furniture and ornaments. The grounds are beautifully maintained to provide a tranquil outdoor area and there are ample car parking facilities. The home’s statement of purpose states that ‘we aim to provide a comfortable, homely environment in which care is provided by skilled staff to a standard that is acceptable and desirable’. The Grove Nursing Home DS0000060330.V278361.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection, which took five hours, was conducted by one inspector. A partial tour of the building took place; documents were examined and care records inspected. The main method of inspection used is called case-tracking, which involves selecting a proportion of residents and tracking the care they receive through the checking of records, discussion with them, the care staff and observation of care practices. Three residents’ care plans were examined. Five of the staff on duty and three of the twenty-two residents were spoken with. Staff were observed in their handling of and dealing with residents both in the lounge and at the mealtime. What the service does well: What has improved since the last inspection? What they could do better: Radiators, which have been required to be covered to protect residents from risk of burns, have not been covered nor are risk assessments in place. The cleaning schedules are not maintained regularly to show that acceptable hygienic conditions are provided at all times in the kitchen. Staff say that they are always too rushed and do not have enough time to give quality time to the residents; that there are too many agency staff used; that often there are not enough staff on duty to care safely or adequately for the residents’ high levels of needs; that they feel that they have no-one at present to go to with any concerns. The Grove Nursing Home DS0000060330.V278361.R01.S.doc Version 5.1 Page 6 Although the statement of purpose states “the home is committed to staff training and development” and “staff are encouraged to put their names forward for any courses that they may wish to undertake as part of their personal development”, staff say this is not happening: some mandatory training and training for Adult Protection is outstanding, leaving residents at risk of harm. Staff who have achieved NVQs are not rewarded in their work so feel they have no encouragement to work for these awards. Staff feel there is no communication from the company so they feel “left out” and “neglected” and “kept in the dark”. 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 Nursing Home DS0000060330.V278361.R01.S.doc Version 5.1 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 Nursing Home DS0000060330.V278361.R01.S.doc Version 5.1 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 The statement of purpose contains all the information necessary for anyone considering living at the home to make an informed choice. EVIDENCE: The statement of purpose and service user guide were seen. They contain the information as required in National Minimum Standards and provide prospective residents and their representatives with details of what the home provides for its residents. Service user guides are given to all residents admitted to the home. The Grove Nursing Home DS0000060330.V278361.R01.S.doc Version 5.1 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, 9, 10 Care plans and medication records show enough up-to-date information about the residents to enable staff to care for them safely and adequately. However, involvement of the resident or relative in the care plan reviews is not documented. Privacy and dignity is respected at all times. EVIDENCE: Care plans examined for those residents case-tracked show detailed records so that staff know how to care for the residents safely and in accordance with their wishes and needs. One relative has requested involvement in the care plans but there is no evidence that this has taken place. Care plans are not signed by any resident or relative to document involvement, although there are forms in place stating how much, if any, involvement the resident or relative wishes to have and these are signed. Pharmacy practices are in accordance with the safe practices required and recommended by the Royal Pharmaceutical Society. The Grove Nursing Home DS0000060330.V278361.R01.S.doc Version 5.1 Page 10 Residents say staff respects their privacy and dignity and that they feel comfortable and safe in the home. Staff were seen and heard to be respectful and pleasant to residents both in their own rooms and in the communal areas. The Grove Nursing Home DS0000060330.V278361.R01.S.doc Version 5.1 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): 13, 15 Relatives and visitors are welcomed to the home. Choice is given to residents in most aspects of their lives at the home although not in the food they would like to eat. EVIDENCE: Contact with families is reported to be good, with relatives writing compliment letters and cards saying how they were welcomed as “part of the ‘family’ of the home” and how they “appreciated the care and devotion that the staff gave to their loved ones whilst they were in the home”. Residents say they are satisfied with the food and meals provided although the menu seen is not seasonal. Choice at each meal is still limited and not fully provided. Fresh fruit and vegetables are available and provided. One resident stated “The food is alright, in fact, very good. I don’t want a choice; I’m not a fussy eater so I’m not bothered about choosing.” Other residents repeated this. Although the food cooked for each lunch time meal is noted, what each residents requests or is given is not recorded so it is not possible to inspect The Grove Nursing Home DS0000060330.V278361.R01.S.doc Version 5.1 Page 12 whether all residents, especially those with special dietary requirements, are getting a balanced, nutritious diet. One residents who has a vegetarian diet says “it is a good menu”. The Grove Nursing Home DS0000060330.V278361.R01.S.doc Version 5.1 Page 13 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, 18 Residents are not fully safeguarded against the risk of abuse but feel safe in the care of the staff team. EVIDENCE: The complaints procedure is clearly displayed in the foyer of the home. No complaints have been received since the last inspection. Staff are aware of how to deal with anyone wishing to make a complaint. Some but not all staff has undertaken adult abuse prevention training. It is imperative that all staff attend this training to ensure that the residents are kept safe at all times. Residents spoken with say they feel very safe with the staff and that they look after them really well. Relatives confirm this in the compliment cards seen. The Grove Nursing Home DS0000060330.V278361.R01.S.doc Version 5.1 Page 14 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, 21, 24, 25 Although most areas of the home are comfortable and meet the wishes and needs of the residents, some areas may expose residents to the risk of harm and some staff to unacceptable working conditions. EVIDENCE: Staff say that new equipment is desperately needed in the kitchen for safe and efficient preparation of food. Several staff said that “the kitchen is a disgrace whilst ‘fancy goods’ are provided to enhance the outward appearance of the home”. Staff say that the temperature in the kitchen is often at an unbearably high level and difficult to work in. Efficient air extractors are needed in the kitchen to maintain a temperature that is acceptable to work in – it currently goes above 28°C - and the laundry to remove unacceptably strong odours from the chemicals used. The Grove Nursing Home DS0000060330.V278361.R01.S.doc Version 5.1 Page 15 Communal areas are clean, tidy, well-maintained and provide a comfortable environment for the residents. However, one bathroom had been used, smelt malodorous and had not been cleared up after use. The residents’ bedrooms are personalised and they say they feel comfortable and safe. Radiators, which have been required to be covered over past inspections, still pose a risk to the safety of some residents; risk assessments having not been put in place where they are exposed and within reach of residents. Cleaning schedules for the kitchen have not been kept regularly to ensure that hygienic standards are maintained. The Grove Nursing Home DS0000060330.V278361.R01.S.doc Version 5.1 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 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, 30 Staff work at the home often in insufficient numbers, without enough training and with not enough company or managerial support to ensure that they care for the residents safely, adequately and appropriately, although residents feel well-cared for and have no complaints about the care they receive. EVIDENCE: All staff feel that staffing levels are not always adequate to care for the residents without feeling rushed; “always too busy and not enough time to spend with the residents”. “Agency staff, both nurses and carers, that are used to supplement the staff team, work slower than the staff team so their work takes longer, which puts extra pressure on staff.” On the day of the inspection, four staff were on duty in the morning, although only two were the home’s own staff. On the late shift, only three staff were on duty. Study of the present and past duty rotas indicate that on a regular basis, there are insufficient staff on duty, especially for the late shifts. On some days, only one nurse and one carer have been on duty. Staff said that they are not paid for overtime so they cannot help out when the home is short-staffed. Residents say “staff have been marvellous; no complaints here. The Grove Nursing Home DS0000060330.V278361.R01.S.doc Version 5.1 Page 17 Staff say that the induction process is not sufficiently robust enough; some staff have been expected to care for residents before they feel confident enough to do so. Although the home’s statement of purpose states that “the home is committed to staff training and development” and “that staff are also encouraged to put their names forward for any courses that they may wish to undertake as part of their personal development”, staff say they are not rewarded for undertaking NVQs, are not encouraged to study and do not feel valued. Staff training is not up-to-date for all mandatory training, some staff’s certificates indicating their training was undertaken up to and more than three years previously. Staff state they feel in need of training updates. The Grove Nursing Home DS0000060330.V278361.R01.S.doc Version 5.1 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 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): 33, 36, 37, 38 The home is not run at all times in the best interests of residents and staff. There are not enough company or managerial monitoring systems in place, which has resulted in low morale amongst staff. EVIDENCE: The home is currently without a manager although the post has been advertised. The acting manager has no supernumery time for administrative and supervisory work and all her time is taken with caring, nursing work. Little evidence has been seen of the responsible person having completed regular, monthly, unannounced visits to monitor the quality of the service and the surroundings. The Grove Nursing Home DS0000060330.V278361.R01.S.doc Version 5.1 Page 19 Since before the previous manager left, staff supervisions and staff meetings have not taken place regularly and insufficient communication has been received from the company, leaving staff feeling unsupported, ignored and uncared for. Staff stated, “when a query was made, no-one got back to us”; “company staff don’t speak to anyone except the manager so staff feel left out”. “No-one even said ‘Hello’ to us staff”. Many staff have worked at the home for a long time but all feel that they’ve “never known it to be so bad. There’s no-one we can talk to.” Maintenance records are kept up-to-date with water and room temperatures, general maintenance and repairs. Not all staff keep up-to-date with records, including the cleaning schedules in the kitchen and what food is given to residents at each meal. Door wedges were in use at the kitchen door and various other rooms. The person in charge needs to seek the advice of the Fire Officer as to alternative acceptable and safe means for keeping doors open, where required or desired. Chemicals and materials regulated by Control of Substances Hazardous to Health (COSHH) are kept, unlocked, in the laundry but the door to this room is not kept locked. It needs to be kept locked to protect residents at all times. The Grove Nursing Home DS0000060330.V278361.R01.S.doc Version 5.1 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 Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 3 X X X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 X 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 X 13 3 14 X 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 2 2 3 2 X X 3 2 X STAFFING Standard No Score 27 2 28 X 29 2 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score X X 2 X X 2 2 2 The Grove Nursing Home DS0000060330.V278361.R01.S.doc Version 5.1 Page 21 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 2 Standard OP18 OP19 Regulation 13.6 23.2 Requirement Adult protection training must be undertaken by all staff to keep the residents safe from harm. All parts of the home, including the kitchen, must be in a good state of repair and the equipment in good working order, to provide staff with suitable conditions to work in. Bathrooms must be kept clean at all times, for the use of residents. Radiator covers must be provided on all radiators where the risk assessment indicates a need to safeguard residents. Staffing numbers and skill mix must be sufficient to care for the residents adequately at all times. A full induction programme must be devised and used to train staff to care for residents appropriately. Staff training must be undertaken by all staff to ensure the health and welfare of the residents. A training programme must be produced to enable staff to determine and cater for their DS0000060330.V278361.R01.S.doc Timescale for action 28/02/06 30/04/06 3 4 OP21 OP25 23.2 23.2 28/02/06 28/02/06 5 6 OP27 OP29 18.1 18.1 28/02/06 31/03/06 7 OP30 18.1 31/03/06 The Grove Nursing Home Version 5.1 Page 22 8 OP33 26.2-5 9 OP36 18.2 10 11 OP37 OP38 17.1,2 16.2, 23 training needs. The responsible person must visit the home unannounced, monthly, to monitor the service provided and write a report which must be imparted to the manager and CSCI. Staff supervision must take place on a regular basis to ensure that the care provided by staff is appropriate to the needs of the residents. All records must be kept up-todate and accurately reflect the home’s practices and situation. COSHH materials must be kept in locked facilities to keep them from the reach of residents. 31/03/06 30/04/06 31/03/06 28/02/06 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 2 3 Refer to Standard OP19 OP36 OP38 Good Practice Recommendations It is recommended that the air extraction system in the kitchen should be suitable for staff to work in comfortable conditions. It is recommended that staff supervision should take place six times a year for all staff. A keypad to the laundry door would allow access to only staff and not unauthorised persons. The Grove Nursing Home DS0000060330.V278361.R01.S.doc Version 5.1 Page 23 Commission for Social Care Inspection Lincoln Area Office Unity House, The Point Weaver Road Off Whisby Road Lincoln LN6 3QN 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 Nursing Home DS0000060330.V278361.R01.S.doc Version 5.1 Page 24 - 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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