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Inspection on 06/09/05 for The Grove Residential Home

Also see our care home review for The Grove Residential Home for more information

This inspection was carried out on 6th September 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.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

This home provides a comfortable, clean and homely environment for residents. The staff group know the residents well as most have been working in the home for a number of years. Residents spoken to said they liked living in the home and that the staff responded to their needs promptly and spoke respectfully to them. Specific comments were "The staff are very kind, very nice" and "I feel I am listened to by the staff".

What has improved since the last inspection?

One care plan has been re-written and this now includes sufficient information to ensure that all aspects of health, personal and social care needs are identified and planned for. Water safety valves have been fitted to all taps, a new fridge and dishwasher has been purchased together with a new drugs fridge. Electrical and gas safety certificates have been obtained. Improvement work in the kitchen has now been completed and cleaning schedules are being maintained.

What the care home could do better:

Action must be taken to address the requirements and recommendations raised during the last three inspections. Care plans must be re-written (including risk assessments) to ensure staff know what to do for each resident. Residents should be involved in this process and sign in agreement with their plan of care. Staff training and supervision must be prioritised so that staff are given clear guidance to carry out their roles and responsibilities.

CARE HOMES FOR OLDER PEOPLE The Grove Residential Home West Ashby Horncastle Lincs LN9 5PR Lead Inspector Elisabeth Pinder Unannounced 6 September 2005 @ 9:30 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 Residential Home C53 C04 S57752 The Grove V244133 060905 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service The Grove Residential Home Address West Ashby Horncastle Lincs LN9 5PR 01507 522507 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) Highgrove Care Ltd Care Home Only (PC) Old Age, not falling within any other category (OP) Category(ies) of 19 registration, with number of places The Grove Residential Home C53 C04 S57752 The Grove V244133 060905 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: None Date of last inspection 06.07.05 Brief Description of the Service: The Grove cares for older people in a non-smoking environment in a large detached property situated in the village of West Ashby, which is two miles from the market town of Horncastle. The home used to be a country house and is set in its own mature grounds and walled gardens with car parking facilities to the front and rear. The house is a listed building and therefore any changes to the facade must involve a planning process. The home has three floors and there is a passenger lift to the bedrooms on the first floor and a stair lift to the second floor. The rooms on the second floor have been created from attic accommodation and all four have traditional sloping ceilings. On the first floor there are four stairs to negotiate to access three of the single bedrooms. Thirteen of the bedrooms are single, two of them have an ensuite toilet. There are two toilets on the ground floor, two bathrooms with toilets and one single toilet on the first floor and a shower room on the second floor. The Grove Residential Home C53 C04 S57752 The Grove V244133 060905 Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was undertaken by one inspector and took place over 5 hours. The main method of inspection used was ‘case tracking’, which involved selecting three residents and tracking the care they receive through the checking of records, discussions with them and the care staff. What the service does well: What has improved since the last inspection? What they could do better: Action must be taken to address the requirements and recommendations raised during the last three inspections. Care plans must be re-written (including risk assessments) to ensure staff know what to do for each resident. Residents should be involved in this process and sign in agreement with their plan of care. Staff training and supervision must be prioritised so that staff are given clear guidance to carry out their roles and responsibilities. The Grove Residential Home C53 C04 S57752 The Grove V244133 060905 Stage 4.doc Version 1.40 Page 6 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 Residential Home C53 C04 S57752 The Grove V244133 060905 Stage 4.doc Version 1.40 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 Residential Home C53 C04 S57752 The Grove V244133 060905 Stage 4.doc Version 1.40 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) The above standards were not inspected on this occasion. EVIDENCE: The Grove Residential Home C53 C04 S57752 The Grove V244133 060905 Stage 4.doc Version 1.40 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 standard(s) 7 & 9 Care plans do not contain sufficient detail to ensure that the health and personal care needs of residents are met. Medication coming into the home is not being recorded correctly and these shortfalls have the potential to place residents at risk. EVIDENCE: Since the last inspection only one care plan has been re-written and now includes sufficient information to ensure that all aspects of health, personal and social care needs are identified and planned for. This was discussed during the previous two inspections but has not been addressed. Therefore, an immediate requirement was made. Daily entries in care records are written, however, these often state ‘fine today’ and give little indication of the actual care given. This was also discussed during the last inspection but has not changed. Although appointments to visit the dentist, opticians and chiropodists have not been recorded, residents said that they were able to access these services either within the home or in the nearby town. Policies and procedures are in place regarding the receipt, storage, administration and disposal of medication and staff responsible for giving residents their medication confirmed that they have completed medication training. However, ‘Temazepam’ medication is not being recorded according to The Grove Residential Home C53 C04 S57752 The Grove V244133 060905 Stage 4.doc Version 1.40 Page 10 The Royal Pharmaceutical Guidelines. During the previous visit management were asked to complete a competency assessment for one resident who manages her own medication. This has not been done. The Grove Residential Home C53 C04 S57752 The Grove V244133 060905 Stage 4.doc Version 1.40 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 standard(s) 12 & 14 The home provides a range of activities and leisure interests both within the home and community. These are based on residents preferences who are encouraged to make choices about their preferred lifestyles and routines. EVIDENCE: Residents spoken to during the inspection said that they are able to take part in a variety of activities and leisure interests, including knitting, dominoes, reading and gardening. Residents also said that they have the choice of whether and what they participate in, one resident said that she prefers her own company in her room and loves to read. She said that she is able to change her books frequently and said that staff respect her wishes, giving her the privacy to live as she chooses. Residents talked about the recent ‘fair’ held in August saying that they had really enjoyed this event and that it had been well attended by their families and friends. Staff said that regular church services are held offering communion for residents who wish to take part in this activity. The Grove Residential Home C53 C04 S57752 The Grove V244133 060905 Stage 4.doc Version 1.40 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 standard(s) The above standards were not inspected on this occasion. EVIDENCE: The Grove Residential Home C53 C04 S57752 The Grove V244133 060905 Stage 4.doc Version 1.40 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 standard(s) 26 The home is clean and free of unpleasant odours. EVIDENCE: Separate staff are employed to carry out domestic duties and on the day of the inspection the home was clean, tidy and free from any unpleasant smells. During the last inspection the home’s Environmental Health Officer had served an improvement notice for work to be carried out immediately to ensure the health and safety of residents. This work has now been completed and cleaning schedules for the kitchen and food storage areas are being maintained. Residents spoken to said that the home is always kept clean and tidy. The Grove Residential Home C53 C04 S57752 The Grove V244133 060905 Stage 4.doc Version 1.40 Page 14 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 & 30 The staff group are an established team and staffing levels are sufficient to meet the current needs of residents. Staff are committed to the work they do but must be provided with training to ensure they have the knowledge and skills needed to carry out their roles. EVIDENCE: All residents spoken to were complimentary about the care staff provide. They said that they felt there was enough staff on duty and that their needs are being met. However, they did not know who was in charge but said that they felt able to raise any problems with all staff should they arise. Discussion with staff and records examined demonstrated that there are always two care staff on duty in the mornings and two in the afternoons. There is one wakeful and one staff member “sleeping-in” and on-call at night. Staff work additional hours to cover any shortfalls. The home does not have a training record and staff spoken to have not had up to date training in health and safety, moving and handling or first-aid. Therefore, an immediate requirement was given. One new member of staff has not undertaken a recognised induction training programme and staff are not receiving supervision. The Grove Residential Home C53 C04 S57752 The Grove V244133 060905 Stage 4.doc Version 1.40 Page 15 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) 33, 35 & 38 There is insufficient leadership and direction for staff to ensure residents receive consistent quality care. Some record keeping systems need attention in order that they adequately demonstrate that residents are being protected from risks to their health and safety. EVIDENCE: An additional visit was made to the home in July after notification that the registered manager had suddenly left her post. The home has been running without a registered manager since June with support and guidance being given by the registered provider who visits approximately once a week. Two members of staff were covering the role of acting managers, however, one has returned to her role as team leader. The registered provider was present during the inspection and acknowledged that a number of requirements raised during the previous inspection had not been addressed. At present there is no system in place for monitoring quality assurance and management are asked to address this and seek the views of The Grove Residential Home C53 C04 S57752 The Grove V244133 060905 Stage 4.doc Version 1.40 Page 16 residents, their relatives/representatives and all other professionals involved in the service as to whether or not the home is achieving its goals. Residents spoken to said that they have family dealing with their finances and the registered provider does not currently hold any money on behalf of residents. Risk assessments must be documented in relation to health and safety issues that may arise from the environment of the home. The Grove Residential Home C53 C04 S57752 The Grove V244133 060905 Stage 4.doc Version 1.40 Page 17 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 2 2 x x x x HEALTH AND PERSONAL CARE Standard No Score 7 2 8 x 9 2 10 x 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 x 14 3 15 x COMPLAINTS AND PROTECTION 2 x x x x x x 3 STAFFING Standard No Score 27 3 28 x 29 x 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score x x x x x 2 x 3 x x 2 The Grove Residential Home C53 C04 S57752 The Grove V244133 060905 Stage 4.doc Version 1.40 Page 18 Yes Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard 1 Regulation 4&5 Requirement A copy of the Statement of Purpose must be forwarded to the Commission and made available for every service user. The Service User Guide must be forwarded to the Commission and given to every service user.(Although the previous timescales of 31.12.04 and 31.07.05 had not been met, the inspector was informed that these have been completed and just need printing). All service users must be given contracts/terms and conditions of residency.(Although the previous timescales of 31.06.04 and 31.01.05 had not been met, the inspector was informed that all privately funded residents were being issed with terms and conditions on the day of the inspection and management would liaise with social services contracting department regarding the others). All residents must have an up to date plan of care.(Previous timescales of 31.06.04 and 31.07.05 not met) Medication coming into the home Timescale for action 30.09.05 2. 2 5 31.10.05 3. 7 15 Immediate 4. 9 13 30.09.05 Page 19 The Grove Residential Home C53 C04 S57752 The Grove V244133 060905 Stage 4.doc Version 1.40 5. 19 23 6. 33 24 7. 36 18 8. 30 & 38 13 must be recorded according to The Royal Pharmaceutical Guidelines. Equipment provided must be maintained and in good working order, therefore the hoist must be repaired.(Although the previous timescale of 31.08.05 has not been met the inspector was informed that arrangements for a new hoist have been made). The management must maintain a system for reviewing and improving the quality of care provided at the home.(Previous timescales of 31.10.04, 31.03.05 and 31.08.05 not met) The management must demonstrate the arrangements in place for staff supervision in the home.(Previous timescales of 31.08.04, 31.01.05 and 31.07.05 not met) Health and safety training must be undertaken.(Although previous timescales of 28.02.05 and 31.07.05 have not been met arrangements are being made for this training to be carried out).Training in COSHH, moving and handling,infection control and first-aid must also be undertaken. Immediate 30.11.05 Immediate Immediate 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 9 Good Practice Recommendations It is recommended that appointments to visit the dentist, opticians and chiropodists are recorded in individual care records. It is recommended that a competency assessment is C53 C04 S57752 The Grove V244133 060905 Stage 4.doc Version 1.40 Page 20 The Grove Residential Home 3. 12 4. 19 completed for one resident who manages her own medication All bedroom doors should be fitted with locks suited to service users capabilities and accessible to staff in emergencies. Residents should be provided with keys unless their risk assessment suggests otherwise. It is recommended that a risk assessment is undertaken regarding the action to take should a resident fall whilst the hoist is out of action. The Grove Residential Home C53 C04 S57752 The Grove V244133 060905 Stage 4.doc Version 1.40 Page 21 Commission for Social Care Inspection 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 Residential Home C53 C04 S57752 The Grove V244133 060905 Stage 4.doc Version 1.40 Page 22 - 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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