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Inspection on 08/09/05 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 8th 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 made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

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

The home is run by a qualified and efficient manager and a stable staff team. All residents spoken with said they like living in the home, are satisfied with the care and services provided and that the atmosphere is friendly, homely and cheerful. Communication between the staff and the residents, relatives and healthcare professionals is good and well-documented.

What has improved since the last inspection?

New care plans have been introduced which are more comprehensive and easier to read. Receipts collected when staff buy items on behalf of residents, are documented, logged and signed for to monitor easy tracking of residents` finances. The gas facility to the home has been serviced and a gas leak repaired to ensure the home is maintained safely.

What the care home could do better:

Residents would like more choice of meals at lunchtimes, which is currently not offered. The covering of radiators has not been completed, as required at previous inspections, to make sure that residents are not exposed to potential harm. Staff supervisions have still not been put in place although staff say they would appreciate the support they would provide.

CARE HOMES FOR OLDER PEOPLE The Grove Nursing Home 14 Church Road Skellingthorpe Lincoln, Lincs LN6 5UW Lead Inspector Vanessa Gent Unannounced 08 September 2005 10:00 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 Nursing Home C53-C04 S60330 TheGroveNursingHome V248578 080905 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service The Grove Nursing Home Address 14 Church Road Skellingthorpe Lincoln Lincs LN6 5UW 01522 500710 01522 698586 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) Guardian Care Homes (UK) Limited Mrs Catherine Mary Healy Care home with nursing 25 Category(ies) of OP Old age - 25 registration, with number of places The Grove Nursing Home C53-C04 S60330 TheGroveNursingHome V248578 080905 Stage 4.doc Version 1.40 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) 2) The maximum number of service users to be accomodated is 25 Date of last inspection 21 March 2005 Brief Description of the Service: The Grove, which is owned by Guardian Care, is in a two storey, Grade II listed building, 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 twenty-five residents of both sexes over the age of 65 years, with one bed currently dedicated to providing intermediate care. The residents are housed in thirteen single, 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 residentss rooms containing their own furniture and ornaments. The grounds are beautifully maintained to provide a secure, 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 C53-C04 S60330 TheGroveNursingHome V248578 080905 Stage 4.doc Version 1.40 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, documentation 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. Three of the staff on duty, the manager, six of the twenty-four residents and a relative were spoken with. What the service does well: What has improved since the last inspection? New care plans have been introduced which are more comprehensive and easier to read. Receipts collected when staff buy items on behalf of residents, are documented, logged and signed for to monitor easy tracking of residents’ finances. The gas facility to the home has been serviced and a gas leak repaired to ensure the home is maintained safely. The Grove Nursing Home C53-C04 S60330 TheGroveNursingHome V248578 080905 Stage 4.doc Version 1.40 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 Nursing Home C53-C04 S60330 TheGroveNursingHome V248578 080905 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 Nursing Home C53-C04 S60330 TheGroveNursingHome V248578 080905 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) 2, 3 The home has a good admissions procedure and residents are assured that their needs will be met. EVIDENCE: A terms and conditions contract is in place for each resident with the number of the room and the fees payable recorded. Residents are given a copy along with the service user guide on admission to the home. Pre-admission and community care assessments were seen and used as a basis for the creation of the care plans examined. All residents spoken with said that they felt that the home understood and was able to meet their needs. The Grove Nursing Home C53-C04 S60330 TheGroveNursingHome V248578 080905 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, 8 Good care planning, excellent contact with healthcare professionals and monitoring of health issues ensure that the health, social and emotional needs of residents are met. EVIDENCE: Care plans examined are clear, comprehensive, easy to read and understand and kept in an orderly state, with risk assessments, care plan issues, health needs assessments, a social history and monitoring and involvement of residents in evidence. The care plans are reviewed monthly. Care plans and resident comments demonstrated that there is good contact with community healthcare professionals, including tissue viability, diabetes care and district nurses, GPs and hospital doctors, optician, chiropodist and dentist, which ensures that appropriate treatment and care is given when residents have health needs. Residents and relatives have commented that the manager and staff really care for them and are meeting their needs. One resident, a retired nurse, says that “the nursing care is excellent: second to none”. Specialist equipment including pressure-relieving mattresses and cushions are in use. The Grove Nursing Home C53-C04 S60330 TheGroveNursingHome V248578 080905 Stage 4.doc Version 1.40 Page 10 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, 15 Although residents are satisfied with the activities and food provided, limiting their choices means that their wishes are not known or catered for at all times. EVIDENCE: An activities organiser is employed who provides an activity each afternoon. Residents say that she gets people involved. During the inspection, residents were seen joining in, laughing and enjoying themselves. Choice at lunch mealtimes is limited, despite residents saying they would prefer more choice. The cook states that she knows the residents’ likes and dislikes but these are not documented so other staff are not aware of them. Special diets are catered for although these have not been documented. The food provided is reported by residents to be good, wholesome and tasty. The manager says the issue of choice will be brought to a Residents’ meeting. The Grove Nursing Home C53-C04 S60330 TheGroveNursingHome V248578 080905 Stage 4.doc Version 1.40 Page 11 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) 18 The number of staff who have received training to protect the residents from harm or abuse does not ensure that all residents are kept safe at all times. EVIDENCE: Nine of the twenty-two care and nurse staff have received training in the prevention of abuse to vulnerable people although training is required to include all staff. Residents say that they feel safe at the home and the “staff are lovely”; “the care is second to none”. The Grove Nursing Home C53-C04 S60330 TheGroveNursingHome V248578 080905 Stage 4.doc Version 1.40 Page 12 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) 19, 22, 26 The home provides a comfortable, clean, attractive environment to ensure the residents are well cared for and feel ‘at home’. EVIDENCE: The home is clean, tidy and fresh smelling. A resident said “This home is great; I can’t fault it; I’m so happy here; it has such a comfortable feeling and lovely atmosphere”. Many residents have personalised their rooms with their own furniture and ornaments. The garden provides a secure, tranquil outdoor area for residents to sit in. There are ample car parking facilities. Specialist equipment is in use, including pressure-relieving mattresses and cushions, an electric hoist, a mechanical hoist and a stand-aid, grab-rails throughout the home and ramps to outside areas. One resident said that “the laundry service is really good and the residents get care like they would get in their own home”. A relative said that the residents always look clean and well-dressed. The Grove Nursing Home C53-C04 S60330 TheGroveNursingHome V248578 080905 Stage 4.doc Version 1.40 Page 13 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 home maintains staffing levels sufficient to meet the needs and wishes of the residents, however, due to the lack of mandatory staff training for all staff, residents may be at risk of harm. EVIDENCE: The staffing levels are adequate for the number of residents and layout of the building but staff say the provider and manager are flexible about increasing staff numbers as and if necessary. Some staff training has been completed but some areas of mandatory training, such as moving and handling, first aid, infection control, prevention of adult abuse and health and safety needs to be addressed to ensure that all staff care for the residents safely, competently and confidently. One staff is completing a trainer’s course in moving and handling to pass the knowledge on to other staff. Staff say they work in a good team and are supportive of each other. One staff said she enjoys coming to work. The Grove Nursing Home C53-C04 S60330 TheGroveNursingHome V248578 080905 Stage 4.doc Version 1.40 Page 14 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, 36, 37, 38 The maintenance of the home ensures that residents are cared for in a safe and appropriate manner although the lack of training and supervision of staff does not fully enhance this element of safe care. EVIDENCE: The manager has been in post for 3½ years, with previous experience and relevant qualifications in the care of older people. Staff supervision has not been held regularly although this has been a requirement from previous inspections. Inspections of fire, environmental health and health and safety are up-to-date, the certificates for which were seen; records for the maintenance of the property are well-documented. The maintenance man, an experienced fire officer, provides fire safety maintenance throughout the home. He also provides the fire awareness The Grove Nursing Home C53-C04 S60330 TheGroveNursingHome V248578 080905 Stage 4.doc Version 1.40 Page 15 training which all staff have undertaken. Other mandatory training has not been accessed by all staff. The Grove Nursing Home C53-C04 S60330 TheGroveNursingHome V248578 080905 Stage 4.doc Version 1.40 Page 16 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 x 3 3 x x x HEALTH AND PERSONAL CARE Standard No Score 7 3 8 4 9 x 10 x 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 x 14 x 15 3 COMPLAINTS AND PROTECTION 3 x x 3 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 2 3 x x x x 2 4 2 The Grove Nursing Home C53-C04 S60330 TheGroveNursingHome V248578 080905 Stage 4.doc Version 1.40 Page 17 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 OP15 Regulation 16 Requirement Choice of menu must be given to all residents and what they eat should be documented to ensure their wishes and nutritional needs are met. Training of staff to protect residents from abuse must be undertaken. (Timescale of 01/05/05 not met.) All unprotected radiators must be covered to safeguard residents from risk of scalding. (Timescale of 01/05/05 not met.) All staff must be up-to-date with mandatory training to ensure the residents safety at all times. (Timescale of 01/06/05 not met.) Staff supervision must be undertaken on a regular basis. (Timescale of 01/05/05 not met.) Timescale for action 30/11/05 2. OP18 13(6) 31/12/05 3. OP25, OP38 13(4)(a) (b)(c) 30/11/05 4. OP30 18 31/12/05 5. OP36 18 31/12/05 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. The Grove Nursing Home C53-C04 S60330 TheGroveNursingHome V248578 080905 Stage 4.doc Version 1.40 Page 18 No. 1. Refer to Standard Good Practice Recommendations The Grove Nursing Home C53-C04 S60330 TheGroveNursingHome V248578 080905 Stage 4.doc Version 1.40 Page 19 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 Nursing Home C53-C04 S60330 TheGroveNursingHome V248578 080905 Stage 4.doc Version 1.40 Page 20 - 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!