Inspection on 18/06/07 for The Old Grange

This inspection was carried out on 18th June 2007.

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 found no outstanding requirements from the previous inspection report, but made 1 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

The Old Grange 29/06/06

Similar services:

Claremont House

Coopers Mill Ltd

Sun Court Nursing Home

Bramley Avenue (73)

Paradise Lodge

Grangewood

Upaya Ananda

15 Bramble Close

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

CARE HOME ADULTS 18-65 The Old Grange College Road Cheshunt Herts EN8 9LT Lead Inspector Mrs Alison Butler Unannounced Inspection 18th June 2007 10:00 The Old Grange DS0000064341.V343676.R01.S.doc Version 5.2 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 Old Grange DS0000064341.V343676.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Adults 18-65. 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 Old Grange DS0000064341.V343676.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service The Old Grange Address College Road Cheshunt Herts EN8 9LT 01707 646567 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) Grange Care Services Limited Manager post vacant Care Home 7 Category(ies) of Learning disability (7), Physical disability (3) registration, with number of places The Old Grange DS0000064341.V343676.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 29th June 2006 Brief Description of the Service: Old Grange is a listed building close to Cheshunt town centre and provides care for people with a learning disability. Up to three of those people may also have a physical disability. Fees for the services are £950-£1,600 per week. Additional charges are made for newspapers, toiletries etc. (this is correct as at 18/06/07). The home is provided on three floors, the ground floor is able to accommodate up to three people with a physical disability. The middle floor can only accommodate mobile residents. The top floor consists of two self-contained flats that are provided with 24-hour on-call support and additional support as agreed in their contract. Each bedroom is fitted with a telephone socket and a portable telephone is available for the residents. On the ground floor there is a lounge/diner and a separate seating area. The kitchen has lowered worktops to allow all residents to take an active part in the preparation, cooking and serving of meals. Upstairs there is a sleep-in room that has some storage space for staff, a toilet and a shower. The laundry is situated on the first floor and is equipped with a washing machine that has a sluice cycle. A small office is in the ground floor and does not impinge on the residents’ communal space. There is a secluded and secure rear garden that is fully wheelchair accessible and a small car park The Old Grange DS0000064341.V343676.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection was conducted with the Director of Care, the manager (although not yet registered), staff and those who use the service. Care, staff and administration records were checked. The individuals who live in the two flats on the top floor are provided with a fourteen-hour per week care package, which meets their needs. They also have access to 24-hour support if required. What the service does well: What has improved since the last inspection? Risk assessments have been completed and ensure that risks have been identified and minimise where possible. A more efficient way of recording medication has been introduced and this is clear and easy to understand. The storage of medication is recorded and staff are now able to relocate the medicines store should the room temperature increase. All staff information is available for inspection that is required by regulation. Staff have received training in moving and handling and a matrix has been developed to demonstrate that staff retain their skills and competences and can meet individual needs appropriately. The Old Grange DS0000064341.V343676.R01.S.doc Version 5.2 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 summary of this inspection report can be made available in other formats on request. The Old Grange DS0000064341.V343676.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection The Old Grange DS0000064341.V343676.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 2. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Information to people who may choose to use the service is available, but may not be up to date. Full assessments are carried out prior to the admission of an individual. EVIDENCE: Examination of the Statement of Purpose showed that it did not reflect the service it provides. The Director of Care updated this during the inspection. There will be a further update once the manager is registered with the Commission For Social Care Inspection. The service users guide has yet to be put in a format that is easy to understand for the individuals. The company have recently purchased WIDGET, (a programme that converts information into a pictorial format) and will be undertaking the work soon. An assessment has been received for an individual and a transition process has been set up including tea visits and over the coming weeks. There will also be some overnight stays arranged. The manager feels this should ensure that the service is able to meet the identified needs. The Old Grange DS0000064341.V343676.R01.S.doc Version 5.2 Page 9 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7 & 9. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents’ goals are identified and assessments detailed in their care plans. Risk have been identified and minimised where possible. EVIDENCE: Examination of two care plans they showed that goals (and the staff support needed) had been clearly identified. The plans had been reviewed and changes made as required. At the last inspection, a newly admitted individual was unable to walk they have had a physiotherapist providing staff with information to support them. The individual is now able to walk small distances. This has been a great achievement for the individual and also the supporting staff. Examination of the risk assessments showed that more detail has been included and a discussion took place over additional information that could be included, (especially in regard to the uncovered radiators). The manager confirmed that this would be added to the risk assessment. The Old Grange DS0000064341.V343676.R01.S.doc Version 5.2 Page 10 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 15, 16 & 17. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Individuals have the opportunity to take part in a variety of appropriate activities and are provided with staff support as needed. EVIDENCE: There are close links maintained with families. Individuals also take holidays with their families and receive regular visits from and to them. Staff support individuals as necessary and provide transport etc. Each individual has a weekly programme in place. Two work on a voluntary basis in a local charity shop. Individuals attend the local college learning new skills and staff support in this. The needs of two individuals mean that their programme of activities is centred in the home. Staff also support them to enjoy the local community and to take part in activities of their choice. The residents are all going on a holiday to Southwold in accommodation that is able to meet all the needs of the individuals. Staff are knowledgeable about the needs of the individuals and were seen to interact well with them. The Old Grange DS0000064341.V343676.R01.S.doc Version 5.2 Page 11 There is a menu available and copies have been sent to the Commission. Individuals are encouraged and supported to help in the preparation and serving of meals. Where they do not like the choice on offer, alternatives are provided (and the menu adjusted for next time). The Old Grange DS0000064341.V343676.R01.S.doc Version 5.2 Page 12 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19 & 20. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Those who use the service have their health and personal care carried out, ensuring that their wishes and choices are promoted. EVIDENCE: Examination of two care plans showed that they were detailed and recorded actions required by staff and what people could do for themselves. Where appropriate, information is sought from professionals (such as the physiotherapist who has enabled an individual to become a little more mobile over the pat year). Since the last inspection, a new recording system has been introduced that is much easier to monitor. A spot check showed that not all medication had been signed in; the Director for Care and the manager said that they would address this issue with the individual concerned. There is a risk assessment in place and the room temperature is being taken and recorded. During the hotter months they are to relocate the medication cabinet to a cooler place. The Old Grange DS0000064341.V343676.R01.S.doc Version 5.2 Page 13 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 22 & 23. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Those who use the service are protected from abuse and a complaints procedure is in place although not easily accessible to all. EVIDENCE: A complaints procedure is available. The manager should ensure that details of the Commission for Social Care Inspection are the same on all copies to prevent confusion. Although a pictorial copy of the complaints procedure was available, this should be updated as it had been badly reproduced. The complaints folder was examined and no further complaints have been made since the last inspection. The form in use enables the service to record the complaint, any action and the outcome. The service has a copy of the Hertfordshire County Council Adults Protection Procedure available to all staff and on display in the office. The Old Grange DS0000064341.V343676.R01.S.doc Version 5.2 Page 14 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 24 & 30. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home creates a welcoming, homely, safe, well-maintained and clean atmosphere for those who use the service. EVIDENCE: The premises were well maintained and clean on the day of the inspection. A previous visit to the home showed that the bedrooms were decorated to suit individualised tastes. The manager was informed that disposal hand towels must be in place in areas that staff need to wash their hands to prevent the risk of the spread of infection (cotton hand towels were in place). The manager stated she would arrange the purchase of towels and a dispenser that day. The Old Grange DS0000064341.V343676.R01.S.doc Version 5.2 Page 15 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 34 & 35. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Adequate levels of suitably trained staff are provided to meet the needs of those who use the service. EVIDENCE: Examination of the rotas showed that adequate levels of staff are in place to ensure that those who use the service have their needs met. Three staff cover the core waking hours Monday to Friday with one waking night staff and one sleep in covering the night. At weekends there is a minimum of three staff with more being available depending on what has been planned etc. A training programme is in place to ensure that staff have their skills and competency updated regularly to meet the individuals needs. They have an additional person who can undertake driving for individuals at the weekends where they visit family or the local community as required. Four staff have attained at least a level 2 NVQ award. Two staff are working towards an NVQ award. Staff records showed that all the required information was available prior to them commencing employment at the home. The manager should ensure that when they use staff from other homes within the Grange Care Service, a copy of the staff file must be available. The Old Grange DS0000064341.V343676.R01.S.doc Version 5.2 Page 16 The staff are knowledgeable about the needs of those who use the service and a member of staff is able to communicate with a family whose first language is not English. The Old Grange DS0000064341.V343676.R01.S.doc Version 5.2 Page 17 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. 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 are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39 & 42. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is run in the best interest of those who live at The Old Grange. Health and safety is promoted throughout the home. EVIDENCE: A new manager has been in post since December 2006 but has not yet applied for registration and a requirement has been made. There is an annual audit that takes place that concentrates on policies and procedures. They also conduct an annual service review where the views of those who use the service, families and other professionals are sought. A report is created from this information and is available in the home for interested parties. Fire records were up to date; also accidents and incidents have been appropriately recorded. The manager ensures that meetings for staff and those who use the service are carried out on a monthly basis. A check on the monies held by the home was conducted and shown to be wellmanaged and good records kept. The Old Grange DS0000064341.V343676.R01.S.doc Version 5.2 Page 18 The health, welfare and safety of all who enter the home is protected and promoted through a number of checks and risk assessments are in place. The Old Grange DS0000064341.V343676.R01.S.doc Version 5.2 Page 19 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 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 3 2 3 3 X 4 X 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 3 25 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 X 34 3 35 3 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 X 3 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 X 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 2 X 3 X X 3 X The Old Grange DS0000064341.V343676.R01.S.doc Version 5.2 Page 20 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 YA37 Regulation 8&9 Requirement The service provider must put forward a manager to be registered. Timescale for action 31/07/07 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations The Old Grange DS0000064341.V343676.R01.S.doc Version 5.2 Page 21 Commission for Social Care Inspection Hertfordshire Area Team CPC1 Capital Park Fulbourn Cambridge CB21 5XE National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 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 Old Grange DS0000064341.V343676.R01.S.doc Version 5.2 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. 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