CARE HOMES FOR OLDER PEOPLE
The Range Rest Home 10/12 Hooley Range Heaton Moor Stockport Cheshire SK4 4HU Lead Inspector
Jackie Kelly Unannounced Inspection 22nd February 2006 15:30 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 Range Rest Home DS0000008580.V284576.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 Range Rest Home DS0000008580.V284576.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION
Name of service The Range Rest Home Address 10/12 Hooley Range Heaton Moor Stockport Cheshire SK4 4HU 0161 431 9408 0161 432 4805 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) Mr John Francis Williams Mrs. Anita Williams Mrs. Anita Williams Care Home 13 Category(ies) of Mental Disorder, excluding learning disability or registration, with number dementia - over 65 years of age (3), Old age, of places not falling within any other category (10) The Range Rest Home DS0000008580.V284576.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION
Conditions of registration: 1. Service users to include up to 10 OP and up to 3 MD (E). Date of last inspection 26 July 2005 Brief Description of the Service: The Range is a care home providing personal care and accommodation for 13 older people. The registration also allows for up to three older people (within the 13) who may have a mental health problem. The home is owned and managed by Mr and Mrs Williams who live on the premises. The Range comprises of two semi-detached houses, which have been converted into one large house. The accommodation is spread over two floors, with each floor having bathroom and toilet facilities. The laundry, office, kitchen and staff room are situated in the basement. There is no passenger lift but a stair lift is available to take those service users who cannot manage the stairs to the first floor bedrooms. There is a well-stocked and mature garden for residents to use. The home is located in the Heaton Moor area of Stockport and is close to local shops and other amenities such as cafés, restaurants, public houses, banks, post office and a cinema. There are churches of most denominations, a library and a selection of health centres, surgeries, dentists and opticians. Stockport town centre, motorway network and public transport are easily accessible. The Range Rest Home DS0000008580.V284576.R01.S.doc Version 5.1 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This was an unannounced inspection, which took place late afternoon. Time was spent talking with the owner/managers Mr and Mrs Williams, residents and care workers. Care plans were looked at. On the day of the inspection there were ten people living at the home. The vacancies were in two single rooms and one shared. Seven of the ten residents (the majority having lived at the home between five and eight years) were over 90 years old with the eldest being 96. A tour of the ground and first floors took place, which included bathroom, dining room, lounge, and bedrooms. The home was clean and homely with bedrooms reflecting the residents’ personality. Care workers have achieved National Vocational Qualifications Level 2 and Level 3. The owners have also provided other training such as adult protection and care of the dying. Not all the standards were looked at during this inspection as they had been met and found to be satisfactory during previous inspections. Neither the home nor the Commission for Social Care Inspection had received any complaints and there had been no adult protection investigations. What the service does well:
All of the residents who were spoken with said that they were happy, had good food and the staff looked after them well. Questionnaires that were distributed to relatives at the time of the previous inspection in July 2005 were positive; with no one having any complaints. The owner/managers have owned and managed the home for many years and live on the premises. They are very much a part of the staff team and have good relationships with residents, relatives and care workers. There was a core group of care workers that had worked at the home for a long time and were committed to the care of the residents. The care workers that were seen during the inspection were pleasant, friendly and welcoming. The home was satisfactorily decorated and furnished. The Range Rest Home DS0000008580.V284576.R01.S.doc Version 5.1 Page 6 Activities took place most evenings and a list was displayed in the entrance hall. Residents were able to spend time and have meals in their rooms if that is what they wanted. Residents were encouraged to continue with their previous life style as far as their capabilities would allow. One resident still sews and uses her sewing machine. Each care plan began with a ‘pen picture’ of the resident, which made the care plan very personal. The owner/managers had distributed questionnaires at the time of the previous inspection in July 2005. From the feedback received a number of small changes had been made to the evening activities and meals. All the residents had been given a named carer who was responsible for making sure that the overall care needs of the individual resident were being met. The staffing levels are above those required by the Department of Health. Friends and relatives were made to feel welcome and be part of the home. What has improved since the last inspection? 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 Range Rest Home DS0000008580.V284576.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 Range Rest Home DS0000008580.V284576.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): 3,4,5. Standard 6 is not applicable. Residents were assessed before being offered a place. The staff team were able to meet the needs of the residents. EVIDENCE: The home had three vacancies. Any new referral would require a social work assessment. The owner/manager would visit the prospective resident when they were in hospital prior to an initial visit. The prospective resident would also be given the opportunity to visit the home before being offered a place. The owner/manager would visit the person in their own home if she thought it necessary; preferring people to spend time at The Range and have a meal instead. The staff team are equipped with the necessary skills to look after the current group of residents. The Range Rest Home DS0000008580.V284576.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): 7,8,9,10. The owners and care workers met the health care needs and privacy of the residents. EVIDENCE: The improvements to care plans, which had been implemented prior to the previous inspection in July 2005, had been maintained. All the necessary information required in order to ensure that the health care needs of the residents were met was documented in the care plan. There was also a record of the reviews that had taken place. The residents who were spoken with said that they were happy with the care they received. The Range Rest Home DS0000008580.V284576.R01.S.doc Version 5.1 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 the following standard(s): 12,13,14,15. Residents were given choices so that they could maintain control over their daily life as far as their capabilities would allow. EVIDENCE: There had been some changes to the daily routines to allow more time for entertainments and activities in the evenings. The residents who were spoken to on the day of the inspection were happy with the food. Each resident was asked what he or she would like for tea from a list of choices. The owner/managers live on the premises and are available the majority of the time. Each resident was also allocated a care worker known as a ‘key worker’ with whom the resident could talk to on a more personal and private level. The key worker was also responsible for the monthly review of the care plan. Friends and relatives were welcomed at the home at all reasonable times of the day and evening. On the day of the inspection a relative had been visiting the home. The Range Rest Home DS0000008580.V284576.R01.S.doc Version 5.1 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 the following standard(s): 16,17,18. The owner/managers protected the residents through the complaints procedure, training and daily monitoring of care workers. EVIDENCE: The home was not responsible for any of the residents’ finances apart from a small amount of money for daily items such as hairdressing; a record was kept which was not looked at during this inspection. The Stockport All Agency Adult Protection Policy was available for all the care workers to read. Training on the protection of vulnerable adults had been given to all the care workers. The policy and procedure had been amended as recommended in the previous report of July 2005 to include information about the Protection of Vulnerable Adults (POVA) and the register. Neither the home nor the Commission for Social Care inspection had received any complaints. There had been no Adult Protection investigations. The Range Rest Home DS0000008580.V284576.R01.S.doc Version 5.1 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 the following standard(s): 19,26. The home was clean, satisfactorily maintained and decorated. All furnishings, fittings and equipment were in good condition and suitable for the needs of the residents. EVIDENCE: The inspector looked round the home which was satisfactorily maintained and decorated, clean, and pleasant. The bedrooms that were seen by the inspector were well furnished and contained personal items. One bedroom was in the process of being decorated and refurbished. There is no passenger lift but there is a stair lift for access to the first floor. The Range Rest Home DS0000008580.V284576.R01.S.doc Version 5.1 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 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): 27,28,29,30. Experienced care workers who had received appropriate training looked after the residents. EVIDENCE: There had been no changes to the number of staff employed since the previous inspection of July 2005, which were sufficient to meet the needs of the residents. The total number of care hours, are higher than the minimum, which the Department of Health say are necessary. The owner/managers Mr & Mrs Williams live on the premises and are on duty most days. Many of the care workers had been working at the home for a number of years. National Vocational Qualification training was ongoing with a small number having a level 2 and one person had a level 3. Other training had taken place such as death and dying, dementia care and protection of vulnerable adults. The Range Rest Home DS0000008580.V284576.R01.S.doc Version 5.1 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 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): 31,32,33. The home was run for the residents by a staff team who were experienced and were aware of the health and safety of residents. EVIDENCE: The owner/managers have many years of experience but have no recognised social care or management qualifications. Therefore an experienced care worker has been appointed as a trainee manager and will be applying for registration with the Commission for Social Care Inspection from the 1st March 2006. The trainee manager is currently undertaking a National Vocational Qualification Level 4 in Care and once this qualification has been achieved will go on to take the Registered Managers Award. The Range Rest Home DS0000008580.V284576.R01.S.doc Version 5.1 Page 15 The residents were asked their views through individual talks with the owner/managers, key-workers and questionnaires. The health and safety of the residents and workers was overseen by the owner/managers. The Range Rest Home DS0000008580.V284576.R01.S.doc Version 5.1 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 Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 x x 3 3 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 3 18 3 3 x x x x x x 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 3 x x x x x The Range Rest Home DS0000008580.V284576.R01.S.doc Version 5.1 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. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations The Range Rest Home DS0000008580.V284576.R01.S.doc Version 5.1 Page 18 Commission for Social Care Inspection Ashton-under-Lyne Area Office 2nd Floor, Heritage Wharf Portland Place Ashton-u-Lyne Lancs OL7 0QD National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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