Inspection on 25/07/07 for The Range Rest Home

This inspection was carried out on 25th July 2007.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

The Range Rest Home 06/12/06

The Range Rest Home 22/02/06

The Range Rest Home 26/07/05

The Range Rest Home 20/01/05

The Range Rest Home 26/07/04

The Range Rest Home 18/02/04

Similar services:

Chirnside House

Keer Sands Residential Home

Sunny Bank (P.R.S.) Ltd

Ruskin Lodge

Bushell House

Ashwood Court Unit 1

Langrigg House

Parkside

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

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 25th July 2007 12:30 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.V339609.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 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.V339609.R01.S.doc Version 5.2 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.V339609.R01.S.doc Version 5.2 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 6th December 2006 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 the accommodation of people 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; two rooms have an en-suite, which comprised of toilet and washbasin. 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. There is a service user guide and statement of purpose available for all the residents. The fees range from £321.00 to £421.00 depending on requirements and personal circumstances. The inspection report is available on request. The Range Rest Home DS0000008580.V339609.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced inspection visit, which took place over four and a half hours. Time was spent talking with the providers, trainee manager, residents and cook. Care plans and staff files were looked at. Other information was received from the owners in the form of the completed Annual Quality Assurance Assessment document and the Quality Assurance Report, which were considered when making judgements throughout the report. Survey forms were sent to the home to be distributed to the residents and relatives. At the time of writing this report 3 relative and 2 resident questionnaires had been returned. One of the resident survey forms had been completed with the support of a relative. All indicated that people were happy with the service provided. Comments received were; ‘the home is very flexible, in a good way, to enable my mum to feel part of the home and have a meaningful role’; ‘caters for the individual needs of clients’; ‘my mum has dementia but is physically fit and the home provides a stable environment for her to feel part of the community’; we are very pleased with the home and they look after the ladies with care and respect. They have everything they could wish for’. On the day of the inspection there were eleven people living at the home; the majority of whom had lived there for many years. A tour of the ground and first floor took place, which included bathrooms, dining room, lounge, and bedrooms. The home was clean and homely with bedrooms reflecting the residents’ personalities. Care workers had achieved National Vocational Qualifications Level 2 with a small number also having completed a Level 3. The owners had also provided other training such as adult protection, safe handling of medicines, food hygiene, moving and handling, fire training and care of the dying. Neither of the owners has a relevant qualification; although they have many years of experience. Therefore they have appointed a trainee manager who had recently completed a National Vocational Qualification Level 4. The trainee manager will be put forward for registration with the Commission for Social Care Inspection. The trainee manager said that since the previous inspection of December 2006 she had taken responsibility for increasing amounts of managerial work. The Range Rest Home DS0000008580.V339609.R01.S.doc Version 5.2 Page 6 Neither the home nor the Commission for Social Care Inspection had received any complaints and there had been no safe guarding adult referrals. What the service does well: The residents who were spoken with either individually or in a group in the conservatory said that they were happy with the care provided, had good food and the staff looked after them well. Residents were encouraged to keep their independence by taking part in the day-to-day routines of the home such as helping with washing up and laying tables if they wished to do so. A ‘shop night’ had been introduced; with the shop selling toiletries, cards and sweets. All said that they really enjoyed this activity. The owners live on the premises and are very much a part of the staff team with good relationships with residents, relatives and care workers. A number of the care workers had also worked at the home for a long time and were committed to the care of the residents. During the visit the inspector observed and spoke with the two owners, trainee manager and cook; they were all pleasant, friendly and welcoming. The residents were relaxed and happy in their company. The home was satisfactorily decorated and furnished. 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. The majority of the care plans began with a ‘pen picture’ of the resident, which made the care plan very personal. All the residents had been given a named carer. The care worker was responsible for making sure that the overall care needs of the individual resident were being met and that the care plan was reviewed on a monthly basis. One person commented; ‘there is a good mixture of staff, which should enable all residents to relate well to a good percentage of staff’. Friends and relatives were made to feel welcome and be part of the home. One comment received from a relative was; ‘as a relative I always feel welcome and included’. The Range Rest Home DS0000008580.V339609.R01.S.doc Version 5.2 Page 7 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 summary of this inspection report can be made available in other formats on request. The Range Rest Home DS0000008580.V339609.R01.S.doc Version 5.2 Page 8 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.V339609.R01.S.doc Version 5.2 Page 9 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 3,6 Quality in this outcome area is good. There was an assessment procedure in place, which ensured that the home could meet the needs of the prospective resident. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The provider and trainee manager had in place an assessment procedure, which included a social work assessment, a visit to the prospective resident and completion of a pre-admission assessment form. Prospective residents were also invited to spend some time at the home whenever this was possible. The information obtained was used in the care plan in order to meet the needs and provide for the likes and dislikes of the residents. During the inspection the trainee manager discussed the implementation of an improved pre-admission assessment form, which would provide more The Range Rest Home DS0000008580.V339609.R01.S.doc Version 5.2 Page 10 information to assist the home in caring for the residents and in making the right choices. Standard 6 was not applicable, as the home did not have any intermediate care beds. The Range Rest Home DS0000008580.V339609.R01.S.doc Version 5.2 Page 11 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 7,8,9,10 Quality in this outcome area is good. The owners and care workers met the health care needs and privacy of the residents. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The care plans were formed from the pre-admission assessment and information about the residents’ health care needs, their likes and dislikes, as the care workers gradually got to know the residents. Each resident was allocated a care worker known as a ‘key worker’ with whom the resident could talk to on a personal and private level. The key worker was responsible for a monthly review of the care plan with the trainee manager reviewing them on a three monthly basis. The medication records were pre-printed by the chemist who also provided a monitored dosage system. The records had been completed satisfactorily. The trainee manager had improved systems to include a disposal/receiving of The Range Rest Home DS0000008580.V339609.R01.S.doc Version 5.2 Page 12 medication record. Some staff had done a distance learning safe handling of medicines course other staff will need to complete this training. All the residents had a single room, which enabled them to receive visitors in private and a portable phone was available. The owners and care workers respected the residents’ privacy and dignity. The Range Rest Home DS0000008580.V339609.R01.S.doc Version 5.2 Page 13 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 12,13,14,15 Quality in this outcome area is good. Residents were given choices so that they could maintain control over their daily life as far as their capabilities would allow. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The inspector was informed that a number of activities were organised which included bingo, music, craft sessions and memory games. Large dominoes and cards had been purchased for those people who may have difficulties in handling and seeing small objects. A ‘shop’, which sold items such as; toiletries, sweets, tissues, cards and was ‘open’ on a Tuesday evening; was proving very popular. Friends and relatives were welcomed at the home at all reasonable times of the day and evening. Relatives were often involved in the admission process of residents. The provider had no responsibility for any of the residents’ finances apart from small amounts of money for day-to-day needs for which a record was kept. The Range Rest Home DS0000008580.V339609.R01.S.doc Version 5.2 Page 14 The residents who were spoken with on the day of the inspection said that the food was good. Each resident was asked what he or she would like for lunch, which was a snack type meal with the main meal being served in the evening. As the residents were getting older and frailer they were reluctant to go out of the home and any offers of trips out were often declined. However four had recently attended a musical afternoon, which had been enjoyed. The provider and trainee manager were looking to try and encourage residents to attend other events in the community. The Range Rest Home DS0000008580.V339609.R01.S.doc Version 5.2 Page 15 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 16,18 Quality in this outcome area is adequate. There was a gap in the recruitment process, which could have put the residents at risk from unsuitable staff. However training and complaints procedures were in place, which offered protection. This judgement has been made using available evidence including a visit to this service. EVIDENCE: A copy of the complaints procedure was given to all residents or their relatives through the service user guide. Training on the protection of vulnerable adults had been given to the majority of the care workers by a trainer who visited the home. Neither the home nor the Commission for Social Care Inspection had received any complaints and there had been no adult protection investigations. During the inspector checks on the Criminal Record Bureau Disclosures it became apparent that the correct procedures had not been followed. This was discussed with the provider and trainee manager who started the process immediately whilst the inspector was present. The Range Rest Home DS0000008580.V339609.R01.S.doc Version 5.2 Page 16 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 19,26 Quality in this outcome area is good. 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. This judgement has been made using available evidence including a visit to this service. 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. The dining room and a bedroom had recently been re-decorated; all the residents had been consulted and they were pleased with the new colours. There was no passenger lift but there was a stair lift for access to the first floor. The Range Rest Home DS0000008580.V339609.R01.S.doc Version 5.2 Page 17 The home had recently been awarded a government grant to improve the facilities within the home. The provider hopes to add three en-suite rooms and improve the downstairs bathroom. The Range Rest Home DS0000008580.V339609.R01.S.doc Version 5.2 Page 18 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 27,28,29,30 Quality in this outcome area is good. Experienced care workers who were sufficient in numbers and had received appropriate training looked after the residents. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The providers employed sufficient staff that were experienced and trained to care for the residents. The providers never used agency staff as the existing staff team covered holidays and sickness. National Vocational Qualification (NVQ) training was ongoing with a small number having a level 2 or a level 3. Four care workers were about to start their NVQ training. Other training had taken place such as moving and handling, safe handling of medicines and basic food hygiene. All the staff team had a training assessment One person had been employed since the last inspection of December 2006. Apart from the Criminal Record Disclosure (see standard on protection) the recruitment process had been conducted in a satisfactory manner. The trainee manager was looking at using the Skills for Care Induction Standards for any new employees who had not undergone this process in their previous employment. The Range Rest Home DS0000008580.V339609.R01.S.doc Version 5.2 Page 19 The Range Rest Home DS0000008580.V339609.R01.S.doc Version 5.2 Page 20 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 31,33,35,36,38. Quality in this outcome area is adequate. The home was run for the residents by a staff team who were experienced and trained. However some areas of record keeping require further knowledge in order to comply with legislation. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The owners have many years of experience but no relevant qualification. Therefore a trainee manager had been employed who had completed a National Vocational Qualification (NVQ) Level 4 and once qualified would apply to be the registered. Unfortunately there had been problems with the training company. In the mean time the providers should delay no longer and apply to the Commission for Social Care Inspection to register the trainee manager. The Range Rest Home DS0000008580.V339609.R01.S.doc Version 5.2 Page 21 A quality assurance report had been written and sent to the Commission for Social Care Inspection. The company had implemented a new comprehensive quality assurance questionnaire the results of which will be included in the next quality assurance report due June 2008. A small number of policies and procedures need to be implemented. The providers do not have any responsibility for residents’ finances. Small amounts of cash for individual residents were kept for day-to-day expenses; receipts and records were kept. Staff development and training needs were discussed in individual supervision sessions all of which were recorded. The owners and trainee manager for the most part followed safe working practices and had in place risk assessments, moving and handling training, food hygiene training and complied with all the relevant legislation. However the managers must report any deaths, which take place in the home or admissions to the accident and emergency unit to the Commission for Social Care Inspection. A Regulation 37 form should be completed and faxed through to the Commissions office. All resident accidents should be recorded in the accident book and reported to RIDDOR where applicable. The environmental health department had recently visited the premises. The cook reported that he was pleased with current practices. The fire safety officer had visited October 2006 and was pleased with the risk assessment. The Range Rest Home DS0000008580.V339609.R01.S.doc Version 5.2 Page 22 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 x x 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 X 18 2 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 2 x 2 x 3 3 x 2 The Range Rest Home DS0000008580.V339609.R01.S.doc Version 5.2 Page 23 Are there any outstanding requirements from the last inspection? Yes STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 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. 1. Refer to Standard OP18 Good Practice Recommendations All prospective employees must have a Criminal Records Bureau Disclosure, which has been obtained by the prospective employer before they commence work. A Disclosure obtained by another organisation is not acceptable. The trainee manager should register with the Commission for Social Care Inspection without further delay. All the policies and procedures required under the National Minimum Standards should be devised and implemented. All accidents to residents must be recorded in the accident book and reported to RIDDOR as and when necessary. The Commission must be informed of any admission to the accident and emergency unit and of any death that takes place at the home using the Regulation 37 form, which should be faxed through, to the Commissions office. 2. 3. 4. OP31 OP33 OP38 The Range Rest Home DS0000008580.V339609.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Manchester Local Office 11th Floor West Point 501 Chester Road Manchester M16 9HU 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. 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