CARE HOMES FOR OLDER PEOPLE
The Range Rest Home 10/12 Hooley Range Heaton Moor Stockport SK4 4HU Lead Inspector
Jackie Kelly Announced 26 July 2005, 09:45 am
th 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 Range Rest Home F54-F04 s8580 The Range v230921 260705 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION
Name of service The Range Rest Home Address 10/12 Hooley Range, Heaton Moor, Stockport, Cheshire SK4 4HU 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) 0161 431 9408 0161 432 4805 anita@anitawilliams.wanadoo.co.uk Mr John Francis Williams Mrs Anita Williams Mrs Anita Williams Care Home 13 Category(ies) of OP Old Age - 10 registration, with number MD(E) Mental Disorder - 3 of places The Range Rest Home F54-F04 s8580 The Range v230921 260705 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION
Conditions of registration: None Date of last inspection 20th January 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 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 F54-F04 s8580 The Range v230921 260705 Stage 4.doc Version 1.30 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This was an annual announced inspection, which took place over one day. Time was spent talking with the owner/managers Mr & Mrs Williams, the care workers and residents. Care plans, staff files, and drug administration records were looked at. A tour of the home took place. Questionnaires were sent to the home for the residents and relatives to complete; at the time of writing this report four of the five relative/visitor questionnaires, which were given out, had been completed and returned to the Commission. All of the questions were answered positively, no one had ever made a complaint and one person said that it was ‘a very happy home’. What the service does well:
All of the residents who were spoken with said that they were well cared for. Comments received were; ‘staff will do anything for you’; ‘food good’; ‘lovely dinners’; ‘have a cup of tea whenever you want’. The questionnaires that were received back from the relatives were positive; with no one having any complaints. Both the owner/managers live on the premises and are part of the staff team. A number of staff had worked at the home for a long time and were committed to the care of the residents. The home was satisfactorily decorated and furnished. Activities took place most evenings. 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 Each care plan began with a ‘pen picture’ of the resident, which made the care plan very personal. The owner/managers had distributed questionnaires to all the residents to seek their views on daily activities. 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 resident were being met. Friends and relatives are made to feel welcome and be part of the home. The Range Rest Home F54-F04 s8580 The Range v230921 260705 Stage 4.doc Version 1.30 Page 6 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 F54-F04 s8580 The Range v230921 260705 Stage 4.doc Version 1.30 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 Range Rest Home F54-F04 s8580 The Range v230921 260705 Stage 4.doc Version 1.30 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) 1,2,3,4,5. Standard 6 is not applicable. Residents and their relatives were offered written information which told them what the home provided. The staff team were able to meet the needs of the residents EVIDENCE: A service user guide and statement of purpose was available for residents and their relatives. There were social work assessments, the homes own assessments and contracts; all of which gave the relatives, residents and care workers facts about the home and the care needs of the resident. All residents were given the opportunity to visit the home before making the decision to move in for the trial period of six weeks. The owner/manager always visited prospective residents when they were in hospital but only occasionally visited them when they were living in their own home; preferring people to spend time at The Range and have a meal. This the owner/manager feels helps the service user and care workers make a better judgement as to the suitability of the home.
The Range Rest Home F54-F04 s8580 The Range v230921 260705 Stage 4.doc Version 1.30 Page 9 The Range Rest Home F54-F04 s8580 The Range v230921 260705 Stage 4.doc Version 1.30 Page 10 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) 7,8,9,10,11. The owners and care workers met the health care needs and privacy of the residents. Medication for the most part was handled safely. EVIDENCE: The care plans had improved since the previous inspection with the updated ones having been signed by the residents, which confirmed that the residents had been involved. Further information would be added to the care plans as necessary; such as copies of the annual social work review and ongoing risk assessments so that care workers are fully aware of current needs. The residents who were spoken with said that they were happy with the care they received; one resident said that it was ‘very nice – do anything for you’, couldn’t have better girls’, ‘cup of tea whenever you want’; ‘plenty of vegetables – lovely dinners’. The inspector observed the care staff respecting the residents’ rights to privacy by knocking on bedroom doors and waiting for a reply before entering.
The Range Rest Home F54-F04 s8580 The Range v230921 260705 Stage 4.doc Version 1.30 Page 11 Medication records were looked at and had been completed properly. One resident who was living at The Range on the day of the inspection was in charge of her own medication. The resident had signed a ‘self medication form’ accepting responsibility. The initial risk assessment was done some time ago therefore it needs reviewing and updating; a review should be done on a regular basis. The care staff are due to take a course on death and dying in September 2005. The Range Rest Home F54-F04 s8580 The Range v230921 260705 Stage 4.doc Version 1.30 Page 12 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) 12,13,14,15 Residents were given choices so that they could maintain control over their daily life as far as their capabilities would allow. EVIDENCE: The owner/manager had given out their own questionnaires, which had lead to some changes being made to the food and activities. The residents who were spoken to on the day of the inspection were happy with the food. The care worker asks each resident what he or she would like, for his or her meals from a small number of choices; the inspector was able to confirm that this practice took place. Questionnaires provided by the Commission for Social Care Inspection were on the table next to the visitors’ book in the entrance hall for people to take and fill in if they wished. On the day of the inspection the owner/manager gave five relatives the Commissions questionnaire four of which had been returned at the time of writing this report. 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.
The Range Rest Home F54-F04 s8580 The Range v230921 260705 Stage 4.doc Version 1.30 Page 13 Friends and relatives were welcomed at the home at all reasonable times of the day and evening. On the day of the inspection a number of relatives or friends visited the home. These visits were part of normal practice and not because of the inspection. The Range Rest Home F54-F04 s8580 The Range v230921 260705 Stage 4.doc Version 1.30 Page 14 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) 16,17,18. The owner/managers protected the residents through the complaints procedure, training and daily monitoring of care workers. EVIDENCE: The service user guide had a section on how, and to whom, residents could complain. None of the residents or relatives with whom the inspector had contact with had any complaints. 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. 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 the care workers who had done the National Vocational Qualification in Direct Care Level 2. The owner/managers are to organise a course on the protection of vulnerable adults. The policy and procedure needs to have a section added about Protection of Vulnerable Adults (POVA) and the register. The Range Rest Home F54-F04 s8580 The Range v230921 260705 Stage 4.doc Version 1.30 Page 15 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) 19,20,21,22,23,24,25,26 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 home which was satisfactorily maintained and decorated, clean, and pleasant. There were enough bathrooms and toilets. The bedrooms that were seen by the inspector were well furnished and contained personal items. There is no passenger lift but there is a stair lift for access to the first floor. The Range Rest Home F54-F04 s8580 The Range v230921 260705 Stage 4.doc Version 1.30 Page 16 The Range Rest Home F54-F04 s8580 The Range v230921 260705 Stage 4.doc Version 1.30 Page 17 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) 27,28,29,30. The recruitment and selection methods used ensured that suitable care workers are employed. Experienced care workers looked after the residents. EVIDENCE: The rota’s seen by the inspector showed that there were sufficient numbers of care workers on duty to meet the needs of the residents. The total number of care hours, which were put into the home each week, was 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 have been working at the home for a number of years. A small number have a National Vocational Qualification and others are being encouraged to take this form of training. The two care workers who were spoken with were happy with the care the residents received and the general management of the home. The Range Rest Home F54-F04 s8580 The Range v230921 260705 Stage 4.doc Version 1.30 Page 18 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) 31,33,35,36,38. 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. 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 residents were asked their views through individual talks with the owner/managers, key-workers and questionnaires. The Range Rest Home F54-F04 s8580 The Range v230921 260705 Stage 4.doc Version 1.30 Page 19 A staff appraisal had been done with all the staff team. This will lead onto staff supervision and training needs programme being developed for each care worker. A staff meeting had taken place on the 23 June 2005; the minutes were seen by the inspector. The home was not responsible for any of the residents’ finances other small amounts of ‘pocket money’. Training for care workers on first aid, administration of medication and moving and handling was in place. A training programme was in the process of being developed which would include training on adult protection from abuse and fire safety from a fire safety professional. The home had produced a written annual development/building maintenance programme, which was shown to the inspector on the day of the inspection. A annual quality assurance report, had been sent to the Commission for Social Care inspection. The health and safety of the residents and workers was overseen by the owner/managers. The Range Rest Home F54-F04 s8580 The Range v230921 260705 Stage 4.doc Version 1.30 Page 20 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 3 3 3 3 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 2 10 3 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3
COMPLAINTS AND PROTECTION 3 3 3 3 3 3 3 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 Standard No 16 17 18 Score 3 3 2 3 x 3 x 3 3 x 3 The Range Rest Home F54-F04 s8580 The Range v230921 260705 Stage 4.doc Version 1.30 Page 21 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 9 Regulation 13 (2) Requirement The registered person must ensure that up to date risk assessments are kept for those residents who manage their own medication. Timescale for action 12 September 2005 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 18 Good Practice Recommendations The registered person should include in the policy and procedure for the protection of vulnerable adults information about the Protection of vulnerable Adults (POVA) legislation. The registered person should also provide training for all staff on the protection of vulnerable adults from abuse. The Range Rest Home F54-F04 s8580 The Range v230921 260705 Stage 4.doc Version 1.30 Page 22 Commission for Social Care Inspection 2nd Floor, Heritage Wharf Portland Place Ashton-under-Lyne OL7 0QD National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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