Inspection on 06/12/06 for The Range Rest Home

This inspection was carried out on 6th December 2006.

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 made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

The Range Rest Home 25/07/07

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 6th December 2006 11:10 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.V317698.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.V317698.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.V317698.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 22 February 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 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. There is a service user guide and statement of purpose available for all the residents. The fees range from £346.00 t0 £404.00 The inspection report is available on request. The Range Rest Home DS0000008580.V317698.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 1 day. Time was spent talking with the senior person on duty, residents and care workers. Care plans and staff files were looked at. Comment cards were left at the home to be distributed to the residents and relatives. At the time of writing this report 2 relative and 6 resident questionnaires had been returned. All indicated that people were happy with the service provided. On the day of the inspection there were twelve people living at the home. The one vacancy was in a shared room. Apart from the last three residents to be admitted the majority had lived at the home between five and eight years. A tour of the ground and first floor took place, which included bathroom, dining room, lounge, and bedrooms. The home was clean and homely with bedrooms reflecting the residents’ personality. Care workers had achieved National Vocational Qualifications Level 2 and 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. All the key standards were looked at during this inspection. 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: A group of residents was sat in the conservatory all whom said that they were happy with the care provided, had good food and the staff looked after them well. Other residents were spoken with on an individual basis and they too were pleased with the home. Residents were encouraged to keep their independence including going out to the local shops and taking part in the day-to-day routines of the home such as helping with washing up, laying tables if they wished to. The provider/managers have owned and managed the home for many years and lived on the premises. They were very much a part of the staff team and had good relationships with residents, relatives and care workers. The Range Rest Home DS0000008580.V317698.R01.S.doc Version 5.2 Page 6 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. 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 who was responsible for making sure that the overall care needs of the individual resident were being met. Friends and relatives were made to feel welcome and be part of the home. One comment was received from a relative who said that they were very pleased with the care the resident received and that they could see an improvement in the resident’s physical and mental health. The Range is a wonderful ‘family’ home. What has improved since the last inspection? What they could do better: All prospective residents were either seen by the provider/manager or visited the home for an assessment prior to admission. However there was no written evidence of these visits and the outcome. A record of the assessments and what was discussed should be kept on the residents file. The care plans for the most part were satisfactory however there was one that had some important detail missing. The provider/manager must ensure that all relevant information is included on the care plan to ensure that the residents receive the care they need. The Range Rest Home DS0000008580.V317698.R01.S.doc Version 5.2 Page 7 Personal information was recorded in the daily diary. This was not acceptable as it could breach the residents’ confidentiality. All information should be recorded in the care plan. The recruitment and selection procedures with regard to the completion of the application form and references must be tightened up in order to make sure that only suitable people are employed. On the day of the inspection both the provider/managers and the trainee manager were on holiday. A senior member of staff was in charge of the home and whilst the senior was competent and had many years of experience working at the home there was only one other member of staff on duty with her. The senior was also cooking as well as managing the home and caring for the residents. Whilst the situation was only temporary (five days in total) it was not acceptable and could have put the residents and other members of staff at risk. The staff on duty said that they received formal supervision and appraisal regularly however the record looked at had no evidence of this. It was believed that the supervision records were held on computer; however some evidence is needed on the persons file. 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.V317698.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.V317698.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): 1,2,3,4,5. Standard 6 is not applicable. Quality in this outcome area is adequate. There was no written evidence from the provider/manager of the assessment of residents prior to admission, however information was provided to prospective residents. This judgement has been made using available evidence including a visit to this service. EVIDENCE: All of the three most recent residents to be admitted to the home had received a service user guide. There was evidence on the file via the admission checklist that all had been given a copy but only signatures from two relatives confirming this. The manager had visited one of the three service users at the hospital before they were offered a place at the home. However there was no written evidence in the care notes of this visit. The remaining two residents had not received a visit by the manager prior to admission but both had visited the home for the day; there was no written information of these visits. The provider/manager The Range Rest Home DS0000008580.V317698.R01.S.doc Version 5.2 Page 10 should write up the outcome of assessment visits to the hospital or to the home. There were care needs assessments from the social workers for two of the residents and one hospital transfer/assessment form on the files. There was a copy of a contract on two of the three residents files looked at which contained information about payment of fees and when changes were likely to be made. There had been no changes to the contract or changes in fees since the admission of the three residents. For various reasons it was not possible to obtain confirmation verbally from the residents if they had received a service user guide or contract. Standard 6 was not applicable, as the home did not have any intermediate care beds. The Range Rest Home DS0000008580.V317698.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): 7,8,9,10. Quality in this outcome area is adequate. 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 for the most part satisfactory and contained information regarding the residents’ care needs and likes and dislikes. However one care plan had some important detail missing which had been disclosed on the medical/assessment form but not transferred to the care plan. This was discussed with the senior staff member. Other information was missing on care plans such as details of dentist and opticians; all the information required must be completed. Each resident was also 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 also responsible for the monthly review of the care plan. There was evidence of these reviews on the care plan. The medication records were pre-printed by the chemist who also provided a monitored dosage system. The records had been completed satisfactorily. One The Range Rest Home DS0000008580.V317698.R01.S.doc Version 5.2 Page 12 of the residents managed their own medication and a second partially self medicates. All the residents who were spoken with were happy with the care they were receiving. The Range Rest Home DS0000008580.V317698.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): 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 shown the ‘activities book’, which was a record of events that had taken place. These included bingo, music, craft sessions and memory games. The care workers had started a ‘shop’, which sold items such as; toiletries, sweets, tissues and cards. The residents had welcomed this idea and it was proving very popular. Friends and relatives were welcomed at the home at all reasonable times of the day and evening. Relatives were 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.V317698.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. The Range Rest Home DS0000008580.V317698.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): 16,18. Quality in this outcome area is good. The provider/manager protected the residents through the complaints procedure and training of care workers. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Training on the protection of vulnerable adults had been given to all the care workers by a trainer who visited the home; the inspector saw evidence in the form of certificates. Neither the home nor the Commission for Social Care Inspection had received any complaints and there had been no adult protection investigations. A copy of the complaints procedure was given to all residents or their relatives through the service user guide. Two of the residents said that they would tell the staff if there was anything wrong a third was unable to say. The Range Rest Home DS0000008580.V317698.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): 19,24,26. 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 lounge and conservatory had recently been re-decorated; all the residents 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.V317698.R01.S.doc Version 5.2 Page 17 The Range Rest Home DS0000008580.V317698.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): 27,28,29,30. Quality in this outcome area is adequate. Experienced care workers who had received appropriate training looked after the residents. However the number of staff on duty was not sufficient to ensure that the residents were protected at all times. This judgement has been made using available evidence including a visit to this service. EVIDENCE: There had been two new care workers appointed since the last inspection of February 2006. The files of one were looked at which showed evidence that recruitment and selection procedures were not as robust as they could be. The application form had not been completed satisfactorily and there were gaps in the employment record. The references were not satisfactory. This was discussed with the senior member of staff. The provider/managers Mr & Mrs Williams live on the premises and are on duty most days but on the day of the inspection they were on holiday and so was the trainee manager. Provision had been made for a member of staff with many years of experience to be in charge in their absence, which was satisfactory. However it was unacceptable that the senior person was cooking and helping with the personal care needs of residents with just one other member of staff per shift to assist. The providers must ensure that there are at least three people on the premises in their absence to ensure that the residents are kept safe and that their needs The Range Rest Home DS0000008580.V317698.R01.S.doc Version 5.2 Page 19 would be met. Should there have been an emergency the residents could have been put at risk through insufficient staff. The care workers that were seen had been working at the home for many years. National Vocational Qualification training was ongoing with a small number having a level 2 and one person with a level 3. Other training had taken place such as death and dying, moving and handling, safe handling of medicines and food hygiene. The Range Rest Home DS0000008580.V317698.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): 31,33,35,36,37,38. Quality in this outcome area is adequate. The home was run for the residents by a staff team who were experienced. However insufficient staff and appropriate record keeping compromised the confidentiality and health and safety of residents at this inspection. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home is owned and managed by Mr & Mrs Williams who have many years of experience but do not have a qualification. The trainee manager is undertaking a National Vocational Qualification Level 4 and is to apply in early 2007 for registration with the Commission for Social Care Inspection. The Range Rest Home DS0000008580.V317698.R01.S.doc Version 5.2 Page 21 The Commission received a quality assurance report for 2006 however the provider and manager should look at the amended regulations before producing the 2007 report. The care workers on duty said that staff supervision and staff meetings had taken place but there was no up to date evidence of this on the files. This was discussed with the senior on duty that said the records would probably be on the computer. This was not satisfactory paper copies should be available for inspection purposes and accessible to the care workers. The keeping of personal notes on the residents’ welfare in the daily diary is not acceptable, as it does not comply with data protection legislation. The most the daily diary should contain is a note referring people to the care plan for information. The home 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. The Range Rest Home DS0000008580.V317698.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 3 3 3 2 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 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 3 3 x x x x 3 x 3 STAFFING Standard No Score 27 2 28 3 29 2 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 x 3 x 3 2 2 3 The Range Rest Home DS0000008580.V317698.R01.S.doc Version 5.2 Page 23 Are there any outstanding requirements from the last inspection? NO 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 OP29 Regulation 19 Requirement The registered person must ensure that the recruitment and selection procedure is robust and complies with Schedule 2 of the Care Homes Regulations 2002. Timescale for action 31/03/07 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard OP4 Good Practice Recommendations The registered person should provide written evidence on the resident’s file of the pre-admission assessment to demonstrate that they can meet the needs of the prospective resident. The registered person should ensure that all the relevant information regarding the residents’ health and personal care needs are included on the care plan. The registered person should ensure that there are sufficient numbers of staff at all times to maintain the health and safety of the residents. The registered person should make an application to register the trainee manager with the Central Registration Team. DS0000008580.V317698.R01.S.doc Version 5.2 Page 24 2. 3. 4. OP7 OP27 OP31 The Range Rest Home 5. 6. 7. OP33 OP36 OP37 The registered person should ensure that the quality assurance report meets with the amended Care Homes Regulations. The registered person should ensure that there is a record available that supervision has taken place, which is accessible to all the relevant personnel. The registered person should ensure that the daily diary contains no personal information about residents in order to maintain their confidentiality. The Range Rest Home DS0000008580.V317698.R01.S.doc Version 5.2 Page 25 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: 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 Range Rest Home DS0000008580.V317698.R01.S.doc Version 5.2 Page 26 - 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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