Inspection on 21/10/08 for Tolson Grange

This inspection was carried out on 21st October 2008.

CSCI found this care home to be providing an Good service.

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

Tolson Grange 30/10/07

Tolson Grange 21/11/06

Tolson Grange 23/01/06

Tolson Grange 03/10/05

Tolson Grange 11/02/05

Tolson Grange 08/07/04

Tolson Grange 09/03/04

Extracts from inspection reports are licensed from CQC, this page was updated on 31/03/2009.

Inspecting for better lives Key inspection report Care homes for older people Name: Address: Tolson Grange 12 Coach House Drive Dalton Huddersfield West Yorkshire HD5 8EG     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Karen Summers     Date: 2 1 1 0 2 0 0 8 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. the things that people have said are important to them: They reflect This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop 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 Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Older People Page 2 of 27 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.csci.org.uk Internet address Care Homes for Older People Page 3 of 27 Information about the care home Name of care home: Address: Tolson Grange 12 Coach House Drive Dalton Huddersfield West Yorkshire HD5 8EG 01484432626 01484519126 karen.wilson@anchor.org.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Miss Karen Wilson Type of registration: Number of places registered: Anchor Trust care home 38 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia Additional conditions: Date of last inspection Brief description of the care home Tolson Grange is a residential home providing personal care and accommodation for up to thirty-eight older people with dementia. Anchor Trust, a national housing association and organisation providing residential care, own the home. Tolson Grange is located on the outskirts of Dalton, a residential suburb of Huddersfield. It is near to local shops and public transport and there is car parking to the front of the property. Tolson Grange recently increased the number of rooms available by incorporating an attached former sheltered housing complex. The original home was purpose built for the current client group. The home has twenty-four large, single en-suite bedrooms and 14 large single suites with bedroom, lounge and a walk-in shower room with toilet facilities. All rooms are fitted with privacy locks and an emergency call system. There are good communal facilities over three floors. Stairs and a shaft lift are available to allow access to the upper and lower floors. Security at the home is ensured through the Care Homes for Older People Page 4 of 27 Over 65 38 0 Brief description of the care home provision of coded door locks. The home has enclosed sloping gardens. Information about the home in the form of a Statement of Purpose, Service User Guide and the latest Commission for Social Care Inspection report are available from the home. Care Homes for Older People Page 5 of 27 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: The last inspection on this service was completed on 30th October 2008 The quality rating for this service is two star. This means the people who use this service experience good quality outcomes. This report refers to an inspection, part of which included an unannounced visit, on the 21st October 2008, commencing at 11 am, and the length of the inspection was 5.75 hours. There were 37 people living at the home on the day of the visit. Care Homes for Older People Page 6 of 27 During the visit we spoke with members of staff and people who receive care to obtain their views. We also looked at a sample of care records, staff recruitment, and training records, quality assurance audits and looked around the home. To enable people who sue the service to comment on the care it provides, we sent surveys to 10 people living at the home, three of these were returned. Ten surveys were handed to relatives, advocates, friends, four of which were returned, ten to staff, six were returned, and five to local doctors and health care workers (social workers, community nurses), none of which were returned at the time of writing this report. The comments in the surveys were positive about the standard of care provided by the staff at the home. The provider informed the Commission for Social Care Inspection on the day of the visit that fees range from 524 pounds to 580 pounds. Additional charges include hairdressing, private chiropody, newspapers, magazines, and personal toiletries. We would like to thank all the people who gave feedback about this home, and would like to thank the person in charge and staff for their cooperation throughout the inspection process. What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking Care Homes for Older People Page 8 of 27 following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 240 7535. Care Homes for Older People Page 9 of 27 Details of our 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) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 10 of 27 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are assessed prior to them moving into the home to ensure that their needs can be met, and are able to visit the home to establish whether or not it is the right place for them. Evidence: The information from the home prior to inspection said that people are only admitted after an assessment to ensure that their needs can be met, and that people are able to visit the home and spend time there before making a decision to move in. The care records of there people who use the service were examined, all of which contained a pre-admission assessment carried out by the funding local authority. Each assessment contained information about the persons current needs, and in addition to this there was evidence that the home had carried out an assessment of the persons needs. Care Homes for Older People Page 11 of 27 Evidence: People living in the home confirmed that they received enough information about the home before they moved in so they could decide if it was the right place for them. Care Homes for Older People Page 12 of 27 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Peoples care plans outline the level of support and care each person requires in ensuring their health and welfare needs will be met. The recording and administration of medication is satisfactory. Evidence: Surveys sent to relatives asked if the care home meets the needs of their relative. Two people said that their relatives needs were, Always met, and one person said that they Usually were. One person said that personal care is sometimes poor when their relative refuses care, whilst another person said that the home provides a good source of information for relatives who cannot cope. People who live at the home were assisted by the activities person to complete their surveys, and the activities person had recorded that people receive the care and support that they need. Three peoples care records were looked at and the documentation identified the care Care Homes for Older People Page 13 of 27 Evidence: needs, and level of support the person requires. Risk assessments had also been completed and included the risk of falls. Unfortunately, not all the documentation had been dated and signed, and not all the care plans had been reviewed ad updated monthly. This was discussed in detail with the person in charge who said that there was a meeting the next day regarding care plans, and that she would ensure that the short falls were addressed. The health care needs of people are met. Evidence was seen of involvement from peoples doctors, physiotherapist, optician, dentist and other health care professional where needed. Relatives said that they were kept up to date with important issues effecting their relative, and one person said that, Any significant issues are communicated by telephone. People who use the service confirmed that they receive the medical support they need, and one person said that the district nurse visited daily. On the day of this inspection, samples of three peoples medication were checked. The storage, administration and recording of the medication were done correctly, and there was evidence to show that regular audits of the medication systems take place. The person in charge also confirmed this. The medication refrigerator temperature has not always been recorded daily to show that the correct temperature has been maintained. This recommendation was also made at the last inspection. The person in charge said that she would ensure that the daily readings were recorded. Care Homes for Older People Page 14 of 27 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People living at the home are offered a range of activities and are able to make their own choices about how they spend their time. Meals provided are good, varied and served in a pleasant environment. Evidence: The home employs an activities co-ordinator who works 30 hours per week (MondayFriday). Unfortunately the person is due to retire, therefore the home is currently interviewing for her replacement. A programme of activities is on display in the corridor of the home, and at the time of the visit people were seen joining in making making a Christmas cake. Staff were also sat talking to people and generally passing the time of day. Activities that take place include, baking, bing, hoopla, skittles, memory cards, reminiscence, dominoes and outings. The people living in the home and that completed the survey, said that there were activities that they could always take part in. At this moment in time ministers from local churches do not visit the home and no one regularly goes to church however, the person in charge said that the Catholic Priest does visit when requested, and that a minister of the church will visits on request and Care Homes for Older People Page 15 of 27 Evidence: on occassions throughout the year. Two relatives wrote that the home always helped their relative to keep in touch, and two said that this was not applicable due to the illness of their relative. One person said that if there were any problems, the home would telephone them. Relatives were asked if the service supports people to live the life they choose? One person said that the home always did, and that the staff keep people safe, calm and as comfortable as possible. This person also said that staff respond to people positively, and encourage them to do what is most beneficial them. Two people said that they usually did, and one person said never, due to their relatives illness. Relatives also said that the service met the different needs of people in relation to race ethnicity, age, disability, gender, and faith. Although it was not possible to get direct feedback from people loving at the home as to whether they are able or encouraged to make their own choices, it was clear through observing care practice that people are encouraged to make choices. When offered lunch, people were shown the meal that was on offer that day and people then chose which one they wished to have. The menus offered a variety of food, and food preferences and diets were also also taken into consideration. The manager said that no one presently requires a specific diet due to his or her culture however, she also said that should this arise then one would be provided. People commented that they liked the meals at the home. The person in charge said that with the exception of one member of staff, all staff that handle food have the basic food hygiene certificate. The person whos certificate was out of date, confirmed that she had a date booked in the near future to have the up date training. As a tribute the home has received a five stars, excellent award in association with Kirklees Councils Health Choice Award Scores on the doors. Care Homes for Older People Page 16 of 27 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People can be confident that their complaints will be dealt with effectively. Staff have received suitable training and understand the adult protection policies and procedures, which makes sure that the people they support are safe. Evidence: There is a compliments procedure, which is clearly communicated to people using the service. People who use the service and their relatives, said that they knew how to make a complaint and knew who to speak with if they were not happy. One person said, that although they had not needed to complain they knew how to make a complaint. The manager keeps a log of all complaints and there had been five received in the last twelve months. Discussions took place with the person in charge, that all correspondence needs to be held in one file to clearly see the action that has been taken. There are policies and procedures at the home that staff should follow should they suspect that abuse has taken place. Those staff spoken with during this visit spoke with confidence about how they would report poor care practice and abuse. With the exception of one member of staff, all staff have received safeguarding (adult protection) training which provides information on how to protect people from abuse. Care Homes for Older People Page 17 of 27 Evidence: The person in charge said that the staff who had not already received the training would be booked on the next available course. Care Homes for Older People Page 18 of 27 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home continues to be in a good state of repair and decorative condition. Peoples needs are met in a comfortable and homely way. Evidence: As part of the inspection a tour of the home was conducted which included the communal areas and a number of peoples bedrooms. The corridor handrails in a some areas were worn, and the person in charge said that there are plans to address this in the near future. The bedrooms are tastefully decorated and there was evidence in peoples rooms that they had been able to bring small items of furniture with them. The home was generally clean however, in the sample of bedrooms looked at, one had a stained carpet and a slight unpleasant odour, and a couple of rooms had not been vacuumed. The cleaner was informed of these areas and they were addressed at the time of the visit. The person in charge explained that a domestic had left, and that they had recently interviewed for their replacement. In the interim period staff have been carrying out these duties, and they have been extra to their normal hours of work. Relatives were asked in their surveys, What do you feel the care home does well? One person said that the home, Provides a clean and attractive environment. Care Homes for Older People Page 19 of 27 Evidence: People who use the service said that the home was, Usually fresh and clean. Care Homes for Older People Page 20 of 27 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. There are sufficient numbers of staff to meet peoples needs. Staff receive training to assist them to carry out their responsibilities and they have had all the necessary checks before working with people so that they are kept safe. Evidence: Care practice observed during this visit, and the relationship between staff and people being care for, was positive. The atmosphere at the home was warm and friendly. When asked if the care staff have the right skills and experience to look after people properly, three relatives replied, Always and one said, Usually. One person said, All the care staff are very good, some are not as experienced, and so are still learning, so they give the best care they can within their experience. A sample of three recruitment records ere inspected and the correct information and checks had been carried out. Evidence was also seen in the staff records and staff confirmed that they had induction training, training in abuse awareness, fire, dementia care, and movement and handling. The company continue to work to wards 50 of care staff to have an NVQ (National Care Homes for Older People Page 21 of 27 Evidence: Vocational Qualification) level 2. This will ensure that qualified staff have a better understanding of peoples needs in their care. The information received from the home said that in the next twelve months they plan to increase the number of staff who have an NVQ qualification. The information received from the home states, that there has been minimum agency staff used over the last twelve months, and that there is a good ratio of experienced and non- experienced staff. The list of staff on duty showed that there were sufficient staff in number to meet the needs of the people in their care, and the person in charge confirmed this. This included support staff, administrator, maintenance, activities coordinator, kitchen staff, and laundry and housekeeping. (Please refer to section 19 to 26 regarding the domestic cover.) One person who lives at the home said that there are staff available when you need them, and two people said that there are usually staff available. Care Homes for Older People Page 22 of 27 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home is well managed and the health, safety and welfare of people living at the home and staff are protected. Evidence: The company are in the process of interviewing for the managers position, and until that person is appointed, an experienced member of staff who has worked at the home for a number of years is managing the service. To ensure that the home is run in the best interest of people who live there, satisfaction surveys were sent out in July and August however, not many have been returned. The ones that were returned said that they were happy with the service and care that their relative receives. One person wrote, I think it is a lovely home, my dad seems happy and is well cared for. The staff are always polite and ready to help, I cannot ask for anything more. Smashing people. We discussed with the person in Care Homes for Older People Page 23 of 27 Evidence: charge that the outcome of the surveys should be made available to people within the home, relatives, and other interested parties. To ensure that the quality of service provided is maintained, a senior member of staff carries out monthly management visits. The documentation relating to these visits was seen, and the person in charge also confirmed that this person visits the home frequently. Minutes were seen of support group meetings that professionals e.g. Dementia Care adviser, are invited. The person in charge confirmed that the next meeting is due to take place in January 2009. There was also evidence seen, and staff confirmed that regular staff meetings take place. Staff were asked in their survey if the manager meets with them to give support and discuss how they are working? One person said, Regularly two people said, Often and one person said, Never. The person who said never, also said, The deputy manager does, but the home manager who has now left never gave any support when needed. Some people have small amounts of personal money that is held safely at the home. Records are available to show when money is deposited on behalf of people. The records show the individual cash balance for each person and how their money is used on their behalf, including receipts for goods and items purchased. Three peoples finances were checked during the visit and were found to be correct. Routine health and safety checks and maintenance checks are carried out and appropriate records were seen of those looked at. Satisfactory records were seen for practice fire alarm and emergency lighting tests. There was also evidence to suggest that staff have had fire drills/ lectures, and movement and handling training, and staff also confirmed this. Care Homes for Older People Page 24 of 27 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 25 of 27 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations 1 7 The care plans should be reviewed a minimum of monthly to ensure that any changes in care or needs of the person are updated. Care plans need to be dated and signed to show when the information has been recorded and by whom. The temperature of the drug refrigerator should be recorded on a daily basis to ensure that the correct temperature, between 2 - 8 decrease Celsius is maintained. All areas within the home should be kept clean and odour free. 50 of care staff should have an NVQ level 2 or equivalent, as this will ensure that they have a better understanding of the needs of people in their care. 2 7 3 9 4 5 26 28 Care Homes for Older People Page 26 of 27 Helpline: 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 We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. Care Homes for Older People Page 27 of 27 - 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. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!