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Inspection on 04/01/06 for Treeton Grange Nursing Home

Also see our care home review for Treeton Grange Nursing Home for more information

This inspection was carried out on 4th January 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 found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

There is a very good atmosphere created within the home and there is a good range of activities offered to help pass the day for the residents. The residents and staff were very willing to discuss issues and there was a very happy, friendly atmosphere throughout. Visitors said how welcome they were made to feel and the residents said that they could receive their visitors either in the communal areas or in the privacy of their own bedrooms.

What has improved since the last inspection?

There has been a manager designate appointed since the last inspection and she is beginning to mould the staff group into different teams with specialist responsibility for specific aspects of care. There has also been another hot food trolley bought so that the lunch can be served to all the service users at the same time.

What the care home could do better:

There have been several changes in the management of the home recently and there would be a benefit from a complete audit of the way the staff are working to ensure that the standards of care are consistent with the policies of the home.

CARE HOMES FOR OLDER PEOPLE Treeton Grange Nursing Home Wood Lane Treeton Rotherham South Yorkshire S60 5QS Lead Inspector Alan Bartrop Unannounced Inspection 4th January 2006 09:30 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 Treeton Grange Nursing Home DS0000003092.V273639.R01.S.doc Version 5.0 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. Treeton Grange Nursing Home DS0000003092.V273639.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Treeton Grange Nursing Home Address Wood Lane Treeton Rotherham South Yorkshire S60 5QS 0114 2692826 0114 2695434 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) Treeton Grange Limited ** Post Vacant *** Care Home 50 Category(ies) of Old age, not falling within any other category registration, with number (50) of places Treeton Grange Nursing Home DS0000003092.V273639.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 28th September 2005 Brief Description of the Service: Treeton Grange is a care home with nursing situated on the outskirts of the village of Treeton that is near both Rotherham and Sheffield. Buses pass by the home, though access to the village is limited for people with disabilities. The company no longer has its own minibus; it now accesses community transport for outings. The home is set in large gardens overlooking the countryside, and has ample car parking. The building was converted to a home from offices, and has had a large purpose built extension. It now accommodates up to fifty elderly people on two floors, accessed by shaft lifts and stairs. The rooms are mainly single rooms and all have en-suite toilets and washbasins. Five lounge areas and four dining areas are available, with one of the lounges having access on to the garden. Treeton Grange Nursing Home DS0000003092.V273639.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection was conducted over 2 days starting at 09:30 on 4/1/06 and concluding on 5/1/06. The reason for the time delay between the start and the finish of the inspection was due to external circumstances that were not related to this home. Then inspection included a tour of the home, talking to residents, staff and the manager, reading of documents and care files, and sampling of lunch. What the service does well: What has improved since the last inspection? There has been a manager designate appointed since the last inspection and she is beginning to mould the staff group into different teams with specialist responsibility for specific aspects of care. There has also been another hot food trolley bought so that the lunch can be served to all the service users at the same time. Treeton Grange Nursing Home DS0000003092.V273639.R01.S.doc Version 5.0 Page 6 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. Treeton Grange Nursing Home DS0000003092.V273639.R01.S.doc Version 5.0 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Treeton Grange Nursing Home DS0000003092.V273639.R01.S.doc Version 5.0 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 3 Each resident is assessed prior to admission to ensure that the care that can be provided at the home will meet their needs. EVIDENCE: Assessments were seen in all the care files inspected. The assessments were used as a basis for the initial care plan. These are reviewed periodically. The care plans cover the categories needed to meet the National Minimum Standards. There is a new system of care planning being introduced into the home, this is to be trialled at Treeton Grange in the near future. Treeton Grange Nursing Home DS0000003092.V273639.R01.S.doc Version 5.0 Page 9 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8 The care plans and records of care given on a daily basis are due to be changed in the near future. Medication administration was not carried out in an appropriate manner. The health needs of the service users are assessed and appropriate measures taken to meet these needs. EVIDENCE: Issues of maintaining oral hygiene are detailed in some care plans where there has been a need for help identified. Charts were seen on care plans to indicate areas of pressure care and these had been passed onto outside agencies for advice and guidance to be given. There was evidence that mobility issues had been identified and that the plans for addressing these issues were clear and individual to the resident. Treeton Grange Nursing Home DS0000003092.V273639.R01.S.doc Version 5.0 Page 10 Records of the care given on a daily basis showed that the psychological health of the service user was taken into account as well as their physical wellbeing. The medication round was observed and concerns raised that the nurse administering the medication was handling the tablets without wearing gloves, this practice may cause contamination of the tablets as well as absorption of the medications into the administrators body through their skin. The service users are able to keep their general practitioner when they are admitted if there is no objection from the general practice. Treeton Grange Nursing Home DS0000003092.V273639.R01.S.doc Version 5.0 Page 11 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 13,14 There are a good number of visitors to the home and some of the residents visit their families in the community. The philosophy within the home is to allow the service users to make as many choices as possible about the way they want to live their lives. EVIDENCE: The register of visitors was inspected and this showed that there were a lot of different visitors to the home, some of whom were very frequent. The visitor asked said that they were always made welcome and that they often visited their relative in private, although the other residents made them very welcome in the communal areas. Staff were heard to be asking the service users what they wanted and giving them ample time to respond. When service users had difficulty communicating the staff appeared to be aware of the different communication methods used and these appeared to extract the right results. Treeton Grange Nursing Home DS0000003092.V273639.R01.S.doc Version 5.0 Page 12 Residents confirmed that they were given choices and that they appreciated the way the staff let them keep some control. Treeton Grange Nursing Home DS0000003092.V273639.R01.S.doc Version 5.0 Page 13 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 18 There are procedures in place to protect vulnerable service users from being abused whilst in the home. EVIDENCE: The adult protection procedures are kept in the home and available for the staff to read and use. There is a policy on ‘whistle blowing’, which makes it clear what staff should do if they think that the treatment of any resident is not as good as it should be. The adult protection policy works in conjunction with that of Rotherham Metropolitan Borough Council. There are no adult protection issues in the home. Treeton Grange Nursing Home DS0000003092.V273639.R01.S.doc Version 5.0 Page 14 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19 The home is a converted building that has a good range of communal areas, wide corridors, and large bedrooms. EVIDENCE: The inspection included a partial tour of the building, concentrating on the resident’s areas. A lot of the service users bedroom contained personal items that had been brought in to personalise their space. The communal areas are large and well lit, they were clean and free from obstacles that the service users could fall over. All the corridors were clear and clean, the domestic staff had adequate equipment and were trained in how to use it. The residents said how much they liked the décor and space within the home. Treeton Grange Nursing Home DS0000003092.V273639.R01.S.doc Version 5.0 Page 15 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 30 There is a strong commitment to training staff and developing the skills that are needed to maximise the wellbeing of the residents. EVIDENCE: A large number of care staff are qualified to National Vocational Qualification level 2 level. There is a training plan for each member of care staff to enable them to undertake training in areas of interest for their personal development. There is a need for increased monitoring to ensure that all the Registered General Nurse’s are using up to date practice when administering medication. Treeton Grange Nursing Home DS0000003092.V273639.R01.S.doc Version 5.0 Page 16 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 38 There were no health and safety issues identified other than the one already referred to. EVIDENCE: A partial tour of the building evidenced that there were no immediate health and safety issues to be seen. All the cleaning chemicals and equipment was appropriately stored or used. The staff questioned were aware of the dangers associated with the chemicals they were using and what preventative measures they had to take to ensure safety. The fire extinguishers that were checked were in date for testing. Treeton Grange Nursing Home DS0000003092.V273639.R01.S.doc Version 5.0 Page 17 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 X HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 2 10 X 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 X 13 4 14 3 15 X COMPLAINTS AND PROTECTION Standard No Score 16 X 17 X 18 3 3 X X X X X X X STAFFING Standard No Score 27 X 28 X 29 X 30 4 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X X X X X X 3 Treeton Grange Nursing Home DS0000003092.V273639.R01.S.doc Version 5.0 Page 18 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. 1 Standard OP9 Regulation 13 Requirement Staff administering medication are monitored and additional training put in place where a need is identified. Timescale for action 01/03/06 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 OP31 Good Practice Recommendations The manager designate be registered as soon as possible Treeton Grange Nursing Home DS0000003092.V273639.R01.S.doc Version 5.0 Page 19 Commission for Social Care Inspection Doncaster Area Office 1st Floor, Barclay Court Heavens Walk Doncaster Carr Doncaster DN4 5HZ National Enquiry Line: 0845 015 0120 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 Treeton Grange Nursing Home DS0000003092.V273639.R01.S.doc Version 5.0 Page 20 - 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!