Inspection on 17/05/07 for Upton Grange

This inspection was carried out on 17th May 2007.

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

Upton Grange 25/05/06

Upton Grange 18/08/05

Upton Grange 18/04/05

Upton Grange 10/11/04

Upton Grange 19/07/04

Upton Grange 18/02/04

Upton Grange 05/11/03

Upton Grange 07/01/03

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

CARE HOMES FOR OLDER PEOPLE Upton Grange 214 Prestbury Road Macclesfield Cheshire SK10 4AA Lead Inspector Bronwyn Kelly Unannounced Inspection 09:30 17th May 2007 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 Upton Grange DS0000006599.V332752.R02.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. Upton Grange DS0000006599.V332752.R02.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Upton Grange Address 214 Prestbury Road Macclesfield Cheshire SK10 4AA 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) 01625 829735 01625 820266 Cheshire Residential Homes Trust Ms Jacqueline Ross Care Home 25 Category(ies) of Old age, not falling within any other category registration, with number (25) of places Upton Grange DS0000006599.V332752.R02.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 25th May 2006 Brief Description of the Service: Upton Grange is one of three care homes owned by the Cheshire Residential Homes Trust, which is a charitable non-profit making organisation. A committee of volunteers runs the home, which provides personal care and accommodation for up to 25 older people. There is one bedroom available for a person to stay for a short stay. The home is close to Macclesfield town centre. There are a number of shops, and other facilities nearby. There are adequate car parking facilities available at the home. Upton Grange is an older style large country house, with bedrooms on the ground and first floor. Access between floors is via a passenger lift or the stairs. There are 25 single bedrooms of varying sizes, all of which have en-suite facilities. Communal space consists of 2 lounges and a dining room. There is a large well-maintained private garden with walkways and seating areas and an enclosed courtyard seating area. The current fees are £422 per week or £1828 per calendar month. Further details regarding fees are available from the manager. Additional charges are made for newspapers, hairdressing, private chiropody, dentist, toiletries and opticians. Visitors to the home and residents are able to read the latest CSCI inspection report, which is available in the office. Upton Grange DS0000006599.V332752.R02.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. An unannounced visit by one inspector took place on the 17 May 2007 and lasted 6.00 hours. This visit was just one part of the inspection. Before the visit the home manager was also asked to complete a questionnaire to provide up to date information about services in the home. Questionnaires were also made available for residents, families, and health and social care professionals such as doctors, nurses and social workers to find out their views. Other information received by CSCI since the last key inspection was also reviewed. During the visit, various records and the premises were looked at. A number of residents and relatives were also spoken with and they gave their views about the service, which have been included in the report. What the service does well: The home is well maintained so people live in homely, comfortable surroundings with good facilities. The residents are happy living there, and some of the comments received during the inspection include: • “The home is lovely. Like a 1st class hotel and you couldn’t get any better” • “I am very happy here” • “I find the staff without exception extremely kind and helpful at all times” • “After 2 years residence at Upton Grange, I am unable to offer any adverse comments on the care service that would call for improvement”. • “They deal promptly and competently with any problems that arise from time to time”. Relatives spoken with during the inspection also felt happy with the care given at the home. One relative commented in a questionnaire “The care home has adjusted well to our relatives increased dependency……….the staff have coped with patience and understanding”. Many residents have large bedrooms and all have ensuite facilities. The rooms are furnished in a style in keeping with the period of the house. The grounds to the house are spacious and pleasant, and are enjoyed by a number of the residents. All residents spoken with commented that there was a good variety of wellcooked food so they all enjoyed their meals. Upton Grange DS0000006599.V332752.R02.S.doc Version 5.2 Page 6 The atmosphere in the home is warm and welcoming and there is evidence of good relationships between residents, relatives and the staff group. What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Upton Grange DS0000006599.V332752.R02.S.doc Version 5.2 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 Upton Grange DS0000006599.V332752.R02.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 3. Standard 6 does not apply, as intermediate care is not provided at he home. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents’ needs are assessed before they move into the home. This ensures that each resident and their family know that these needs can be met when they move into Upton Grange. EVIDENCE: The manager visits people who have expressed a wish to move in to the home to carry out an assessment of their needs to ensure they can be met at Upton Grange. Records, discussion with people who live at the home and others showed that this was done well. Four care plans were seen and all contained assessments done before the person moved into the home, which was signed and dated. The manager explained the admissions procedure and said the care plan is built up over a period of weeks, as people’s needs often change after they Upton Grange DS0000006599.V332752.R02.S.doc Version 5.2 Page 9 move in. She writes the basic information for staff, so they know how to care for the residents, and this information is built upon to form a full care plan. Staff spoken with explained that each new resident is allocated a key worker, whose role is to build on the care plan over a period of time. Residents spoken with confirmed their needs are well met at the home. Upton Grange DS0000006599.V332752.R02.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 and 10 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The people who live at the home are well looked after, ensuring their health, social and personal care needs are met. EVIDENCE: Care plans were well written, up to date and reviewed monthly, with any changes recorded, so that staff are always aware of people’s changing needs. There is a very good residents’ profile on the front of the plan, detailing previous history and lifestyle, which enables the care staff to have a greater understanding of each resident. The care plan is a working document and the key worker for each resident ensures the plans are up to date. Although staff said they discussed the reviews with residents and involved them in any changes, the care plans did not contain any evidence, such as signatures, that residents are involved. Five residents spoken with said they had never seen their care plan. Staff said this could be as they had ‘forgotten’. It is good practice to ensure that care plans are drawn up with the residents where possible. Upton Grange DS0000006599.V332752.R02.S.doc Version 5.2 Page 11 Risk assessments are in place, and this has enabled a number of residents to be more independent. An example of this is resident who takes the bus alone regularly into town. Discussions with the staff showed that they have a good understanding of the importance of residents’ confidentiality. Residents spoken with said a doctor is called when they are feeling ill and they are seen by their GP their own bedrooms. Care plans contained medical information, showing the dates of visits from GPs and nurses. Residents spoke about the personal care they received from the staff, and all said, without exception, that the care was very good and met all their needs. The medication system was seen, and a senior member of staff was observed giving medicines to the residents. This was well managed with no concerns. Medicine administration records showed no gaps, and stocks of medicines were not too large. The home does not have a controlled drugs cupboard or the necessary register book. The manager said the home did not have any residents who took controlled drugs. However, the manager should consider having the necessary equipment in place in case any residents are prescribed controlled drugs in the future. This would ensure that they are stored and administered safely. Care staff were observed to treat the residents with dignity and respect and communicate with them in a variety of appropriate ways. Some comments received from people who use the service were: “I’ve come on in leaps and bounds”. “Very happy, no restrictions, very well cared for”. Upton Grange DS0000006599.V332752.R02.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 and 15 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People who use the service are given the opportunity to choose their lifestyle, social activities and food from a wide range. This means that the residents have some control over their lives. EVIDENCE: Residents spoken with said the home meets their expectations and they are able to live their life as they choose. One resident said, “It’s like being at home but without having to do the cooking!” There are leaflets on display in the hall and dining room giving details about the activities available each month. During May, there are 2 or 3 visits every week by entertainers such as musicians, singers, exercise classes and other visiting groups. Care staff are also involved in activities with the residents. A number of residents still go out on a regular basis with their families, and some residents enjoy walks in the garden or out to the shops. People from a local church visits regularly and there is opportunity for communion. Upton Grange DS0000006599.V332752.R02.S.doc Version 5.2 Page 13 The administrator for the home co-ordinates the entertainment, and care staff get involved on a small group or individual basis with residents according to their individual wishes. One resident commented that she enjoyed the activities in the home and said “Good activities – we have concerts”. A group of residents in the lounge spoken with all said there was enough going on and they could please themselves whether or not they joined in. Residents also expressed satisfaction with the laundry and hairdressing services. With regard to the food, only positive comments were received. The cook has worked at the home for 40 years, and enjoys getting to know the residents and their likes and dislikes. The menu offers a good variety of well-balanced food. There is a large choice for breakfast and supper, which is served at 6.00pm. Lunch is usually the dish of the day, and this is displayed in the dining room, giving residents time to ask for something different if they prefer. Residents were asked about this to check whether they would prefer to have a choice of 2 dishes at lunch, but all were happy with the present system. One resident said they always cook something different for those who do not like what is the dish of the day e.g. prawns or salmon. On the day of the visit, lunch for the residents was savoury mince and herb dumplings, lyonnaise potatoes, cauliflower and carrots followed by cherry sponge and custard or fresh fruit salad. One resident said, “Food is very good – we choose the supper menu at lunchtime”. Another resident said, “Food is good – they are very accommodating if you want something different”. Upton Grange DS0000006599.V332752.R02.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Arrangements for making complaints and protecting residents from abuse are satisfactory so that people using the service are not at risk from harm or poor practice. EVIDENCE: The complaints procedure is available in the service user’s guide, and each resident has a copy of this in their bedroom. Residents and visitors are encouraged to express any comments they have about the home and a suggestions box is displayed in the dining room. CSCI has not received any complaints about the home since the last inspection. The information sent to CSCI before this visit took place indicated that the home has not received any complaints in the past year. The manager encourages families to discuss any issues or concerns they have with her and the staff, so that these can be put right immediately. One resident wrote on a questionnaire“They deal promptly and competently with any problems that arise from time to time”. Residents spoken with said they would be happy to discuss any concerns they had with the manager. There is also an opportunity for residents to talk with the committee members who visit the home each week. Upton Grange DS0000006599.V332752.R02.S.doc Version 5.2 Page 15 There are policies and procedures in place for the protection of residents. Since the last inspection, staff have received training in adult abuse procedures so that they are aware of the action to be taken if an allegation is made. Staff spoken with displayed a good understanding of the procedures. Upton Grange DS0000006599.V332752.R02.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 and 26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is well maintained so the people at the home live in safe, comfortable surroundings. EVIDENCE: The people living at Upton Grange all have single ensuite bedrooms, in a variety of sizes, which contain many of their own possessions and furniture occassionally, creating a homely effect. The home is well maintained so there is a comfortable, well-maintained environment for the residents, which meets their needs. There are very well tended gardens with lawns, bushes, trees, and plants with seating areas, walkways and a courtyard. The grounds are spacious and pleasant, and residents spoken with appreciated and used the grounds. Upton Grange DS0000006599.V332752.R02.S.doc Version 5.2 Page 17 There are two lounges, one of which is a smoking room. The main lounge is divided into two seating areas, providing a quieter area. However, there is no additional small lounge where residents could enjoy total quiet. The dining room is spacious and welcoming. A maintenance programme for the next fifteen years is in place. Bedrooms are decorated plus re-carpeted when a new person moves in. The home is clean, with no odours, and all in good order. The domestic staff take pride in their work. Some areas of the home will need redecorating in the near future, but the management are aware of this. One resident commented that he had never seen anywhere being cleaned so thoroughly. Upton Grange DS0000006599.V332752.R02.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 and 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. There are sufficient well-trained and properly recruited staff to meet the needs of the people that live in the home and provide safe care. EVIDENCE: Staff spoken with described the training they had attended over the past year, which included medicines awareness, fire safety training, health and safety, moving and handling, challenging behaviour, adult abuse and first aid. They all felt that the opportunities for training were good and helped them look after the residents well. 71 of staff have achieved an NVQ 2/3 qualification in care. The staff rotas showed that there are sufficient staff on duty throughout the day and night to meet the needs of the people that live in the home. One member of staff said,“ We are a good team and all get on well with each other”. Staff cover shifts for each other during holiday periods and sickness. This is good for the residents, who receive continuity of care without having to have a constantly changing staff group. The staff turnover is low and there have been no new staff in the last year. Staff have mostly worked at the home for many years, and have built up good relationships with the residents and their families over this time. Upton Grange DS0000006599.V332752.R02.S.doc Version 5.2 Page 19 Staff said supervision was taking place on a regular basis and recorded. As a number of the staff are related to each other, they are supervised by a member of staff who is not part of their family. Discussion with the staff group showed they have a good understanding of equality and diversity issues such as disability, sexual orientation, race, gender and religion, and have a good understanding of the actions they need to take to promote equality and diversity within the home. The staff files of four members of the care team, including the two latest employees, were checked. Each showed that good recruitment procedures are in place. Records also showed that all staff working in the home have had a Criminal Records Bureau check completed. These procedures and checks help ensure that only the right people are employed in the home to care for vulnerable elderly people. People who live at the home who spoken with gave many examples of how well they regard the staff group, and were very complimentary about the care they receive. One resident summed up her experience by saying, “very comfortable, peaceful – excellent staff”. Upton Grange DS0000006599.V332752.R02.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 and 38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The manager is experienced and supported by a senior staff team, ensuring the residents live in a well run home that safely meets their needs. EVIDENCE: The manager of the home is qualified and has had a number of years experience. Residents spoken with felt the home was well run and well organised. They don’t have regular meetings, but the manager said she feels that as they are a small home, and she sees everyone on a daily basis, issues get discussed on a one to one basis. Also, the committee members visit weekly and talk with the people who live in the home. Upton Grange DS0000006599.V332752.R02.S.doc Version 5.2 Page 21 Residents/families have been sent questionnaires from the home, seeking their views of the service. The administrator for the home has collated the responses, but it would be good practice to make this report more available, so that prospective residents are able to see what it is like to live in the home. The families of residents are encouraged to care for any financial affairs if residents are unable to do this for themselves. Staff do not handle any of the residents’ money or savings, only small amounts deposited by the families for the shop/hairdressing. Each resident’s money is kept in a separate bag in the safe and the accounts for these were in order, with receipts obtained. The information provided from the home before the inspection visit showed that equipment and installations at the home are serviced regularly providing a safe environment for staff and residents. Upton Grange DS0000006599.V332752.R02.S.doc Version 5.2 Page 22 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 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 X X 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X X 3 Upton Grange DS0000006599.V332752.R02.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. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 Refer to Standard OP7 Good Practice Recommendations Care plans should be drawn up with the agreement of the residents and signed by them or their representative. This will show that the residents agree to the way they are being cared for in the home and that their needs are being met. A Controlled Drugs cupboard and Controlled Drugs register should be in place in the home so that any such medicines, which may be prescribed for residents in the future, are stored and administered safely. 2 OP9 Upton Grange DS0000006599.V332752.R02.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Northwich Local Office Unit D Off Rudheath Way Gadbrook Park Northwich CW9 7LT 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 - 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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