Inspection on 18/04/07 for Walton Grange Christian Residential Home

This inspection was carried out on 18th April 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

Walton Grange Christian... 25/09/07

Walton Grange Christian... 27/06/06

Walton Grange Christian... 08/03/06

Walton Grange Christian... 27/09/05

Walton Grange Christian... 13/12/04

Walton Grange Christian... 28/06/04

Walton Grange Christian... 24/11/03

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

CARE HOMES FOR OLDER PEOPLE Walton Grange Christian Residential Home 12 Avenue Road Doncaster South Yorkshire DN2 4AH Lead Inspector Ian Hall Key Unannounced Inspection 08:00 18th April 2007 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 DS0000008004.V332773.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. DS0000008004.V332773.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Walton Grange Christian Residential Home Address 12 Avenue Road Doncaster South Yorkshire DN2 4AH 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) 01302 328439 F/P01302 328439 NONE Mrs Sandra Walton Mrs Sandra Walton Care Home 22 Category(ies) of Dementia - over 65 years of age (22) registration, with number of places DS0000008004.V332773.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 27th June 2006 Brief Description of the Service: Walton Grange is a Christian care home registered for 22 older people. The Christian approach is offered to those residents for whom Christianity is important. It does not intrude into the lives of others who attach no importance to religion. The home does not discriminate against potential residents on the grounds of non-belief. The building is a large Victorian property situated on a wide tree lined avenue with similar properties on both sides. Walton Grange is registered to provide personal care for service users with Dementia. Staff has received additional training to equip staff to meet care needs. Walton Grange offers single room accommodation for all service users. Ten rooms have en-suite facilities. All bedrooms are fitted with locks to enable service users to carry a key and lock their individual bedrooms. Staff has a master key to facilitate entry in case of emergency. Lounge areas and other communal spaces include a room where smoking is permitted with other areas providing television and quiet areas. Information gained on the 18th April 2007 indicates the current fees are £410.00 for residential care and additional charges are made for newspapers, hairdressing and toiletries. These fee charges only applied at the time of inspection, more up to date information may be obtained from the home. Fees range from £410.00 as of 1st April 2007. Additional charges are levied for hairdressing, chiropody, toiletries and newspapers etc. DS0000008004.V332773.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place over 1 day with a total of 6.5 hours being spent at the home. As part of the inspection the inspector spoke to 6 service users, three relatives, 3 staff, the homes manager and homes owner. Three residents care files and the associated records were checked. The inspector toured the home. All people spoken with were open and happy to provide comment to assist with the inspection process. Comments received were very positive describing the motivation, care and commitment of the staff team. The service provided was described as good overall. Feedback of the findings was given to both the homes owner/manager before the inspector left the home. What the service does well: What has improved since the last inspection? The system of care management continues to develop and evolve. The home’s manager and deputy manager continue to demonstrate their commitment to training and development of their care team. The Homes Owner has worked to the action plan submitted to the CSCI to upgrade and improve the environment of Walton Grange. DS0000008004.V332773.R01.S.doc Version 5.2 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. The summary of this inspection report can be made available in other formats on request. DS0000008004.V332773.R01.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 DS0000008004.V332773.R01.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, 6. People who use the service experience good quality outcomes in this area. We have made this judgment using a range of evidence, including a visit to this service. Pre admission assessments demonstrated that individual needs had been planned for before the service users moved into the home. Service users and their families were given all the information they required to make a choice of whether Walton Grange is the home for them Individual written contracts detailing terms and conditions of residence provided clear information for people who use the service. EVIDENCE: The case files examined contained individual copies of care assessments, care plans and written contracts that stated both terms and conditions of residence. DS0000008004.V332773.R01.S.doc Version 5.2 Page 9 Local Authority Contract reviews were not all completed in a timely manner, despite the actions of the homes management team. Relatives confirmed that they had discussed the care and service provision before admission to Walton Grange. Relatives confirmed they had been involved in compiling care plans for their loved ones. Staff confirmed that any specialised equipment that may be required is obtained before any service user is admitted to ensure that service users health and wellbeing was maintained. Intermediate care is not provided at the home. DS0000008004.V332773.R01.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, 10, 11. People who use the service experience good quality outcomes in this area. We have made this judgment using a range of evidence, including a visit to this service. Relatives were involved in care planning and setting measurable targets for care. Safe systems for the ordering, storage and administration of prescribed medication were in place to protect service users. EVIDENCE: The case files examined contained individual copies of care assessments, care plans and written contracts that stated both terms and conditions of residence. DS0000008004.V332773.R01.S.doc Version 5.2 Page 11 The care plans were mainly well compiled and complete they promoted dignity, privacy and encouraged independence. They contained adequate information to enable people who were not familiar with the individual to meet care needs. They had been monitored at regular intervals; some plans had been amended within the timescale in response to changing care needs. Risk assessments had been recorded and evaluated to promote safety of service users. Risk areas identified and planned for, poor appetite, risk of falls, episodes of confusion and disruptive behaviours, all had plans for staff to follow. Discussed areas where improved detailed comment within daily records would reflect the quantity and quality of service/care provided. Relatives and staff felt that health needs were met, there was written evidence of consultation and support from Doctors, Psychiatrists and specialist nurses such as Community Psychiatric Nurses. Chiropodist, Ophthalmic and Dental care had been recorded. Specialist equipment had been obtained and used to maintain service users wellbeing such as pressure relieving mattresses. Relatives were observed to visit freely and continue to assist with care of their loved ones. Family members spoken to confirm their involvement in the planning and provision of social, physical and psychological care and provision and they could have access to care plans whenever they wanted. Service users and relatives spoken with confirmed that staff did provide privacy and dignity. The inspector observed staff knocking on bedroom doors and waiting to be invited before entering. Staff were observed to interact with service users skilfully, professionally and with obvious empathy their needs. Staff were observed administering medications and helping service users to take their prescribed medicines. Records were correctly maintained and medicines stored safely. The home had a range of policies and procedures to provide guidance for staff and maintain the safety of service users. Staff had received accredited training for safe administration of medicines. None of the residents was responsible for their own medication although this facility is available. Relatives were fulsome in their praise of the staff and services provided, “nothing is too much trouble, they are most helpful and ring me and keep me fully informed, they escorted my mum to hospital and stayed with her I was so relieved, they have endless patience I don’t know how they do it, I’m very happy with the care my mum gets here” were amongst the many positive comments received during discussions with visitors to the home. DS0000008004.V332773.R01.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, 15. People who use the service experience good quality outcomes in this area. We have made this judgment using a range of evidence, including a visit to this service. Service users were encouraged to maintain and develop social and independent living skills within the home and local community. Service users were encouraged to eat a healthy and varied diet. EVIDENCE: Visitors to the home confirmed that there was an open visiting policy and that they were encouraged to maintain regular contact with their relatives. The religious and cultural needs of service users are documented and records show how these can inform basic lifestyle issues such as diet and dress, and how staff, sometimes in conjunction with families act to meet these. Service users were encouraged to choose their own clothes to wear each day, decide when to bathe, where to sit and select their own meals. DS0000008004.V332773.R01.S.doc Version 5.2 Page 13 Relatives and staff confirmed that nourishing fluids and snacks were readily available throughout the day. Two relatives visiting on the day of the inspection said that their relative liked the food provided and had put on weight whilst at the home. The meals served on the day of the inspection appeared well cooked and well presented. Staff were observed to encourage and assist with meals as needed. Five people were spoken with to ascertain their views about the food. Four were able to say that they liked the food; the other person was not able to clearly say due to problems associated with dementia. Mealtimes were unhurried with extra portions available as required. Portions were adjusted to each service users likes and calorific needs. Specialist diets were available for those requiring this service. Service users were encouraged to eat healthily. Plentiful supplies of food and fresh fruit were available. There was a four weekly menu with records kept of each persons food consumption. Alternative meals were available if they did not like the planned meal. The home does not employ an activities co-ordinator although one member of staff with particular craft type skills/abilities did lead many activities. Care staff organise activities on either a one to one or small group basis. The care plans and daily records included reference to activities that service users had taken part in and their level of participation and attainment such as watching TV, listening to music, reading newspapers, watering plants, visits to church, trips out with staff, locally to shops, garden centres, park and home visits for those service users that have relatives. DS0000008004.V332773.R01.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, 18. People who use the 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 staff and management operated an effective complaints policy to protect service users EVIDENCE: Relatives and staff stated that they had no complaints about care provided. Service users and relatives had received information that would enable them to make a complaint. They confirmed that they were able to easily access the manager and felt they would be listened to. Two relatives discussed concerns that had been raised with the homes manager. They felt these had not always been resolved speedily and concerned meals and laundry services. They confirmed that they had regular and easy access to the home’s manager and felt confident that they would be listened to. DS0000008004.V332773.R01.S.doc Version 5.2 Page 15 Staff confirmed their confidence in their ability to respond to and deal with any issues raised. The home has policies and to provide guidance for staff responding to any complaints received. Two complaints had been received by the CSCI following investigation these had been unsubstantiated with the exception of two areas, actions had been taken to ensure that these would not recur. DS0000008004.V332773.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, 26. People who use the 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 was clean, well-maintained, odour free and homely. The service users bedrooms were clean, comfortable, and overall well decorated and furnished to meet their needs. EVIDENCE: The homes owner had continued to work to her action plan to redecorate and refurbish the home. A range of colours and homely features had been used to individualise and improve the appearance of the bedrooms. A number of families had assisted with personalisation of bedrooms with favourite items and memorabilia. DS0000008004.V332773.R01.S.doc Version 5.2 Page 17 New carpeting and furniture had been provided. Lighting had been changed to provide a well-lit and homely setting. Additional items of furniture were identified for early replacement and updating of two bedrooms within the action plan was discussed. The maintenance record book identified that any faults discovered had been dealt with promptly. The homes secure gardens were accessible to people who live at the home whenever the weather was suitable. Relatives stated that the home’s staff group works hard to maintain a clean and homely environment for service users. DS0000008004.V332773.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. People who use the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including looking at training and supervision records and speaking to available staff. Staff had received training to meet the service user’s general and specific needs. A good range of training was available for staff. Appropriate support and guidance was offered to new staff, enabling them to safely care for service users. Staff files included the required information. The home operated a recruitment policy that promoted the protection of service users. EVIDENCE: Service users and relatives were supportive of staff stating that they were always busy and worked hard. They undertook cleaning, laundry and some kitchen duties in addition to their care role. The numbers of care workers and ancillary staff on duty was able to meet the needs of the service users. DS0000008004.V332773.R01.S.doc Version 5.2 Page 19 The staff group without exception were well motivated and enthusiastic about their work. They confirmed that not only were they well supported in their work but actively encouraged and supported to develop personally. The manager is supporting staff to progress and increase their skills and competence by facilitating staff to undertake level 3 NVQ assessments and training having completed their level 2 awards in care. Staff has undertaken statutory training and updates i.e. basic food handling & hygiene and are involved in national vocational qualification training and medication administration training. Training had been provided to increase staff awareness of dementia care and adult protection this promoted good practise and service users rights. The staff induction programme meets the TOPPS requirements as required by the Care Standards Act 2000. The numbers of staff who had achieved National Vocational Qualifications was below the minimum 50 required by the Care Standards Act 2000, a number of staff had completed their NVQ training and assessments and were awaiting NVQ certificates, this would enable the home to exceed the minimum 50 required by the Care Standards Act 2000. DS0000008004.V332773.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, 38. People who use this service experience good quality outcomes in this area. This judgement has been made using available evidence including interviewing the registered manager and observing staff as they work. Rotas and fire safety and other health and safety records were inspected along with the finance arrangements for service users The staff said that they were well supported by the manager. The health, safety and welfare of residents was promoted and protected DS0000008004.V332773.R01.S.doc Version 5.2 Page 21 EVIDENCE: The manager has not attained her NVQ 4 Managers Award, as required by the Care Standards Act 2000. She is also the homes owner and has in excess of 25 years caring experience. Visitors to the home stated that they had ready and easy access to the homes management and that they felt confident in them. Staff stated here was always a senior member of staff on duty at the home with advice and support readily available. Responsibilities were shared between senior members of the team. The manager monitored case files and the personnel files to ensure policies and procedures were adhered and enabled her to identify where improvements were needed in these areas. Staff files contained evidence of completed statutory checks required to protect vulnerable adults. The managers system for meeting the training needs of staff was under review. This enabled her to ensure staff had the necessary skills to provide the care and service that the service users require. The home assisted 2 service users to manage their pocket monies. The monies held and records maintained were correct. The homes quality assurance and audit system required updating to ensure that people who lived at the home were assured that the care and services provided were continuously reviewed and of the highest standard. Meetings were held for people who live at the home, their advocates and the staff team. This enabled people to have a voice in the running and management of the home. Health & Safety at Work risk assessments have been reviewed to maintain continued safety for service users, visitors and staff at the home. Statutory checks and servicing of equipment are undertaken and records maintained. The Environmental Health and Fire Prevention Services inspection the reports were positive the home met all requirements to provide a safe environment for service users. DS0000008004.V332773.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 X X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 3 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 2 3 2 3 3 3 3 3 DS0000008004.V332773.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 OP31 Regulation 10(3) Requirement Timescale for action 30/09/07 2. OP33 24 3. OP33 24 The registered manager must register to attain a level 4 NVQ and the registered managers award. The home must utilise an 30/09/07 effective quality assurance and quality monitoring system, based on seeking the views of service users, to measure success in meeting the aims, objectives and statement of purpose of the home. Policies and procedures must be 30/09/07 reviewed to reflect good practice RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations DS0000008004.V332773.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Sheffield Area Office Ground Floor, Unit 3 Waterside Court Bold Street Sheffield S9 2LR 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 DS0000008004.V332773.R01.S.doc Version 5.2 Page 25 - 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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