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Inspection on 21/09/05 for WCS - Attleborough Grange

Also see our care home review for WCS - Attleborough Grange for more information

This inspection was carried out on 21st September 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. 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

Residents living in the home said that the staff are kind and caring and were very complimentary about the care provided and the homely atmosphere. Staff were observed to be caring towards residents and were aware of residents likes, dislikes and needs. Meals are varied and home cooked and are nicely presented. There are good quality furnishings and fittings, it is decorated to a good standard and is well maintained. The gardens are accessible and used by the residents in the summer months.

What has improved since the last inspection?

Since the last inspection replacement windows have been fitted and new carpets provided in parts of the home. Redecoration of residents` rooms is ongoing. Staff have introduced a new quality system for care planning.

What the care home could do better:

Care plans need reviewing to ensure that they are up to date so that the staff are able to know what to do for each resident and ensure that individuals care needs are met. The recording of medicines needs further improvement to minimise the potential risk of errors in the administration of medicines.

CARE HOMES FOR OLDER PEOPLE WCS - Attleborough Grange Attleborough Road Nuneaton Warwickshire CV11 4JN Lead Inspector Louise Thompson Unannounced Inspection 21st September 2005 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 WCS - Attleborough Grange DS0000004261.V249852.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. WCS - Attleborough Grange DS0000004261.V249852.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service WCS - Attleborough Grange Address Attleborough Road Nuneaton Warwickshire CV11 4JN 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) 02476 383543 02476 326704 Warwickshire Care Services Limited Mrs Dorothy Collis Care Home 31 Category(ies) of Dementia - over 65 years of age (11), Old age, registration, with number not falling within any other category (20) of places WCS - Attleborough Grange DS0000004261.V249852.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 6th December 2004 Brief Description of the Service: Attleborough Grange was built in the early 1900’s and totally refurbished in 1995. A large extension was added to the rear and side of the original building providing purpose built accommodation. The home is one in a group of care homes owned by Warwickshire Care Services. The home is currently registered to provide personal care for people over 65 and has specialist registration for dementia care. The accommodation includes single bedrooms and one shared bedroom. Twenty of these rooms have en suite facilities. The home is designed for group living in four self contained units. Each unit has its own lounge/dining area and kitchenette facilities. Griff House is a specialist dementia care unit for eleven service users. In addition to long/short stay accommodation; the home also provides day care services for up to 8 clients. Day care service has its own facilities and staff. The home has mature gardens and patio areas, which are accessible to the homes service users. These have been designed to meet the needs of the service user groups catered for at Attleborough Grange. Further developments are planned for the garden areas. WCS - Attleborough Grange DS0000004261.V249852.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was unannounced and took place over one day. This was the first visit for this inspection year. Staff co operated fully with the inspection. The registered manager was present throughout the inspection. The inspection process involved a tour of the home, talking with the manager, examining records and care plans, observation of care practices along with discussions with residents and staff. What the service does well: 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. WCS - Attleborough Grange DS0000004261.V249852.R01.S.doc Version 5.0 Page 6 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 WCS - Attleborough Grange DS0000004261.V249852.R01.S.doc Version 5.0 Page 7 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): These standards were not assessed as part of this inspection EVIDENCE: WCS - Attleborough Grange DS0000004261.V249852.R01.S.doc Version 5.0 Page 8 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): Standards 7, 8, 9 and 10 Care plans require further development to provide the staff with the necessary information to meet individual residents needs. Health needs of residents are met with evidence of liaison with health and social care professionals on a regular basis. The shortfalls in the medication administration records potentially leave the residents at risk. Personal support is offered in such a way as to maintain residents’ privacy and dignity. EVIDENCE: The home has recently introduced a comprehensive new care planning and quality management system. The records of three residents were observed during this inspection. Some of the care plans were lacking in specific detail. Discussions with the manager and staff suggested that care needs were being addressed, even though there was a lack of clear plans and guidance. This approach is dependent upon staff memory and good verbal communication systems. Good risk assessments were observed with ongoing monthly reviews of these enabling staff to monitor changing dependency levels. WCS - Attleborough Grange DS0000004261.V249852.R01.S.doc Version 5.0 Page 9 Care documentation requires a quality questionnaire to be completed monthly along with a review of care plans. Staff had not recorded any changes to care in this section. The current format does not require care plans to be dated it was not possible to identify and track fully these monthly reviews. Care files viewed showed involvement of members of the multidisciplinary team in assessing and meeting residents’ care needs. A visiting Consultant Psychiatrist recorded the following in the home’s comments register “How lovely the home is and how nice the atmosphere is, it is a credit to the company” a visiting optician recorded “This is one of the nicest homes we have been to.” Residents said that they were very happy with the care provided. The arrangement for the management and administration of medications were observed. The following issues were identified and discussed: • • • Not all prn medications specified the reason for administration. A small number of omissions in the administration records. Eye drops and medicines were not always dated when opened. Throughout the inspection it was observed that staff knock on residents’ doors, offer choices and ensure that all personal care and consultations are conducted in private. Residents said they can choose to spend time alone in their bedrooms and their privacy is respected. WCS - Attleborough Grange DS0000004261.V249852.R01.S.doc Version 5.0 Page 10 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): Standard 15 Dietary needs of residents are well catered for with a balanced and varied selection of food available that meets residents’ tastes and choices. EVIDENCE: The inspector ate lunch with the residents on the dementia unit. The meal was tasty and nicely presented. The dining room tables were attractively laid and staff were readily available to assist residents where necessary. Residents were offered a visual choice of meals, photographic menus were also available in the dining area should these be required. Staff were aware of individual residents likes and dislikes. Each floor has a small kitchenette and drinks and snacks are readily available. WCS - Attleborough Grange DS0000004261.V249852.R01.S.doc Version 5.0 Page 11 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): Standards 16 and 18. Systems for the management of complaints are satisfactory residents can be confident that their concerns are listened to, taken seriously and acted up on. Policies and procedures for the protection of vulnerable adults need further development to ensure a safe environment for the people living in this home. EVIDENCE: Residents told the inspector that if they had any concerns about any aspect of the service they would discuss these with the manager. The complaints/comments procedure is located in reception. The inspector observed the complaints/comments records, which included details of investigations and any action taken as a result. The CSCI has not received any complaints since the last inspection visit. Comments entered into the register include “Pass on our thanks to your staff they really do make a difference” and a letter of thanks sent to the local press “the care and love administered inside these walls is second to none- the caring embraces the whole family. My mother could not have spent her final years anywhere better.” Procedures for the protection of vulnerable adults require review. Discussions with the manager and staff demonstrated a good understanding of recognising the types and signs of abuse. Staff knew how to report any allegations of abuse. Some staff had attended an ‘abuse workshop’ the manager said she is arranging further training for new staff members.Residents said that they ‘feel safe and well looked after’ at the home. WCS - Attleborough Grange DS0000004261.V249852.R01.S.doc Version 5.0 Page 12 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): Standard 19 The standard of décor and furnishings is good with evidence of ongoing planned improvement and maintenance. The home presents as very comfortable and homely for residents. EVIDENCE: The home is designed for group living in four self contained units. Each unit has its own lounge/dining area and kitchenette facilities. Griff House is a specialist dementia care unit for eleven service users There is an attractive garden and some residents said that they like to spend time in the garden in the summer months. The standard of the décor, fittings and furnishings are good. The manager said that there is a planned programme of redecoration and ongoing refurbishment. Since the last inspection replacement windows have been fitted to parts of the home. Carpets have been replaced in some areas and new furniture has been ordered. The carpet in the lounge area of the dementia unit and one residents room were stained and require cleaning/replacement. WCS - Attleborough Grange DS0000004261.V249852.R01.S.doc Version 5.0 Page 13 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): Standard 27 and 29 The number and skill mix of the staff is sufficient to meet the needs of the residents. The procedures for the recruitment of staff are satisfactory and protect the residents. EVIDENCE: During the inspection there were six care staff on duty, the manager, a senior care assistant, domestic and catering staff. Duty rotas seen for the period of a month demonstrate that staffing is maintained within previously agreed levels. Discussions with staff and observation showed that they are a well-established team, trained, sensitive to individuals needs and are in sufficient numbers to meet the needs of residents. The inspector examined the records of three recently appointed staff members. Each file contained evidence of CRB/POVA first checks and references. Contracts of employment and evidence of personal identification were available but awaiting filing. None of the files contained evidence of the physical/mental fitness of the staff members. The manager said that staff had been given copies of the General Social Care Council Code of Conduct as part of their induction. WCS - Attleborough Grange DS0000004261.V249852.R01.S.doc Version 5.0 Page 14 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): Standard 36 The manager needs to progress the implementation of a suitable system for formal staff supervision to ensure consistencies in care practice. EVIDENCE: A system for formal staff supervision has been partially implemented with evidence seen of some completed supervisions on staff records observed during the inspection. The manager said that the delay in completing supervisions was partially due to the care manager being on leave, which meant that supervisions had to be rearranged. The manager said she was aiming to re establish individual supervisions as soon as possible. Some group supervisions had been completed in unit meetings. Records of these were seen during this visit. WCS - Attleborough Grange DS0000004261.V249852.R01.S.doc Version 5.0 Page 15 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 X X X X HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 2 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 X 13 X 14 X 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 2 3 X X X X X X X STAFFING Standard No Score 27 3 28 X 29 2 30 X MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score X X X X X 2 X X WCS - Attleborough Grange DS0000004261.V249852.R01.S.doc Version 5.0 Page 16 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 OP7 Regulation 15 Requirement The registered manager must ensure that assessments and care plans are specific to each resident’s; health, personal and social care needs and are up to date. (Old timescale 31.03.05 not fully met) The registered manager shall make arrangements for the safe handling, storage and recording of medication. The registered manager must ensure that all staff attends training in adult protection/abuse. (Old timescale of 31/03/05 part met) The carpets in the lounge on the dementia unit and identified residents room must be cleaned/replaced. Timescale for action 31/12/05 2 OP9 13 30/11/05 3 OP18 13 31/01/06 4 OP19 23, 16 30/11/05 WCS - Attleborough Grange DS0000004261.V249852.R01.S.doc Version 5.0 Page 17 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 2 3 Refer to Standard OP7 OP29 OP36 Good Practice Recommendations The inspector recommends that care plans are dated and signed by the staff members responsible and whenever there are any changes to these. The inspector recommends that the manager use a pre employment health questionnaire as part of the recruitment procedures for staff. It is recommended that the staff in the home receive formal supervision at least six times a year and that all the areas listed in the standard are included in the process. WCS - Attleborough Grange DS0000004261.V249852.R01.S.doc Version 5.0 Page 18 Commission for Social Care Inspection Leamington Spa Office Imperial Court Holly Walk Leamington Spa CV32 4YB 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 WCS - Attleborough Grange DS0000004261.V249852.R01.S.doc Version 5.0 Page 19 - 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. 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