Inspection on 22/11/05 for Woolton Grange Care Home

This inspection was carried out on 22nd November 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.

Other inspections for this house

Woolton Grange Care Home 20/06/08

Woolton Grange Care Home 26/06/07

Woolton Grange Care Home 27/06/06

Woolton Grange Care Home 31/01/06

Similar services:

Chirnside House

Keer Sands Residential Home

Ruskin Lodge

Bushell House

Langrigg House

Parkside

Dystlegh Grange

Thornton Lodge

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

CARE HOMES FOR OLDER PEOPLE Woolton Grange Care Home High Street Woolton Liverpool L25 7TE Lead Inspector Natalie Charnley Unannounced Inspection 22nd November 2005 11:00 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 Woolton Grange Care Home DS0000064524.V272618.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. Woolton Grange Care Home DS0000064524.V272618.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Woolton Grange Care Home Address High Street Woolton Liverpool L25 7TE 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) 0151 428 9861 0151 428 1118 Hill Care Limited Mr Paul Ashmore Care Home 43 Category(ies) of Old age, not falling within any other category registration, with number (43) of places Woolton Grange Care Home DS0000064524.V272618.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 43 beds (OP) providing personal care of which 1 is for a named male service user under the age of 65 years. In addition to 43 service users, 4 older people not needing nursing care may be admitted to Woolton Grange Care Home for day care, between the hours of 9:00 am until 5:00 pm Monday to Sunday. 19.01.05 Date of last inspection Brief Description of the Service: Woolton Grange is a care home located in the Woolton area of Liverpool close to local shops and transport links. The home is registered to take up to 43 residents and provide them with personal care. The home does not provide nursing care. The home was taken over earlier in the year by a new company, Hillcare LTD. The home is within a renovated church and has both single and double bedrooms. Communal space is varied and includes a large conservatory. The home has parking space to the rear and residents can access levels of the home via lifts. The home also has residents who attend for day care and are looking to increase this number in the near future. Woolton Grange Care Home DS0000064524.V272618.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection was carried out over a period of one day The inspector arrived at the home at 11:00 and left at 17.30. The inspector spoke with 5 staff, the home manager and deputy, 2 visitors and 10 residents. The inspector completed the inspection by looking at the homes records, a tour of the building, formal and informal interviews and information from previous inspection reports. The inspector followed an inspection plan written before the start of the inspection to ensure that all areas that needed covering were done so. Feedback was given to the manager during and at the end of the inspection. What the service does well: What has improved since the last inspection? The home has a new phone system in place that allows visitors to be put through to the most appropriate member of staff. Activities have been developed further and have an allocated member of staff to co-ordinate visits/trips/games. Meal times have been altered through staff and resident discussion so residents have their main meal at night. Staff report that residents are now sleeping much better as they have full stomachs Residents and staff report a significant improvement to the smell of the home since the last inspection Woolton Grange Care Home DS0000064524.V272618.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. Woolton Grange Care Home DS0000064524.V272618.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 Woolton Grange Care Home DS0000064524.V272618.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 Pre admission assessments do not contain enough detail for the home to be sure they can meet residents needs. EVIDENCE: All residents moving into the home are visited by the home manager and a pre-admission assessment is completed. A sample of these records were checked, however some residents did not have assessments in place as they had lived at the home for a long time. Other residents had only brief details recorded such as family contacts and brief medical conditions. The manager must ensure that the pre admission assessments are comprehensive and cover aspects such as personal care needs, medication, mental health, social interests, history of falls and mobility. This should then be the basis of how the care plan is then developed. Woolton Grange Care Home DS0000064524.V272618.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 and 9 Care planning at the home is based on the individual and details how care is to be given. Risks that are taken by residents are not recorded in sufficient detail to ensure they are kept safe from harm Staff need to ensure that they are familiar with the home medication policy to ensure that medications are given out safely to protect residents. EVIDENCE: A selection of care plans were sampled. Most care plans had been updated on a monthly basis but many weight records were blank, including one resident whose care plan stated ‘weight monthly’. The information within care plans was very detailed and contained information about a residents social history. There was some detail within care plans and from discussion with residents that suggested that the home are beginning use residents to help draw up their care plans. The manager must continue with this to include all residents. One residents stated “ I don’t know what a care plan is”, however another said that they remembered signing a paper about ‘what I need doing’. Woolton Grange Care Home DS0000064524.V272618.R01.S.doc Version 5.0 Page 10 Some risk assessments were in place on files, however were very brief. The home needs to put in place risk assessments to cover falls, nutrition, moving and handling and pressure area care. This was discussed with the manager during the inspection. These documents then need to be kept under review. Care plans showed that the home involve other health professionals in the care of residents such as doctors, district nurses, opticians and social workers. One resident is receiving support from the community mental health team. Medication storage and records were checked and showed a number of alarming shortfalls. Despite recent staff training on drug administration, many gaps in administration recording were noted along with stickers placed over old entries and handwritten instructions that were not signed and dated. One resident had been given 4 doses of a drug despite it not being prescribed, many records, including that of controlled drugs were scribbled out making reading them impossibility. When drugs had not been given it was not clear as to why this was so and one resident who was prescribed a drug once per week had been given it for seven continuous days. Controlled drugs records, recorded in a separated register were found to be satisfactory; however the register was broken and had pages falling out. An order was placed during the inspection for a new one. No risk assessments were in place for residents who self medicate. The medication storage area was clean and tidy, however would benefit from redecoration. Eye drops were not dated when they were opened and the recording of the fridge temperature was incorrect. Two dirty volumatic spacers were found (used for residents inhailers) and oxygen was being stored in the lounge without the correct safety precautions in place. Dressings no longer in use need to be disposed of. The home need to ensure that an up to date policy from the new company is issued to staff regarding medication practices and that it is suitable to the home. The home must ensure that photographs are put on plans to identify residents and that a specimen signature list is collected from staff. Woolton Grange Care Home DS0000064524.V272618.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): 12,14 and 15 Activities at the home are varied to suit the needs of individual residents. Residents are encouraged to make decisions about their lives and are supported by staff to do this. Dietary needs of residents are well catered for with a balanced selection of food that meets the tastes of residents, however choices are often not known. EVIDENCE: The home has a mini bus which takes residents on trips out every Tuesday and Friday except for when it is very cold or wet. A member of staff is the designated ‘activity co-ordinator’ who is responsible for planning and recording events. Residents are going to a Christmas pantomime and are being visited by local schools and the Salvation Army. Barbershop singers are also visiting the home as part of the Christmas celebrations. Different religious faiths visit the home on a regular basis and hold mass and Holy Communion. Activities are well planned out and advertised around the home, although some are as and when a resident wants them. Residents can join in with exercise classes, singalongs and bingo and the activity co-ordinator also organises 1:1 sessions to read newspapers, have a chat, read and write Woolton Grange Care Home DS0000064524.V272618.R01.S.doc Version 5.0 Page 12 letters and help with finances. Residents described activities as ‘enjoyable’, ‘flexible’ and ‘fun’. Residents are encouraged to personalise their bedrooms when they move in and are encouraged to make choices about their daily routines. One resident commented ‘I can get up when I want’ and another stated ‘ I come and go as I please around the home’. The home is able to put residents in touch with local advocacy groups if they request them to. The inspector watched residents at evening tea time and sat and chatted with some residents at the table. Residents commented ‘meals are lovely here but we don’t know what we are getting’, when asked if they had a choice all replied they did not but stated that they were sure that the cook would if they asked. Teatime was a sociable occasion and residents chatted amongst themselves. Four residents require a special diet which is provided by the home and was well presented. Staff interviewed stated that since the new company have taken over they have improved meals for residents by moving the tea and dinner times around which has resulted in “ a better nights sleep for the residents”. They also stated “blended meals now look edible now they are presented separately”. Woolton Grange Care Home DS0000064524.V272618.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): 16 and 18 The home has a satisfactory complaints procedure, which is easy for residents or families to use. Staff have a good knowledge of adult protection procedures which protects residents from abuse. EVIDENCE: The home has received one complaint since the last inspection. This was well recorded by the manager and was dealt with in a timely way. Residents at the home are aware that the home have a complaints policy and stated that if they needed to make a complaint, they would know whom to approach. Five staff files were sampled at the home. They showed that staff had undergone Police checks and had provided references. Staff are aware of the local and home polices in relation to abuse, most of them had received training over the past 12 months. Woolton Grange Care Home DS0000064524.V272618.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, 20 and 26 The layout, facilities and location of the home are suitable for the residents who live there. The home is safe and clean, however some minor areas of maintenance need addressing EVIDENCE: A full tour of the home was undertaken during the inspection. Residents have easy access to the home and the outside of the building is in good condition. Inside the home, decor is homely and well maintained. The manager explained that the new company have planned areas of redecoration and have already started and completed some areas. Bathroom 9 had lino that had started to peel away from the floor and was a hazard to residents, however all other areas were safe. The lounge and dining areas of the home are nicely furnished. Residents stated “it is nice to sit and chat here”. Residents also stated that the home was always “airy and light” and “warm as toast” and that they particularly enjoyed the bright conservatory area. Woolton Grange Care Home DS0000064524.V272618.R01.S.doc Version 5.0 Page 15 The home was clean and tidy on the day of the inspection and residents commented that it was always like that. A team of domestic staff are employed by the home and have been trained to NVQ standard. The home has policies on infection control and COSHH (control of substances hazardous to health), but only some staff had received training on this subject. Laundry services are provided by the home and was also clean and tidy. Woolton Grange Care Home DS0000064524.V272618.R01.S.doc Version 5.0 Page 16 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): 27,29 and 30 Staff morale is high resulting in an enthusiastic workforce that works positively with residents to improve their quality of life. The home recruit people who are suitable for their jobs. Not all staff are up to date with training and may not have the necessary skills to care for residents. EVIDENCE: The home has a variety of staff that help in the running of the home. In addition to care staff there are two chefs, a team of domestics, an administrator, an activity co-ordinator and a handyman. Rotas showed that care staff cover the home 24-hour per day, and are supported by the manager and deputy manager. Residents said, “there are plenty of staff to help” another visitor stated “staff are always here when I visit”, staff also felt that there were ‘enough staff on each shift to do a good job’. The home has a comprehensive recruitment policy that ensures equal opportunities are given. Staff confirmed that they were made aware of their roles through supervision and induction and had an up to date contract and terms and conditions of employment. The manager acknowledged that training at the home has fallen behind over recent months, however there was evidence that this was being addressed and that training was beginning to be planned. Staff interviews showed that some training had taken place on NVQ’s, Woolton Grange Care Home DS0000064524.V272618.R01.S.doc Version 5.0 Page 17 continence care and manual handling. Staff attending training sessions provided by the home are paid to do so. Woolton Grange Care Home DS0000064524.V272618.R01.S.doc Version 5.0 Page 18 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): 31,33 and 38 The manager leads by example and provides a positive, supportive role model for staff. The home seeks the needs of staff, relatives and residents. These views are then acted upon swiftly. The home maintains the health and safety of staff and residents at all times, protecting them from harm. EVIDENCE: The home manager has worked at the home for a long period of time and has achieved both NVQ level 4 in care and the registered managers award. The home manager is supported by the deputy who is also undertaking level 4 NVQ. The deputy manager deals with daily care issues and the home are planning to give her more supernumerary hours in the future so more audit Woolton Grange Care Home DS0000064524.V272618.R01.S.doc Version 5.0 Page 19 work can take place. The home has a ‘care director’ that visits the home on a monthly basis and undertakes various checks, including speaking to residents and visitors. The home run regular residents meetings which allow ideas and suggestions to be raised. These meetings are recorded and staff act on issues that are discussed. Staff also meet on a regular basis in order to maintain a good standard of care and support for residents. Residents and staff spoke highly of the management team stating, “the manager is supportive” and “we work well together and enjoy our work”. A visitor that was interviewed stated she was always welcomed into the home and made to feel at ease. Accident records at the home are well recorded and detailed. The home has appropriate certificates and health and safety checks in place. Fire checks are carried out on a regular basis and staff receive training in this area. Staff receive health and safety information as part of their induction and confirmed that they knew where to access policies and procedures, it was however highlighted that mandatory training is out of date. Woolton Grange Care Home DS0000064524.V272618.R01.S.doc Version 5.0 Page 20 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 2 X X X HEALTH AND PERSONAL CARE Standard No Score 7 3 8 2 9 1 10 X 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 X 15 2 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 2 X X X X X X 3 STAFFING Standard No Score 27 3 28 X 29 3 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X X X X 3 Woolton Grange Care Home DS0000064524.V272618.R01.S.doc Version 5.0 Page 21 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. Standard Regulation Requirement The registered person must ensure that pre admission assessments are completed on all residents in suitable detail. The registered person must ensure that risk assessments are in place to minimise identified risks to residents 2 OP8 13(4)(a) This remains outstanding from the previous inspection The resident person must ensure that residents are weighed on a regular basis and that this is recorded The registered person must ensure that medication administration records are recorded contemporaneously and accurately. 01/12/05 The registered person must ensure that all medication records are clear Woolton Grange Care Home DS0000064524.V272618.R01.S.doc Version 5.0 Page 22 Timescale for action 1. OP3 14(1) 01/01/06 01/01/06 3 OP9 13(2) The registered person must ensure that residents who wish to manager their own medication are assessed as to their ability to do so and that these assessments are updated on a regular basis. The registered person must ensure that staff are clear as to details of the medication policy The registered person must ensure that the temperature of the fridge is monitored by a maximum/minimum thermometer and recorded daily. The registered person must purchase a new controlled drug record The registered person must ensure that a formal system is put in place to identify residents prior to drug administration The registered person must ensure that appropriate signs are in place when storing oxygen. 4 OP19 13(4)(a) The registered person must ensure the flooring to bathroom 9 is repaired or replaces The registered person must ensure all staff are trained in mandatory subjects 01/01/06 5 OP30 18(1) 01/03/06 Woolton Grange Care Home DS0000064524.V272618.R01.S.doc Version 5.0 Page 23 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 OP15 Good Practice Recommendations The registered person may wish to ensure that all residents are aware of what meals they are having and what alternatives are on offer. 1. Woolton Grange Care Home DS0000064524.V272618.R01.S.doc Version 5.0 Page 24 Commission for Social Care Inspection Liverpool Satellite Office 3rd Floor Campbell Square 10 Duke Street Liverpool L1 5AS 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 Woolton Grange Care Home DS0000064524.V272618.R01.S.doc Version 5.0 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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