Inspection on 27/06/06 for Woolton Grange Care Home

This inspection was carried out on 27th June 2006.

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 31/01/06

Woolton Grange Care Home 22/11/05

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 Woolton Grange Care Home High Street Woolton Liverpool Merseyside L25 7TE Lead Inspector Natalie Charnley Unannounced Inspection 27th June 2006 08:45 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.V295488.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. Woolton Grange Care Home DS0000064524.V295488.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Woolton Grange Care Home Address Woolton Grange Care Home High Street Woolton Liverpool Merseyside L25 7TE 0151 428 9861 0151 428 1118 paul_ashmore33@hotmail.com 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) 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.V295488.R01.S.doc Version 5.2 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, 8 older people, who do not require nursing care, may be admitted for day care between the hours of 9 am - 5 pm, Monday - Sunday. November 22nd 2005 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 recently 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. The home plan to put an 8 bedded extension to the side of the home as soon as planning permission can be obtained from the local council. It costs £324.50 –£385.00 to live at the home Woolton Grange Care Home DS0000064524.V295488.R01.S.doc Version 5.2 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 08:45 and left at 15:00. The inspector spoke with 5 staff and 8 residents and a district nurse. No visitors were available to speak with at the home during the inspection. Comment cards were left at the home for residents, staff and visitors to complete. The person in charge was also given an ‘inspection feedback’ card to complete regarding the inspection process. 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 using all information held on file at Commission for Social Care Inspection regarding the home, to ensure that all areas that needed covering were done so. Feedback was given to the person in charge during and at the end of the inspection. This report is also based on pre inspection information provided by the home as well a site visit. What the service does well: What has improved since the last inspection? Staff training has improved and is developing well. Menus are now clearly displayed in the ding area- residents are now aware of what meals are available on specific days of the week A wet room has been built for use by all the residents Woolton Grange Care Home DS0000064524.V295488.R01.S.doc Version 5.2 Page 6 The new care planning system is now up and running. Staff feel that it is working well. 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.V295488.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 Woolton Grange Care Home DS0000064524.V295488.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 3 Quality outcome in this area is good. This judgement has been made using available evidence including a visit to the service. Information gathered by the home before resident moves in, ensures that they can care for residents appropriately. EVIDENCE: Details were sampled for the most recent resident that had been admitted to the home on 21.3.06. The resident had received a pre admission assessment done at a local hospital. his contained a medical history and details of what the resident could and couldn’t do for themselves. This information then allowed the home manager to decide if the home could meet the needs of that resident. This information was recorded in the care file and then used as a basis for developing a care plan. Woolton Grange Care Home DS0000064524.V295488.R01.S.doc Version 5.2 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): 7,8,9 and 10 Quality outcome in this area is poor. This judgement has been made using available evidence including a visit to the service. Medication practices were found to be unsafe and cause a potential risk of harm for residents. Care plans detail how staff are to care for residents but need to show that residents are involved in this process. Residents feel they are treated with dignity and respect at all times. EVIDENCE: Five care plans were sampled as part of the case tacking methodology, which means that the residents care and experiences of living at the home was closely looked at. These plans are now pre formulated and staff add in further information if required to make plans individual. This is a new system to the home, which staff report is working well, however there was no evidence to show that resident or families are being involved in this process. Residents spoken to stated they had not seen and did not know what their care plan was. Risk assessments were in place to cover nutrition, pressure sores and falls. The deputy manager stated that the home was currently looking at a more suitable risk assessment for manual handling, however were currently using their old forms. Woolton Grange Care Home DS0000064524.V295488.R01.S.doc Version 5.2 Page 10 Care plans and risk assessments are updated monthly by staff to show any changes. One resident had recently had a stroke, which meant that their care needs had changed considerably. The home had recorded these changes well. Plans showed that residents have access to a range of health professionals such as opticians, district nurses and GP’s (general practitioners). One resident had received input from a speech and language therapist. A district nurse was interviewed during the inspection and stated that “ this is a nice home, staff are always helpful to me”. Serious concerns were highlighted during the inspection with regard to the way medication is given out. A member of staff was observed to be ‘potting up’ medication, which is not an acceptable practice. This meant that medication was being removed from its original packing and placed in medication pots to be taken around the home by staff. This practice is unsafe and could lead to the wrong resident being given a medication. The same member of staff was then observed to be administering medication in the lounge area. She left the medication trolley open, with the keys in the lock and went to the kitchen. The trolley was unattended for approximately 3 minutes. This is potentially very dangerous as it left all residents with access to the trolley and its contents. MAR (medication administration records) charts were also sampled. 3 medications were not being given as they had been prescribed and handwritten entries were not always double signed by 2 staff to ensure accuracy. These are similar concerns that have been highlighted over the last two inspections. The home did demonstrate good practice in the way the record the drug ‘warfarin’ which dose can change frequently. Due to the serious concerns identified, a further inspection will take place by the Commission for Social Care Inspection pharmacy inspector. Residents spoken to during the inspection stated that they are treated with dignity and respect. Staff were observed talking to residents in a clear and kind manner and knocking on bedroom doors before entering. One resident commented “ staff here are lovely, the treat us all very well”, another commented “ Staff never come into my room unless I give them permission, they are very respectful”. Woolton Grange Care Home DS0000064524.V295488.R01.S.doc Version 5.2 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): 12,13,14 and 15 Quality outcome in this area is good. This judgement has been made using available evidence including a visit to the service. Activities are available, however could be improved. Residents are encouraged to make independent decisions on a daily basis and have a good quality, varied diet. EVIDENCE: Every resident at the home have an individual activities record. These showed that a variety of activities are undertaken such as discussions, reminiscence, card games and bingo. Residents spoken with commented “ activities could be improved, especially when the activity co-ordinator isn’t here” and “I would like to do more physical activities to keep my joints moving”. Most residents felt that there was a need for some improvements, mainly wanting more activities to be arranged and for more selection in what is offered. The surveys sent to some residents included the question ‘Are there activities arranged by the home that you can take part in?’ all of the surveys returned stated only ‘sometimes’. It is recommended that the home review the types of activities on offer to ensure they suit the needs of all residents. Woolton Grange Care Home DS0000064524.V295488.R01.S.doc Version 5.2 Page 12 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 go to be when I want’ and another stated ‘I love to just move about the home and chat with other people’. The home is able to put residents in touch with local advocacy groups if they request them to. It was also confirmed that visitors are able to come at any time and meet residents in either communal or private areas of the home. The home has a rotating menu that changes every week. Residents are able to see what is on offer for a particular day as staff write the menu on a large blackboard in the dining area. Residents were observed discussing the meals for the day during the inspection. Lunch was observed to be a social and unhurried occasion. Residents stated that they “really enjoyed” their food and felt it was “tasty and very nice”. One resident especially commented on the good standard of cooked breakfast that is available every day. Woolton Grange Care Home DS0000064524.V295488.R01.S.doc Version 5.2 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 Quality outcome in this area is good. This judgement has been made using available evidence including a visit to the service. 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 not received a complaint since the last inspection. 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. The policy is clearly displayed on the notice board in the main reception area. Staff at the home have had recent training in the area of adult protection. Discussion with staff showed that they had a good knowledge base in this area and were confident in dealing with these issues. The home carry out all the necessary checks on staff before they commence employment to ensure they are suitable to work with vulnerable adults. Woolton Grange Care Home DS0000064524.V295488.R01.S.doc Version 5.2 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 and 26 Quality outcome in this area is adequate. This judgement has been made using available evidence including a visit to the service. Residents have expressed a number of concerns, which need addressing in order to satisfy the needs of the people living at the home. The home is kept clean and tidy. EVIDENCE: A full tour of the home was undertaken during the inspection. All areas of the home are easily accessible for residents and visitors, despite accommodation being on many floors. The home has a central communal area that consists of a large lounge and conservatory area and attached dining area. Several residents made comments that they were concerned about the smell of smoke at nighttime, where staff are reportedly smoking in the kitchen areas. The home manager must look into this as a matter of urgency. Another resident commented that she felt the home should offer designated toilet areas for male and female staff. Woolton Grange Care Home DS0000064524.V295488.R01.S.doc Version 5.2 Page 15 She stated that this had been raised with the manger previously. It was also stated by the resident that she did not have access to hot water in her bedroom. This water supply to this room was tested over 15 minutes; only cold water was available from the taps. The maintenance man investigated this and found that a tank thermostat had tripped out. This was fed back to the resident who stated that this was a “common occurrence”. This must be closely monitored in the future. The home was found to be clean and tidy, a comment card received stated that there could be “ a few minor adjustments” to the cleanliness of the home; others received stated that the home is ‘usually’ kept fresh and clean. Woolton Grange Care Home DS0000064524.V295488.R01.S.doc Version 5.2 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): 27,28,29 and 30 Quality outcome in this area is good. This judgement has been made using available evidence including a visit to the service. Staff morale is high resulting in an enthusiastic workforce that works positively with residents to improve their quality of life. Training has improved for staff since the last inspection. 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. Both the manager and deputy work supernumerary hours, enabling them to support staff that work directly with residents. The home has a comprehensive recruitment policy that ensures equal opportunities are given. taff have appropriate checks carried out on them and references are taken up, including from their last employer. Examples of staff files were checked and were found to be completed to a high standard. 50 of staff hold an NVQ (national vocational qualification) in care, which meets the required standard. A further 11 staff are currently studying towards this qualification. The manager has made considerable improvements regarding staff training since the last inspection. The staff training matrix showed that recent training has been given on health and safety, manual handling and infection control. Woolton Grange Care Home DS0000064524.V295488.R01.S.doc Version 5.2 Page 17 A small number of mandatory training remains outstanding for some staff, however these are minimal. One resident commented, “I love living here, the staff are fabulous and the residents are very friendly”, another stated, “ staff are great, they are very helpful and kind”. Woolton Grange Care Home DS0000064524.V295488.R01.S.doc Version 5.2 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): 31,33,35 and 38 Quality outcome in this area is good. This judgement has been made using available evidence including a visit to the service. 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. Health and safety issues are well managed, protecting residents 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 her level 4 NVQ. One residents commented “the manager is very nice” and another stated “ the manager is always around if we need him”. Woolton Grange Care Home DS0000064524.V295488.R01.S.doc Version 5.2 Page 19 The company 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. During the inspection, the emergency buzzer was raised. Staff demonstrated a quick response and left a member of staff to assist residents in the main lounge. This is an example of good practice. The home has up to date safety certificates and record maintenance checks well. Fire records were sampled and showed that appropriate checks are being carried out. Accident records were stored and completed correctly. Records of resident’s monies were sampled. All records were satisfactory and comprehensively recorded. The home keep all receipts for any items purchased on behalf of residents and large sums of money that are accumulated are returned to the resident’s next of kin. One resident commented that she held small amounts of money, however, had no facilities in her bedroom to store this money safely. It appeared that not all rooms had lockable storage facilities during the tour of the building. The manager must audit the bedrooms to assess if any rooms need this additional storage. Woolton Grange Care Home DS0000064524.V295488.R01.S.doc Version 5.2 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 3 X X X HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 1 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 3 15 3 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 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 2 Woolton Grange Care Home DS0000064524.V295488.R01.S.doc Version 5.2 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. 1. Standard OP7 Regulation 15(1) Requirement Timescale for action 30/08/06 2. OP9 13(2) The registered person must be able to demonstrate that residents and or their families are being actively involved in the care planning process. The registered person must 28/06/07 ensure that medication administration records are recorded contemporaneously and accurately. Medication must be given as prescribed. (Remains outstanding from previous report: timescale of 1.12.05 and 5.2.06 not met) The registered person must ensure that the practice of potting up medication stops The registered person must ensure that the medication trolley is kept locked when staff are away from it. 3 OP19 23(2) The registered person must ensure that the hot water supply is repaired and maintained to bedroom 28 30/07/06 Woolton Grange Care Home DS0000064524.V295488.R01.S.doc Version 5.2 Page 22 The registered person must investigate the allegation of smoking in the kitchen area by staff. 4 OP35 23(3) The registered person must audit 30/08/06 the provision of lockable storage facilities at the home. Appropriate residents must be provided with this facility 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. Refer to Standard OP12 OP19 Good Practice Recommendations The registered person may wish to review the types and frequency of activities offered at the home. The registered person may wish to look into the provision of toilets designated to male and female residents. Woolton Grange Care Home DS0000064524.V295488.R01.S.doc Version 5.2 Page 23 Commission for Social Care Inspection Knowsley Local Office 2nd Floor, South Wing Burlington House Crosby Road North Liverpool L22 0LG 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.V295488.R01.S.doc Version 5.2 Page 24 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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