Care Home: Astley Grange Nursing Home

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What the care home does well What has improved since the last inspection? The care records inspected had improved since the last inspection, and there was evidence that peoples identified needs were being met. Staff records now show that they are being supervised on a regular basis. What the care home could do better: The manager could ensure that people`s pre admission records are properly completed, dated and signed which will give an account of the needs of the person, when the assessment was completed, and by whom. Staff could ensure that the activities that people are involved in on a daily basis, and their enjoyment, are recorded in their individual care files. This will show that people`s social and recreational needs are being met. This information was a recommended at the last two inspections. The home should ensure that people have access to their finances out of office hours. CARE HOMES FOR OLDER PEOPLE Astley Grange Nursing Home Woodhouse Hall Road Woodhouse Hill Fartown Huddersfield West Yorkshire HD2 1DJ Lead Inspector Karen Summers Key Unannounced Inspection 4th June 2008 09:15 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 Astley Grange Nursing Home DS0000001108.V365574.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. Astley Grange Nursing Home DS0000001108.V365574.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Astley Grange Nursing Home Address Woodhouse Hall Road Woodhouse Hill Fartown Huddersfield West Yorkshire HD2 1DJ 01484 428322 01484 451440 astleygrange@schealthcare.co.uk 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) Southern Cross Operations Limited Ms Janet Simpson Care Home 40 Category(ies) of Old age, not falling within any other category registration, with number (40) of places Astley Grange Nursing Home DS0000001108.V365574.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The registered person may provide the following category of service only: Care home with nursing - Code N, to service users of the following gender: Either, whose primary care needs on admission to the home are within the following category: Old age, not falling within any other category - Code OP The maximum number of service users who can be accommodated is: 40 One named service user aged under 65 years - category PD One named service user aged under 65 years 2. 3. 4. Date of last inspection 8th June 2006 Brief Description of the Service: Astley Grange Care Home provides nursing and personal care for up to 40 older people. The home is purpose built, and is situated in a quiet cul de sac adjacent to Fartown High School. The accommodation is over three floors with a lounge area on each, and the dining room is situated on the middle floor. There are 32 single rooms and 4 double rooms. The grounds are an array of colour, with well-kept flowerbeds and hanging baskets. Astley Grange is close to local amenities such as shops, churches and is on a bus route. The home also has its own minibus, which is used for social outings on a regular basis. Fees at the home start at £350.76 - £530.73 per week. Information about the home and the services provided are available from the home in the statement of purpose and service user’s guide. Astley Grange Nursing Home DS0000001108.V365574.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is three star. This means the people who use this service experience excellent quality outcomes. This report refers to an inspection, part of which included an unannounced visit to the home on the 04th June 2008, commencing at 9.15 am, and the length of the inspection was 6.25 hours. There were 36 people living at Astley Grange on the day of the visit. As part of the inspection in order to provide information to help us form judgments about how the service is run, the manager was asked to complete an annual quality assessment document. This she did, and the document provided the Commission for Social Care Inspection (CSCI) with a lot of information about the way the home is run, and what they hope to achieve in the future. During the visit we spoke with members of staff and people who receive care to obtain their views. We also looked at a sample of care records, staff recruitment, and training records, quality assurance audits and looked around the home. To enable people who use the service to comment on the care it provides, we sent ten surveys to people living at the home, and ten were returned, ten were sent to their next of kin, seven of these were returned, and ten to staff, all of which were returned. Below are some examples of the feedback we received: • “Astley Grange staff, under a very hard working and dedicated management team, provide support and care of the highest standard, – a benchmark for the other care homes in the Country.” “Staff are really good, (A1)” “I am really happy here.” • • We would like to thank all the people who gave feedback about this home, and would like to thank the deputy manager and staff for their co-operation throughout the inspection process. Astley Grange Nursing Home DS0000001108.V365574.R01.S.doc Version 5.2 Page 6 What the service does well: When relatives were asked this question in the survey, below is a sample of their replies: • • ” Whatever time of day there is always a lovely atmosphere, the staff are happy and this permeates to the people in their care.” “An excellent standard of care is delivered by committed, professional and caring staff. There is a high standard of food and domestic services.” Without exception everyone said that they are kept up to date about important issues affecting their relative/ friend. One person said that if anything happens to their relative, then they are contacted immediately. • People who live at the home also said that they receive the care and support that they need. They said that the staff are very good, and are always available when they need them. What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Astley Grange Nursing Home DS0000001108.V365574.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 Astley Grange Nursing Home DS0000001108.V365574.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. Standard 6 – the home does not take people who require intermediate care. People who use this service experience good outcomes in this area. This judgement has been made using available evidence including a visit to this service. People are assessed prior to them moving into the home and are able to visit the home to establish whether or not it is the right place for them. EVIDENCE: The information received from the home prior to inspection said that all people are assessed by the Home Manager or a senior member of staff to ensure that the home is able to meet their physical, emotional and social needs, and this was confirmed by the person in charge at the time of the visit. The care records of three people who use the service were examined, all of which contained a pre admission assessment and information about the person’s current needs however, one of the assessments had not been completed, one was dated and not signed, whilst another was signed but not dated. (The records should be completed, and should be dated and signed to Astley Grange Nursing Home DS0000001108.V365574.R01.S.doc Version 5.2 Page 9 give an accurate account of the assessment, when it was done, and by whom.) This was discussed with the deputy manager and the Operations manager, and it was agreed that they would ensure that the documentation is completed in the future. In addition to the pre admission assessment carried out by the home, they also receive an assessment of the person’s needs, which has been carried out by the funding authority. Eight out of ten people who use the service said that they received enough information about the home before they moved in, and two people said that they did not receive enough information. Astley Grange Nursing Home DS0000001108.V365574.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 and 10. People who use this service experience excellent outcomes in this area. This judgement has been made using available evidence including a visit to this service. The level of care people need, which includes their health, personal and social care needs are clearly highlighted within their care plan. People are treated with respect. The recording and administration of medication is satisfactory. EVIDENCE: Three people’s care records were looked at and the documentation identified the care needs, and the level of support the person requires. Risk assessments had also been completed and included the risk of falls. There were also movement and handling assessments, nutritional assessment, and skin integrity recorded. There was evidence that care reviews had taken place, and that the care plans are updated monthly or as the needs of the person change. Information provided by the home confirmed that people are consulted on their care plans. Staff were seen to respect the residents privacy and dignity by Astley Grange Nursing Home DS0000001108.V365574.R01.S.doc Version 5.2 Page 11 knocking on doors and wait to enter and call residents by their preferred name of address. Six relatives said that the home helps their relative to keep in touch, and one person said that they visited daily and so were regularly in touch with their relative. One person also said that the home has recently published a monthly newsletter. Without exception everyone said that they are kept up to date about important issues affecting their relative/ friend. One person said that if anything happens to their relative, then they are contacted immediately. People also said that they receive the care and support that they need and one person said, “Mum can be trying at times, but the staff get her laughing again.” Everyone said that the staff listen and act on what they say. Seven people said that staff are available when they need them, two said, “Usually,” and one said, “Sometimes.” Staff were seen to talk to people by name and respect their wishes. There was also evidence in people’s care records that they are able to access health care services, such as the dentist, chiropodist, optician and everyone living at the home is registered with a doctor. Eight people said that they receive the medical support they need, one person said, “Usually” and one person said that they, “Sometimes” receive the support. The person in charge at the time of the visit confirmed that all staff that gives medication to people have had training and there was evidence to suggest that the training had taken place. A sample of medication and records were checked, and the storage, administration and recording of the medication were done correctly. Astley Grange Nursing Home DS0000001108.V365574.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 and 15. People who use this service experience good outcomes in this area. This judgement has been made using available evidence including a visit to this service. People living at the home are offered a range of activities and are able to make their own choices about how they spend their time. Meals provided are good, varied and served in a pleasant environment. EVIDENCE: The information received from the home confirmed that they employs a part time activities coordinator and an outings coordinator to maximise the social activities in and outside of the home, and they also employ a therapist who visits monthly. They said that they have their own minibus bus which enables them to be able to go on outings. Activities in the home include: arts and crafts, cards, dominoes, bingo, music, excercises and many others as requested by the residents. One to one sessions are also held for those that remain in their rooms. Peoples’ social care records were filled in on an ad hoc basis, therefore there was no documented evidence as to how these peoples individual, social, and religious needs were being met, and where the record had been completed the Astley Grange Nursing Home DS0000001108.V365574.R01.S.doc Version 5.2 Page 13 information did not show whether the person had enjoyed the activity. This was also identified at the last key inspection. Discussion took place with the Operations manager and the deputy manager, and they agreed to ensure that the information would be recorded. Five people said that there are always activities that they can take part in, three people said usually, and two people said that there were sometimes activities that they could take part in. One person said, “The activities are very good.” The menus offered a variety of food, and individual peoples food preferences; specialised diets and cultural needs had also been taken into consideration when planning the menus. Everyone who completed the survey said that they liked the meals at the home. One person said that the meals were very good. and another confirmed that that the home always provide their food of choice in relation to cultural needs when they want it. Relatives commented most positively how the staff meet the different needs of people, taking into consideration race, age, disability, gender and faith. Astley Grange Nursing Home DS0000001108.V365574.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 and 18. People who use this service experience good outcomes in this area. This judgement has been made using available evidence including a visit to this service. People can be confident that their complaint will be listened to and acted upon. Staff have received suitable training and understand the adult protection policies and procedures, which makes sure that the people they support are safe. EVIDENCE: There is a complaints procedure which specifies how complaints may be made, and with an assurance that they will be responded to within a maximum of 28 days. There is also a whistle blowing procedure, and staff confirmed that they knew the procedure. Seven people said that they knew how to make a complaint if they were not happy, and three people said that they did not know how to make a complaint. One of these three people said that they have never needed to make a complaint. Without exception, all relatives said that they knew how to make a complaint. Six out of eight staff said that they would know what to do if someone wished to make a complaint. Records showed that all staff have had safeguarding (adult protection) training, which provides information on how to protect people from abuse. Astley Grange Nursing Home DS0000001108.V365574.R01.S.doc Version 5.2 Page 15 Those staff spoken with during this visit spoke with confidence about how they would report poor care practice and abuse. Astley Grange Nursing Home DS0000001108.V365574.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 and 26. People who use this service experience good outcomes in this area. This judgement has been made using available evidence including a visit to this service. The home offers people a homely, comfortable and clean environment. EVIDENCE: As part of the inspection a tour of the home took place that included the communal areas and a number of peoples bedrooms, (of which people gave their consent for inspecting their bedrooms) and the laundry. The information received from the home prior to inspection stated that people are encouraged to personalise their bedrooms with their own furniture and furnishings, and there was evicence of this in the room that were visited. The home is in a good state of repair and decorative condition. The standard of cleanliness was good and there were no unpleasant odours noted in any part of the home. Without exception people commented that the home was always clean. Astley Grange Nursing Home DS0000001108.V365574.R01.S.doc Version 5.2 Page 17 The atmosphere on the day of the visit was warm and friendly and people looked comfortable whilst sitting in various parts of the home. Astley Grange Nursing Home DS0000001108.V365574.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 and 30. People who use this service experience good outcomes in this area. This judgement has been made using available evidence including a visit to this service. People are supported by qualified, competent and experienced staff and in sufficient numbers. Staff also have had all the necessary checks before working with people so that they are kept safe. EVIDENCE: The information in the annual quality assessment document indicates, that the home is staffed with people who are trained and competent to do their job. The list of staff on duty showed that there were sufficient staff in number to meet the needs of the people in their care and the person in charge confirmed this. Eight people who use the service said that there are always staff available when you need them, one said, usually and one said sometimes. Five relatives said in the survey that the care staff have the right skills and experience to look after people properly, and two people said that staff usually have the skills. One person wrote that the staff have attended a Motor Neurone course to learn more about caring for people who have this disease. Another person said, “They also have the right attitude.” Astley Grange Nursing Home DS0000001108.V365574.R01.S.doc Version 5.2 Page 19 The deputy manager confirmed that all care staff now have a NVQ (National Vocational Qualification) level two or above, and the training records showed evidence to support this. The recruitment files of three members of staff were looked at and they contained the required information and employment checks. These checks are necessary to help protect people from potentially unsuitable staff. The home employs a multicultural staff team, and is an equal opportunities employer. Staff records held equal opportunities monitoring forms. New staff undertake induction training in accordance with Skills for Care, the National Training Organisation for care staff, and the person in charge confirmed this. Evidence was also seen in the staff files of the induction programme. One member of staff did not have their induction documentation in their file, and it was explained that their training manager had taken it with them to record some information. The deputy manager was advised that this information should be kept in the home, as it was evidence that the induction training had taken place. Astley Grange Nursing Home DS0000001108.V365574.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 and 38. People who use this service experience good outcomes in this area. This judgement has been made using available evidence including a visit to this service. People benefit from the management approach of the home and the manager ensures so far as is practicable that the health, safety and welfare of people and staff are protected. The home is run in the best interest of people who live there. EVIDENCE: The manager has thirty years experience in the care of older people, and she has achieved the Registered Managers Award. For those people who wish, small amounts of personal money are held safely at the home. Discussion was held regarding the need to ensure that people have access to their monies, at the weekend and evenings when the Astley Grange Nursing Home DS0000001108.V365574.R01.S.doc Version 5.2 Page 21 administration office is closed. The Operations manager said that he would ensure that this takes place. There was evidence in the staff training records that they have regular supervision and staff also confirmed this. Satisfaction questionnaires are sent out annually by the home to staff, people who live at the home/ visitors, and visiting profession. This years questionnaires have yet to be circulated. To keep people informed of forth-coming events, and topics of interest, the home has recently introduced a monthly newsletter, and this was mentioned as a way of keeping people informed by a relative in the surveys we received. A sample of records was looked at relating to health and safety within the home and satisfactory records are being maintained. Astley Grange Nursing Home DS0000001108.V365574.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 Astley Grange Nursing Home DS0000001108.V365574.R01.S.doc Version 5.2 Page 23 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 N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 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 3 X X X X X X 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 2 3 X 3 Astley Grange Nursing Home DS0000001108.V365574.R01.S.doc Version 5.2 Page 24 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 OP12 Regulation 16.(2)(m) Requirement The activities that people are involved in on a daily basis, and their enjoyment, should be recorded in their individual care file. This will show evidence that people’s social and recreational needs are being met. This information was a recommended at the last two inspections. Timescale for action 14/07/08 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard OP3 Good Practice Recommendations Pre admission assessment records should be completed, and should be dated and signed to give an accurate account of the assessment, when it was done, and by whom. The home should ensure that people have access to their finances out of office hours. 2. OP35 Astley Grange Nursing Home DS0000001108.V365574.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection North Eastern Region St Nicholas Building St Nicholas Street Newcastle Upon Tyne NE1 1NB 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. 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