Care Home: Cuerden Grange Rest Home

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What the care home does well The home has developed a person centre approach in care planning and treats every resident as an individual and continues to actively promote resident`s dignity, independence, privacy and rights. This was emphasised from comments received from residents and relatives, who spoke very positively about the care provided by Cuerden Grange Rest Home. Comments from Residents include, ""We can do our own things and we are very well looked after, the staff are really good and caring, I am very happy here". "I have settled very well and have no worries, the staff are kind and helpful". "I am very happy here if I have any problems I can talk to the staff or the manager". Relatives said, "The home delivers good quality of care and always keep me informed" "Cuerden Grange provide good stimulus and has contributed significantly to improvement in the quality of my mothers life since she came to the home, staff are highly professional and caring, the atmosphere created is a very happy one, there are regular meetings with the manager". ""Staff always listen and act when there is a problem". "The standard of care given is of the highest level, the care staff are so patient and caring, they are indeed professionals, Cuerden Grange is like one big family, there is a wonderful atmosphere, we are grateful to all the wonderful staff." "The staff are lovely and very patient and caring, the manager is excellent and has a very good supportive team, residents are treated with dignity and respect, if there are problems, we are listened to immediately and sympathetically, we are very happy with the care". " Care is excellent, there is no discrimination of any kind, the home is run as close to home life as possible". "All care is excellent the home does not need to improve". Comments received from two GPs were, "The home responds quickly to resident needs". "The home generally delivers good quality care to residents, I have no concerns about care provided." There is excellent management, with good support structures in place, staff are well motivated and trained. What has improved since the last inspection? Personal recording on care plans has improved and a more person centre approach to caring has been developed. Management structures are being improved and consolidated with the appointment of a deputy manager who is also qualified and experienced. This will ensure stability when the extensions are completed. Medication policies and procedures have improved and better fridge storage for some medicines has been provided. What the care home could do better: There are no statutory requirements or recommendations made as part of this inspection. CARE HOMES FOR OLDER PEOPLE Cuerden Grange Rest Home 414 Station Road Bamber Bridge Preston Lancashire PR5 6JN Lead Inspector Mr Patrick Rooney Unannounced Inspection 10:00 4 January 2008 th 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 Cuerden Grange Rest Home DS0000005960.V351394.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. Cuerden Grange Rest Home DS0000005960.V351394.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Cuerden Grange Rest Home Address 414 Station Road Bamber Bridge Preston Lancashire PR5 6JN 01772 629532 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) Mr Keith Lowe Mrs Judith Iddon Care Home 32 Category(ies) of Old age, not falling within any other category registration, with number (30), Physical disability (2) of places Cuerden Grange Rest Home DS0000005960.V351394.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. Old Age (OP)(32) including Physical Disability (PD)(UP TO 2) Date of last inspection 1st September 2006 Brief Description of the Service: Cuerden Grange is registered with the Commission for Social Care Inspection to provide personal care for up to 32 older people. The home is situated on the same site as its sister home, which is registered to provide Nursing Care. The home is located on the perimeter of the residential area of Bamber Bridge on the outskirts of Preston. The motorway network is near by and there is easy access to all local amenities. Cuerden Grange residential home is a single storey building, providing accommodation mainly within single rooms, although three shared rooms are available for married couples or friends who wish to share facilities. All rooms are of a good size and have en suite facilities, comprising of WC and wash hand basin. Service users may dine in one of the pleasant dining rooms or in the privacy of their private accommodation, if they prefer. At the time of the inspection the home was in the process of major extensions and refurbishment. Special diets are catered for and a choice of menu is available, although alternative meals are also provided if required. A daily activity programme is in place, in which service users can choose to participate if they wish. Current fees for a place in the home range from £324.50 to £425 per week. Cuerden Grange Rest Home DS0000005960.V351394.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced visit and was carried out over a six-hour period from 10 am. The inspector looked at care records for four residents and spoke to those residents about their care. Other residents and visiting relatives were spoken to. Four staff were also interviewed separately to regarding their role within the home and confirmed they receive a full induction in caring for the elderly and the opportunity for on going training. The inspector toured the building, spoke to individual staff, had discussion with management and consulted records and policies and procedures. Completed questionnaires from two GPs eight relatives and three residents. The manager was present during the inspection. The Quality Rating for this service is three star. This means the people who use this service experience excellent quality outcomes. What the service does well: The home has developed a person centre approach in care planning and treats every resident as an individual and continues to actively promote resident’s dignity, independence, privacy and rights. This was emphasised from comments received from residents and relatives, who spoke very positively about the care provided by Cuerden Grange Rest Home. Comments from Residents include, ““We can do our own things and we are very well looked after, the staff are really good and caring, I am very happy here”. “I have settled very well and have no worries, the staff are kind and helpful”. “I am very happy here if I have any problems I can talk to the staff or the manager”. Relatives said, “The home delivers good quality of care and always keep me informed” “Cuerden Grange provide good stimulus and has contributed significantly to improvement in the quality of my mothers life since she came to the home, staff are highly professional and caring, the atmosphere created is a very happy one, there are regular meetings with the manager”. “”Staff always listen and act when there is a problem”. “The standard of care given is of the highest level, the care staff are so patient and caring, they are indeed Cuerden Grange Rest Home DS0000005960.V351394.R01.S.doc Version 5.2 Page 6 professionals, Cuerden Grange is like one big family, there is a wonderful atmosphere, we are grateful to all the wonderful staff.” “The staff are lovely and very patient and caring, the manager is excellent and has a very good supportive team, residents are treated with dignity and respect, if there are problems, we are listened to immediately and sympathetically, we are very happy with the care”. “ Care is excellent, there is no discrimination of any kind, the home is run as close to home life as possible”. “All care is excellent the home does not need to improve”. Comments received from two GPs were, “The home responds quickly to resident needs”. “The home generally delivers good quality care to residents, I have no concerns about care provided.” There is excellent management, with good support structures in place, staff are well motivated and trained. What has improved since the last inspection? What they could do better: There are no statutory requirements or recommendations made as part of this inspection. Cuerden Grange Rest Home DS0000005960.V351394.R01.S.doc Version 5.2 Page 7 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. Cuerden Grange Rest Home DS0000005960.V351394.R01.S.doc Version 5.2 Page 8 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 Cuerden Grange Rest Home DS0000005960.V351394.R01.S.doc Version 5.2 Page 9 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 Quality in this outcome area is good. The home has a good assessment and introduction procedures. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The assessments of four residents were looked at and their care was case tracked. All had received a full pre assessment and had been provided with information about the home. Residents spoken to were happy with the levels of care they receive and said they are very well looked after. Each resident is provided with a contract and full details of fees to be paid. Those residents who are funded have as social work assessment and contract. Cuerden Grange Rest Home DS0000005960.V351394.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): Quality in this outcome area is excellent. Residents care plans are comprehensive and ensure health, personal and social care needs are met and care is provided ensuring privacy and dignity is maintained. This judgement has been made using available evidence including a visit to this service. EVIDENCE: During the visit the files of four residents were looked at and their care discussed with them. Each resident had an individual care plan, which provided comprehensive information and detail to ensure that health, personal and social care needs can be met. Care plans are person centred and each resident is treated as an individual. This was confirmed in discussion with residents. Staff interviewed separately showed a good understanding of each residents differing needs and understood the principles of person centred caring. Cuerden Grange Rest Home DS0000005960.V351394.R01.S.doc Version 5.2 Page 11 Care plans are reviewed monthly, residents and their families are able to take part in the process. Invitations to relatives and supporters to attend reviews and discussions were seen on file and the resident or their representatives sign outcomes, if possible. Each file contained records for monitoring and recording visits by health care professionals including doctors or district nurses. All these records were up to date and provided detailed information. Residents told the inspector they are happy with the care they receive and everyone spoken to said that staff are kind and respectful to them. The inspector observed good interaction between residents and staff. Comments from residents were all very complementary about care delivered at the home, they include; “We can do our own things and we are very well looked after, the staff are really good and caring, I am very happy here”. “I have settled very well and have no worries, the staff are kind and helpful”. “I am very happy here if I have any problems I can talk to the staff or the manager”. Relatives said, “The home delivers good quality of care and always keep me informed” “Cuerden Grange provide good stimulus and has contributed significantly to improvement in the quality of my mothers life since she came to the home, staff are highly professional and caring, the atmosphere created is a very happy one, there are regular meetings with the manager”. “”Staff always listen and act when there is a problem”. “The standard of care given is of the highest level, the care staff are so patient and caring, they are indeed professionals, Cuerden Grange is like one big family, there is a wonderful atmosphere, we are grateful to all the wonderful staff.” “The staff are lovely and very patient and caring, the manager is excellent and has a very good supportive team, residents are treated with dignity and respect, if there are problems, we are listened to immediately and sympathetically, we are very happy with the care”. “ Care is excellent, there is no discrimination of any kind, and the home is run as close to home life as possible”. “All care is excellent the home does not need to improve”. Comments received from two GPs were, “The home responds quickly to resident needs”. “The home generally delivers good quality care to residents, I have no concerns about care provided.” Medication policies and procedures were seen and medication records and storage was checked. Records were up to date and well kept. Cuerden Grange Rest Home DS0000005960.V351394.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 Quality in this outcome area is excellent. The home provides residents with choice and routines are flexible, this ensures they are able to exercise control in everyday life. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home provides a good variety of activities for residents. The inspector looked at the activity folder, in which there was recorded a variety of activities to suit individual residents needs. These include a daily activity usually in the afternoons. Activities provides are craft sessions, light gardening/ potting, dance exercises, visiting entertainers, holistic therapies, massage, outings to shops pubs etc. On admission details are taken of each resident’s interests and social needs. They are encouraged and assisted to carry on with any outside interests they had prior to coming in to the home one resident said that she was in regular contact with her church and was able to keep in touch with friends. Local ministers of all religions are made welcome and visit the home. Cuerden Grange Rest Home DS0000005960.V351394.R01.S.doc Version 5.2 Page 13 Residents said the home ensures there is always something to do and that they enjoy activities provided. Each resident receives at least thirty minutes individual quality time per day with a staff member, this is written into procedures for staff. The home provides flexibility with regards to daily routine and each resident has their own preferred getting up time in the morning, their individual preferences are recorded on care plans. As seen in the previous section comments received from relatives and residents show that there is a flexible happy atmosphere within the home, which is lead by the needs and wishes of residents. Menus showed that there is a good variety of food available and residents are asked what they like. There are always alternative meals available for those who wish. Meals can be taken in resident’s own rooms if they prefer to eat in private. Residents told the inspector they are happy with the meals they receive. Residents are encouraged to maintain their own financial affairs as long as possible. Information regarding access to independent advocacy services is available in the home. Bedrooms are personalised and residents are able to bring items of furniture, pictures and ornaments with them when they are admitted to the home. Cuerden Grange Rest Home DS0000005960.V351394.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 Quality in this outcome area is excellent. The home ensures residents and their representatives are able to raise any concerns they may have. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home has a complaints procedure, which is accessible to residents and their families. Copies are on the homes notice board and are contained in the service users guide, which is placed in every room. Residents said that they are aware of the procedure and feel able to raise any concerns with the staff or manager. Comments received from both residents and relatives as a part of this inspection show that the home has an excellent record in listening and acting upon any concerns that are expressed. Resident’s records and complaints and comments records also confirmed this. There is a protection of vulnerable adults procedure including a whistle blowing policy available in the home. Staff spoken to were aware of this policy and said that they felt confident in speaking to the manager if they had any concerns about care practice. Staff receive training in the protection of vulnerable adults and abuse. Cuerden Grange Rest Home DS0000005960.V351394.R01.S.doc Version 5.2 Page 15 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 Quality in this outcome area is good. The home is well maintained and the environment is clean and comfortable. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home has an improvement programme in place, which ensure regular maintenance and decorating takes place. A tour of the home took place; all areas were clean, well decorated and comfortable. Residents were happy with their accommodation and their rooms are personalised with their own ornaments and furniture. At the time of the inspection the home was undergoing major extensions and refurbishment, however during this process the home has maintained good standards for residents. Cuerden Grange Rest Home DS0000005960.V351394.R01.S.doc Version 5.2 Page 16 There are policies and procedures in place to ensure infection control and the home is kept clean and hygienic. Staff are issued with protective aprons and gloves and are required to ensure they hand wash after dealing with each resident. A contract is in place for the removal of toxic waste and bags are colour coded. There are good laundry facilities, which ensure washing can be sluiced and cleaned to disinfectant standards. Cuerden Grange Rest Home DS0000005960.V351394.R01.S.doc Version 5.2 Page 17 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 Quality in this outcome area is excellent. Arrangements for staffing the home ensure there are sufficient skilled staff on duty to meet the needs of residents. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Recruitment files for staff were looked at and showed that there is a thorough recruitment process in which references are obtained and Criminal Records Bureau checks carried out prior to employment of staff. Staff records showed that new staff have a comprehensive induction and training to enable them to carry out their duties, this is in line with the “Skills to care” guidelines. Certificates of training were seen on staff files. Staff on duty were spoken to individually and said that they are well supported and are given the opportunity to take part in training. There are above 50 of staff who are qualified to NVQ 2 and more staff are presently completing this training. Staff receive formal supervision every two months and have an annual appraisal, which identifies training needs. The manager has received training in providing supervision. There is a staff handbook, which informs Cuerden Grange Rest Home DS0000005960.V351394.R01.S.doc Version 5.2 Page 18 them of the homes policies and procedures and requires them to respect the confidentiality of residents. Rotas showed that there were sufficient trained and experienced staff on duty to meet the needs of residents. Residents spoken to said staff are very good and provide the right levels of care for them. Comments received for this inspection said that staff are well trained, professional, patient and caring. Four staff were interviewed during the inspection and said that they feel well supported and receive good training to ensure they are able carry out their duties. They all showed a good awareness of the needs of individual residents. Cuerden Grange Rest Home DS0000005960.V351394.R01.S.doc Version 5.2 Page 19 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 Quality in this outcome area is excellent. The home is well managed, which ensures residents interests are protected and health and safety issues are promoted. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home’s manager is qualified and experienced in managing the home, Residents and staff are happy with how the home is run and there are clear lines of accountability. The deputy manager is also qualified and experienced. Residents and relatives said that the home is well run and that the manager or the deputy are always available and listen to any concerns sympathetically. Cuerden Grange Rest Home DS0000005960.V351394.R01.S.doc Version 5.2 Page 20 Any issues requiring attention are always acted upon very quickly. Staff interviewed said they are well supported and receive regular supervision and training. They are clear about the management structure and can discuss any concerns with the manager. Resident’s views are taken seriously and resident surveys have been carried out. Residents meetings are arranged and the manager is in daily contact with all the residents. The home is a preferred provider with the local authority and has received five star RDB rating. The home looks after resident’s personal allowances, these are kept in a safe and good records are maintained of any transactions. All the homes policies and procedures have been reviewed and updated. Health and safety is taken seriously and staff receive training in moving and handling, health and safety and first aid. All safety certificates and risk assessments are carried out and are up to date. Cuerden Grange Rest Home DS0000005960.V351394.R01.S.doc Version 5.2 Page 21 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 4 8 4 9 3 10 4 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 4 13 4 14 4 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 4 17 X 18 4 3 X X X X X X 3 STAFFING Standard No Score 27 4 28 4 29 3 30 4 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 4 X 4 X 4 X X 4 Cuerden Grange Rest Home DS0000005960.V351394.R01.S.doc Version 5.2 Page 22 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. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Cuerden Grange Rest Home DS0000005960.V351394.R01.S.doc Version 5.2 Page 23 Commission for Social Care Inspection Northwest Regional Contact Team Unit 1, 3RD Floor Tustin Court Portway Preston PR2 2YQ National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Cuerden Grange Rest Home DS0000005960.V351394.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. Re-publishing this information is in breach of the terms of use of that website. 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