Care Home: Grafton Lodge

What the care home does well The home offers a warm and homely environment in which to live. People spoken to were very complimentary on the care offered and all spoke highly of the staff. People benefited from recently refurbished pleasant rooms, which they were encouraged to personalise. Some of the rooms do not provide the required amount of space. Visitors to the home also spoke highly of the care offered and of being made very welcomed at all times. People stated that the food was good and that they enjoyed the home cooking. Health needs were well met and people benefit from having full support from other health professionals. The management strives hard to maintain a good solid staff base and training is given a high priority. The management of the home is excellent. What has improved since the last inspection? The internal environment had been improved with a refurbishment programme to most areas of the home undertaken since the last inspection. This included the installation of a new sluice area which contained a pot disinfector and greatly improved the infection control procedures within the home. Several people commented how much they liked the new furniture and fittings in their bedrooms. A new call system had also been fitted for the benefit of the people who live in the home. The chair lift had been extended to the top floor. What the care home could do better: Care plans were in the process of being updated and when completed will improve the information available to staff. CARE HOMES FOR OLDER PEOPLE Grafton Lodge 40 Goddington Road Strood Rochester Kent ME2 3DE Lead Inspector Sue McGrath Unannounced Inspection 5th March 2009 09:30 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Grafton Lodge DS0000028885.V374442.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. Grafton Lodge DS0000028885.V374442.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Grafton Lodge Address 40 Goddington Road Strood Rochester Kent ME2 3DE 01474 833531 01634 722621 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) Mrs Lavinia Mary Boyson Mr Lee James Boyson, Mrs Lesley Ann Boyson, Mrs Sharon Rosemarie Boyson, Mrs Jo Ann Weston, Mr Rickie Michael Boyson Miss Anne Carmel Perkins Care Home 20 Category(ies) of Old age, not falling within any other category registration, with number (20) of places Grafton Lodge DS0000028885.V374442.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 3rd May 2007 Brief Description of the Service: Grafton Lodge is a large house, which accommodates twenty older people. The home has a shaft lift to the first floor, plus stair lifts to the first and second floors. There are steps to the front entrance, but wheelchair access is possible via the driveway to the rear. The home has a large garden, which includes sitting areas. It is located on a hill close to the town centre of Strood, with access to local amenities and public transport. Fees range from £380 - £400 per week. Grafton Lodge DS0000028885.V374442.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 3 star. This means the people who use this service experience excellent quality outcomes. This outcome was reached after the home evidenced continuous excellent levels of care. This was a key unannounced inspection that took place on 5th March 2009 and was conducted by Sue McGrath, Regulation Inspector for the Commission for Social Care Inspection. The key inspections for care home services are part of the methodology for The Commission For Social Care Inspection, whereby the home provides information through a questionnaire process and further feedback is gained through surveys sent to service users and relatives and information provided from professionals associated with the home, wherever possible. The actual date of the site visit is unannounced. Additional information was also obtained through the Annual Assessment Quality Assurance (AQAA) review, which all services registered with the Commission for Social Care Inspection (CSCI) must now complete on a yearly basis. At the site visit, service users and staff were spoken to, records were viewed and a tour of the environment was undertaken. Judgements have been made based on records viewed, observations and verbal responses given by those people who were spoken with. These judgements have been made using the Key Lines of Regulatory Assessment (KLORA), which are guidelines that enable the CSCI to be able to make an informed decision about outcome areas. Further information can be found on the CSCI website with regards to information on KLORA’s and AQAA’s. The requirements made at the last inspection had been complied with. Overall this was a very positive inspection with excellent outcomes for service users. The inspector on leaving the home was satisfied that residents were both safe and well cared for and wishes to thank the manager and her staff for their assistance and hospitality. Grafton Lodge DS0000028885.V374442.R01.S.doc Version 5.2 Page 6 What the service does well: What has improved since the last inspection? What they could do better: Care plans were in the process of being updated and when completed will improve the information available to staff. Grafton Lodge DS0000028885.V374442.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. Grafton Lodge DS0000028885.V374442.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 Grafton Lodge DS0000028885.V374442.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): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People are provided with the information they need to make an informed choice about moving into the home. People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they or people close to them have been involved with. This tells the home all about them, what they hope for and want to achieve, and the support they need. EVIDENCE: The homes statement of purpose was updated in February 2009 and now contains all of the information required under Schedule 1 of the Care Standards Act 2001. Grafton Lodge DS0000028885.V374442.R01.S.doc Version 5.2 Page 10 Evidence was seen that all people undergo a robust assessment of their needs prior to admission so the home can make an informed choice as to whether they can meet these needs. Information is also sought from Social Care professionals to enable the home to gather good background knowledge. The manager confirmed that prospective residents and their families were invited to visit the home prior to admission and if they wished to remain in the home, a four-week settling in period was offered. This time could be extended if necessary. Intermediate care is not offered and the home is not registered for dementia care. Grafton Lodge DS0000028885.V374442.R01.S.doc Version 5.2 Page 11 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 good. This judgement has been made using available evidence including a visit to this service. People receive personal support from staff in a way they prefer and want. Their physical and emotional health needs are met because the home has procedures in place that staff follow. If people take medicines, they manage it themselves if they can. If they cannot manage their medicines, the care home supports them in a safe way. EVIDENCE: All of the people in the home had written care plans that provided information to staff as to how to best meet their needs. Evidence was seen that these plans were regularly updated with any changes recorded and acted upon. The manager was in the process of updating these plans and they will be Grafton Lodge DS0000028885.V374442.R01.S.doc Version 5.2 Page 12 reassessed at the nest inspection. Some area where the plans could improve were discussed with the registered manager. There was good evidence that health care needs were well met and that people in the home had access to all other healthcare professionals as required. At the last inspection some concerns were raised regarding the administration of medication and a Pharmacy Inspection was arranged. The registered manager has reacted positively to the inspection and it can now be evidenced that the medication is safely administered in accordance to the guidelines from The Royal Pharmaceutical Society for Great Britain. Staff were also appropriately trained and monitored in the safe administration of medication. Many of the people were spoken with and they all confirmed that staff treated them very well and they felt respected and safe at all times. People made the following comments; ‘The girls give me full help with personal care and they are so kind.’ ‘Could not wish for better staff’ ‘I like it here; the staff are brilliant to me. Nothing is too much trouble for them. You ask and they give.’ Discussion with some of the staff also confirmed they had a good understanding of privacy and dignity. A quiet room was available for residents to use that has a telephone for private use. Grafton Lodge DS0000028885.V374442.R01.S.doc Version 5.2 Page 13 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): Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability and gender. They can take part in activities that are appropriate to their age and culture and are part of their local community. The care home supports people to follow personal interests and activities. EVIDENCE: One of the homes owners now comes to the home for at least here days a week to undertake activities with the residents. These are recorded and cover a wide range of interests. People spoke highly of the Saturday cinema club where they were able to choose the film. One person said ‘we have popcorn and ice cream, just like at the real pictures’. Another person said ‘we have fresh cream cakes most Saturdays as a special treat’ Grafton Lodge DS0000028885.V374442.R01.S.doc Version 5.2 Page 14 Other activities include a chocolate fountain, fondue tasting and outside entertainers. These include an Elvis impersonator, a music and movement coordinator and a musical instruments session. Other activities included pamper sessions with manicures for both men and women, bingo, cards, games, mobile library and talking books where needed. There was a large picture gallery displaying all events and posters to make people aware of forthcoming events/activities. People were encouraged to go out when possible with relatives and friends and could come and go from the home as they pleased. Although the home had set meal times, people wishing to have a lie in or have a meal in their rooms, or returning from an outing at a different time were catered for. Residents could take visitors to their own rooms or the quiet room and were always offered refreshment. This was confirmed by one visitor on the day of the inspection. Activities were offered in either a group or a one to one. The management place a lot of emphasise on staff being able to spend one to one time with people when needed. One person said ‘We have different games to play and have a music lady come and an exercise lady’ another said ‘There is always something going on, we have no time to get bored’ Mealtimes were made a social occasion with background music being played. People’s likes and dislikes were catered for and people confirmed there was always a choice over the main meal. Staff will often join people for their meals, again to make them a more sociable event. Menus indicated there was a balanced diet offered to people and it was seen that the food was of a good quality, well cooked and well presented. All of the people spoken with confirmed the food was good. ‘We have a lot of good home cooking here’ There is always plenty of food and drinks available here’ During the course of the inspection staff were seen to offer choices at all times, enabling people to retain control over their lives. Discussion with staff confirmed they did their best to respect dignity and privacy, especially when delivering personal care. Grafton Lodge DS0000028885.V374442.R01.S.doc Version 5.2 Page 15 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): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People are protected by a robust complaints system and residents and relatives feel their views are listened to and acted upon. The home has robust adult protection policies and procedures to ensure that people are protected from abuse. EVIDENCE: The home had a written complaints procedure in place that staff and people who live in the home were aware of. The home had one recorded complaint but following investigation it was deemed as unfounded. The Commission had not received any complaints about the service. The home has adopted the Multi Agency Adult Protection Policy for Kent and Medway and staff spoken to were able to demonstrate a good awareness and understanding of the policies. All staff held a current CRB and had received training in Adult Protection Grafton Lodge DS0000028885.V374442.R01.S.doc Version 5.2 Page 16 Grafton Lodge DS0000028885.V374442.R01.S.doc Version 5.2 Page 17 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): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People stay in a safe and well maintained home that is homely, clean comfortable, pleasant and hygienic. The environment helps people to have a good nights sleep. EVIDENCE: All of the bedrooms except one had been decorated. This one did not require further decoration. New carpets, curtains and furniture had been provided. The lounge had also benefited from some refurbishment with new chairs and coffee table being purchased. New table clothes had improved the look of the dining room. Grafton Lodge DS0000028885.V374442.R01.S.doc Version 5.2 Page 18 A new call system had been fitted throughout the home for the benefit of the people and a new sluice room had been provided. This had been fitted with all of the required equipment to enable the staff to provide good infection control procedures. The room was tiled form floor to ceiling and was very clean and fresh. Five of the rooms are shared and some were below the required size but residents all seemed happy with their rooms. All shared rooms had been fitted with privacy curtains. Some of the rooms were unable to contain all of the furniture required by regulation due to their size, but again the residents were happy with this arrangement. The chair lift had been extended to the top floor. The home was very homely and comfortable with several period features. Staff followed strict cleaning schedules and procedures and this enabled them to maintain the high standards seen. On the day of the inspection the home was clean and fresh. Grafton Lodge DS0000028885.V374442.R01.S.doc Version 5.2 Page 19 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): Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. People have safe an appropriate support as there are enough competent and qualified staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure they are suitable. People’s needs are met and they are supported because staff receive the right training, supervision and support they need from their manager. EVIDENCE: Evidence seen on the day through rotas and practises observed indicated that the home had sufficient staff to meet the needs of the people at all times. Staff themselves confirmed they do not feel under pressure and said they felt they have sufficient staff numbers. There was a four week care staff rota with dedicated domestic and cooking staff. Agency staff are not used and the registered manager said this was because they had a dedicated group of staff who covered absences where necessary. Staff training is given a high priority and NVQ levels have improved to over 50 . Other staff are working towards their awards. Mandatory training is being maintained. Grafton Lodge DS0000028885.V374442.R01.S.doc Version 5.2 Page 20 Sound recruitment processes were seen that would protect people in the home. Grafton Lodge DS0000028885.V374442.R01.S.doc Version 5.2 Page 21 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): Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. People have confidence in the care home because it is run and managed appropriately. People opinions are central to how the home develops and reviews their practise, as the home has appropriate ways of making sure they continue to get things right. The environment is safe for people and staff because health and safety practises are carried out. People are confident their day and night time needs will be well met in a well managed and safe service. Grafton Lodge DS0000028885.V374442.R01.S.doc Version 5.2 Page 22 EVIDENCE: The manager had completed her NVQ 4 in Leadership and Management in the Care Sector, which is the replacement award for the Registered Managers Award. She also holds NVQ 4 in Management and NVQ 3 in Care. She has over twenty six years of experience in working with the elderly. Other training had also been undertaken, and some was planned, that indicated that she was continuously updating her skills. The manager was ably supported by her deputy and other staff. Throughout the inspection the manager was able to demonstrate she had the necessary skills to manage the home in a competent and compassionate way. Staff state they feel well supported by both the owners and the registered manager and benefited from regular structured supervision. People in the home commented that they felt happy to discuss anything with the manager or the owners and that they were approachable and friendly. Quality Assurance was undertaken to ensure the views of the people who live in the home were considered at all times. The ethos of the home was positive and supportive to residents and staff alike. The records kept in the home were accessible and also secure. Staff confirmed they receive regular supervision and appraisals and records indicated regular meetings. Residents and staff meetings occurred on a regular basis. Evidence was supplied by the home that confirmed all the necessary health and safety checks were being carried out and that as far as possible the health, safety and welfare of residents and staff was protected. Grafton Lodge DS0000028885.V374442.R01.S.doc Version 5.2 Page 23 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 3 3 3 3 3 n/a HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 3 10 3 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 3 17 3 18 3 3 3 X X 3 3 3 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 4 4 3 X X 3 X 3 Grafton Lodge DS0000028885.V374442.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. 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. 1. Refer to Standard OP21 Good Practice Recommendations It is recommended that the bathroom on the upper floor is considered for refurbishment in the future financial planning for the home. Grafton Lodge DS0000028885.V374442.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Maidstone Office The Oast Hermitage Court Hermitage Lane Maidstone ME16 9NT 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 Grafton Lodge DS0000028885.V374442.R01.S.doc Version 5.2 Page 26 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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