Care Home: Grange Bank

Annual service review Name of Service: Grange Bank The quality rating for this care home is: The rating was made on: three star excellent service 3 1 1 0 2 0 0 8 A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full review of the service. We call this review a ‘key’ inspection We do an annual service review when there has been no key inspection of the service in the last 12 months. It does not involve a visit to the service but is a summary of new information given to us, or collected by us, since the last key inspection or annual service review.   Has this annual service review changed our opinion of the service?   No You should read the last key inspection report for this service to get a full picture of how well outcomes for the people using the service are being met. The date by which we will do a key inspection: Name of inspector: Nancy Saich Date of this annual service review: 1 4 0 1 2 0 1 0 Annual Service Review Page 1 of 8 Information about the service Address of service: Cross Lane Wigton Cumbria CA7 9DL 01697345411 Telephone number: Fax number: Email address: Provider web address:   Name of registered provider(s): Conditions of registration: Category(ies) : dementia Conditions of registration: Mr Tom Ferguson Number of places (if applicable): Under 65 Over 65 19 0 The registered person may provide the following category of service only: Care Home only - Code PC to service users of the following gender: Either whose primary care needs on admission to the home are within the following categories: Dementia - Code DE. The maximum number of service users who can be accommodated is: 19. Have there been any changes in the ownership, management or the No service’s registration details in the last 12 months? If yes, what have they been: Date of last key inspection: Date of last annual service review (if applicable): Brief description of the service Grangebank is an older property set in its own grounds in a residential area of Wigton. The home is on two floors and has been adapted to accommodate residents in the above categories. The home is owned by Tom Fergusson. Margaret Beasley manages the home on his behalf. The home cares for older people who suffer from some form of dementia. Further information and a brochure can be obtained from the manager at the above address and number. Annual Service Review Page 2 of 8 3 1 1 0 2 0 0 8 Annual Service Review Page 3 of 8 Service update since the last key inspection or annual service review: What did we do for this annual service review? We asked the manager to complete an Annual Quality Assurance Assessment (The AQAA). This asks for information about the service since the last inspection and for any plans for the future. We also ask for some statistics about the service. We also checked on any other information we had gathered about the service since we last inspected. We also look at anything the service is required to tell us about under the law. This includes accidents and incidents that may have an impact on peoples well being. We consider any complaints that have been received and we also look at any allegations of harm or abuse. The provider and the manager of this service send us regular updates about changes and progress made in the home and we also receive regular quality reports. We then sent out questionnaires to the staff team and to people who live in the service, their relatives and to professionals who may visit. We had received nothing in the past year that caused us concern about this home. What has this told us about the service? We learned from this information that things in this home continue to go smoothly and that people who live or work in the home are happy with the way it is managed. The AQAA was returned to us within our timescales and contained detailed information about how well the service meets the required standards. We received a number of surveys from people who live at Grangebank or from their relatives. We also had a high level of responses from staff. The manager tells us in the AQAA that people continue to be admitted only after a complete assessment that usually involves social workers and health care professionals. This home is careful to get a proper diagnosis of dementia before a person moves in. The admission is reviewed after the first six weeks to make sure the placement is right for the person. The manager states that each person has a separate care plan for all their needs and that these plans are individual and person centered. Sedative medication is kept to the minimum and shortly after admission the new person has a medicines review with the GP and pharmacist. Staff in the home have received training in a variety of approaches to dementia care and the manager has used books and DVDs to look at updates to practice. Staff are trained and supervised so that they treat people with dementia appropriately. The home has increased the number of staff hours given over to activities. They have improved the garden with a new greenhouse, a gazebo and new fencing and gates. A Annual Service Review Page 4 of 8 number of people have enjoyed gardening through out the year. They have also purchased a pool table and a tennis table table at the request of residents. There is a weekly programme of games, hobbies and activities. There are regular entertainers who come to the home. Local churches visit and people also go out to local events. Visitors are encouraged and several families regularly share meals with their relatives just as they would at home. There is no charge for this. There have been no complaints or issues of abuse reported to the home or to ourselves. Staff are trained to understand and deal with these matters. Relatives are encouraged to speak up in individual reviews and in the regular meetings held in the service. The AQAA tells us of the investments made to the property in the last twelve months. These include improvements to the grounds. Various parts of the building have been redecorated including seven bedrooms. All rooms have new beds that help people with poor mobility and everyone has had new bed linens.Three bedrooms have had new furniture and special pressure mattresses have been purchased. Bathrooms and toilets have been adapted for safety and ease of use.Bathroom flooring has been replaced.The AQAA contained plans for further development. The manager also says that they have increased the number of hours spent on domestic tasks so that the home remains clean and orderly. The main kitchen has had improvements made and retains its Excellent rating from Environmental health. The manager has reviewed the staffing arrangements in the home and this has helped increase hours for care, catering, activities and housekeeping. Two staff are now classed as care supervisors and they each have two days a week when they are supernumerary. This helps with giving people specific care that is written into their care plans. All staff in the home have National Vocational Qualifications in care at level 2. Ten people have been working on level 3. The two supervisors are undertaking a management course and are working toward NVQ level 4 in care. Everyone in the home does yearly core training and all staff - care and non care - do dementia training. The manager has focused on looking at updates to understanding and working with dementia. There is a training plan in place for the coming year. New staff only start to work after their background has been checked and they have completed an induction. They are then mentored by a more experienced member of staff. The manager of this home has devised her own specific quality monitoring system. She sends us regular updates of how this monitoring is being done and changes brought about due to this. There are regular resident meetings and relatives are invited in to talk in a group and individually. Staff meetings, supervision, appraisal and mentoring sessions are all built into the management systems. The AQAA gives plenty of evidence that the management systems are constantly improved to help people have excellent standards of care. Annual Service Review Page 5 of 8 Here are some quotes from people who live in the home or from their families: Very caring staff... I could not wish for a better place for my mother...we are very happy with the quality of care she receives. Do everything well..... Excellent food.... Good care and attention.... The staff treat each person with lots of patience and understanding...encourage them in activities...You are made to feel as if time is of no importance when it comes to care...nothing is too much trouble..... The staff surveys confirmed what was said in the AQAA about the delivery of care, recruitment, training and management. Everybody is caring and work well as a team.... Its not like a care home...its just a big house where a lot of people live and its a happy and friendly place. Makes sure no one is discriminated against. The atmosphere and working conditions are excellent. Everyone - residents and staff are well looked after. We are a good team and we follow the training we are given...The home is improving all the time. Staff dont always agree but we are respectful of one another. There is a lot of training that I enjoy. A lot of work has been carried out recently...improving all the time. I get opportunities to expand my knowledge and skills. We also received surveys from social workers and health care providers: They work with people with complex needs in a caring, professional manner...minimising the use of medications.... I have no concerns about my patients care ....use reassurance and support to manage difficult behaviour.... The staff team are well managed and this creates the happy atmosphere. Annual Service Review Page 6 of 8 What are we going to do as a result of this annual service review? This review has not changed our opinion of the service and we will continue to monitor the way the home operates. We plan to do a key inspection, where we visit the service and look at all aspects of the operation, no later than the end of October 2011. 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