Care Home: Grange Care Centre, The

What the care home does well The home is being very effectively managed and the management style promotes an atmosphere of openness and communication. Prospective residents are fully assessed prior to admission and the processes in place ensure the home is able to fully meet their needs. Service user plan documentation is well formulated, personalised and up to date, providing a clear picture of each residents needs. The privacy and dignity of the residents is prioritised and there is an excellent, happy atmosphere throughout. Information regarding residents` end of life care wishes has been sought and recorded. The activities provision is very good and residents are encouraged to participate in a range of individual and group activities. The wishes of the residents regarding their involvement with activities are respected. The home has an 24 hour open visiting policy and visiting is encouraged. Information regarding advocacy services is available. The food provision is good, offering variety and choice, and input from the residents regarding the menus is sought. The complaints procedure is on display throughout the home and complaints are dealt with appropriately. Safeguarding Adults procedures are in place and are followed, and any issues are reported promptly. The home provides a good environmental standard and there is an ongoing redecoration and refurbishment programme in place. Procedures for infection control are in place and are followed, thus minimising risks. The home is appropriately staffed to meet the needs of the residents, and the staffing is adjusted in accordance with resident dependency. Ancillary staff are employed in such numbers as to meet the needs of the home. Staff training opportunities are excellent with the majority of care staff having qualified to NVQ in care level 2 or above, and ongoing training programmes in progress. The induction programmes for all new staff are also very thorough. There are clear systems in place for quality assurance and results of surveys and meetings do influence the ongoing planning in this area. Personal monies held on behalf of residents are being well managed and securely stored. Staff receive individual supervision on a regular basis and this is based on clear guidelines. Health & safety is being well managed at the home. CSCI surveys received from residents, staff and visitors were very positive and indicated that the home is being effectively managed, the care provision is good and that staff are appropriately trained to meet the needs of the residents. What has improved since the last inspection? Service user plan documentation completion and updating has improved, to include the completion of assessments. Medication management has improved, and action is being taken to address the findings from the recent CSCI Pharmacist Inspection. Care plans for activities are now more personalised to reflect individual interests. Residents are being offered a choice of meals and their choices are being recorded and provided. What the care home could do better: There are no requirements from this inspection and the home is being well managed in all areas. 2 good practice recommendations have been made. CARE HOMES FOR OLDER PEOPLE Grange Care Centre, The The Grange Care Centre 2 Adrienne Avenue Southall Middlesex UB1 2QW Lead Inspector Mrs Clare Henderson Roe Key Unannounced Inspection 14th January 2008 10:55 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 Grange Care Centre, The DS0000063541.V356876.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. Grange Care Centre, The DS0000063541.V356876.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Grange Care Centre, The Address The Grange Care Centre 2 Adrienne Avenue Southall Middlesex UB1 2QW 020 8832 8600 020 8832 8601 manager.grange@lifestylecare.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) Life Style Care (2005) Plc Ms Deborah Noela Northrop Care Home 160 Category(ies) of Dementia (10), Dementia - over 65 years of age registration, with number (94), Old age, not falling within any other of places category (46), Physical disability (10) Grange Care Centre, The DS0000063541.V356876.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 25th September 2006 Brief Description of the Service: The Grange Care Centre is a purpose built care home and is situated in Greenford off the Ruislip Road. It is easily accessed via public transport and the A40. The home is divided into 8 units. On each unit there are three communal areas. Each unit has two serveries where staff can provide drinks and snacks for residents and visitors. All bedrooms are single with en suite facilities, consisting of toilet and wash hand basin, with 50 also containing shower facilities. There are assisted bath and shower facilities, plus additional toilet facilities in each unit. Each floor has an activities room. On the first floor there is a hairdressing salon and a cafe. There is dedicated storage space for the hoists and wheelchairs on each unit. There is a dedicated servicing area on the second floor where the laundry and kitchens are situated. There are several staff changing facilities and two staff rooms. A ‘relatives’ room, training rooms and additional staff areas are available on the third floor. There is a wellmaintained enclosed garden that backs onto the canal. Fees range from £566.50 to £1000 per week dependent on assessed need. Grange Care Centre, The DS0000063541.V356876.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 2 star. This means the people who use this service experience good quality outcomes. This was an unannounced inspection carried out as part of the regulatory process. A total of 26 hours was spent on the inspection process, and was carried out by 2 Inspectors. The Inspectors carried out a tour of the home, and service user plans, staff rosters, staff records, financial & administration records and maintenance & servicing records were viewed. A CSCI Pharmacist Inspector carried out an inspection of the medication management on 28/12/07 and a separate report is available. 21 residents, 24 staff, 9 visitors and one healthcare professional were spoken with as part of the inspection process. The pre-inspection Annual Quality Assurance Assessment (AQAA) document completed by the home, plus comment cards from residents, representatives/visitors and health & social care professionals have also been used to inform this report. What the service does well: The home is being very effectively managed and the management style promotes an atmosphere of openness and communication. Prospective residents are fully assessed prior to admission and the processes in place ensure the home is able to fully meet their needs. Service user plan documentation is well formulated, personalised and up to date, providing a clear picture of each residents needs. The privacy and dignity of the residents is prioritised and there is an excellent, happy atmosphere throughout. Information regarding residents’ end of life care wishes has been sought and recorded. The activities provision is very good and residents are encouraged to participate in a range of individual and group activities. The wishes of the residents regarding their involvement with activities are respected. The home has an 24 hour open visiting policy and visiting is encouraged. Information regarding advocacy services is available. The food provision is good, offering variety and choice, and input from the residents regarding the menus is sought. The complaints procedure is on display throughout the home and complaints are dealt with appropriately. Safeguarding Adults procedures are in place and are followed, and any issues are reported promptly. The home provides a good environmental standard and there is an ongoing redecoration and refurbishment programme in place. Procedures for infection control are in place and are followed, thus minimising risks. The home is appropriately staffed to meet the needs of the residents, and the staffing is adjusted in accordance with resident dependency. Ancillary staff are employed in such numbers as to meet the needs of the home. Staff training opportunities are excellent with the majority of care staff having qualified to NVQ in care level 2 Grange Care Centre, The DS0000063541.V356876.R01.S.doc Version 5.2 Page 6 or above, and ongoing training programmes in progress. The induction programmes for all new staff are also very thorough. There are clear systems in place for quality assurance and results of surveys and meetings do influence the ongoing planning in this area. Personal monies held on behalf of residents are being well managed and securely stored. Staff receive individual supervision on a regular basis and this is based on clear guidelines. Health & safety is being well managed at the home. CSCI surveys received from residents, staff and visitors were very positive and indicated that the home is being effectively managed, the care provision is good and that staff are appropriately trained to meet the needs of the residents. 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. Grange Care Centre, The DS0000063541.V356876.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 Grange Care Centre, The DS0000063541.V356876.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. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Prospective residents are fully assessed prior to admission, thus the home ensures they are able to meet each persons needs. EVIDENCE: The home has a comprehensive pre-admission assessment document that provides a good picture of the resident and their needs. This is completed for all prospective residents in order to ascertain if the home is able to fully meet their needs. Completed assessments were viewed on each unit and had been well completed. The home also obtains a copy of the needs led assessment undertaken by social services. The Registered Manager reviews all preadmission documentation to ascertain that the home can meet their needs and then determines the most appropriate unit for the person to be admitted to. Grange Care Centre, The DS0000063541.V356876.R01.S.doc Version 5.2 Page 9 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9, 10 & 11. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The service user plan documentation is well completed to provide staff with the information to meet each resident’s needs. Medications are being well managed at the home, with shortfalls being promptly addressed, thus safeguarding residents. Staff care for residents in a gentle and professional manner, respecting their privacy and dignity. The home provides good end of life care, thus ensuring that residents and their families have their wishes and needs fully discussed, recorded and met. EVIDENCE: Service user plans were sampled on each unit. These had been well completed to provide staff with information about each residents needs and how these are to be met. Comment was received that on one unit some of the information was ‘standardised’ and not personalised and this was discussed with the Team Leader who took action to personalise the care plans for the second day of inspection. All the other care plans viewed had been personalised. The service user plan documentation had been reviewed monthly and when a residents’ condition had changed, for example, following a hospital admission. There was Grange Care Centre, The DS0000063541.V356876.R01.S.doc Version 5.2 Page 10 evidence of input from the residents and/or their representatives. Risk assessments for falls and other identified areas of risk had been completed and updated following any falls or other relevant events. Risk assessments for the use of bedrails had been completed and written consents for their use obtained. Wound care documentation was viewed. Care plans were in place and body charts and photographs of wounds were available plus wound treatment, assessment and dressing record documentation had been completed. In one instance more than one wound had been included on one care plan and the Inspector recommended that a separate care plan be formulated for each wound. Pressure sore risk assessments were in place for all residents and the specific pressure relieving equipment in use for each resident had been identified. Moving & handling assessments were in place and the specific equipment to be used for each move had been documented. Nutritional assessments had been carried out and there was evidence of weekly and monthly weight monitoring, depending on the residents identified needs. The Registered Manager carries out a weekly audit of weights and any concerns are referred to the GP and dietician. Continence assessments are carried out. There was evidence of input from healthcare professionals to include GP, tissue viability nurse, dietician, speech & language therapist, physiotherapist, chiropodist, optician and dentist. The CSCI Pharmacist Inspector carried out a medication inspection on 28/12/07 and a separate report is available. The Inspectors discussed the 4 requirements and 2 recommendations made in that report with the Registered Manager who was able to confirm that action had been taken to address all of the shortfalls identified. Staff were seen caring for residents in a gentle, caring and professional manner and excellent interaction between residents, relatives and staff was observed on both days of the inspection. Residents’ preferences in respect of personal care givers to include gender was clearly recorded. Bedrooms had been personalised and there was a very homely feel throughout. Residents can have their own telephones, either mobile or landline. At the time of inspection 2 residents became unsettled and requested to speak with their families and staff arranged promptly for them to telephone a relative for reassurance. The home has adopted ‘The Dignity Challenge’ – a document formulated in respect of maintaining dignity. This has a list of areas regarding dignity and individuality and the home has recorded their evidence as to how they meet each one. This document is read by all staff who sign to say they have done so. The Registered Manager carries out a dignity audit 6 monthly. Residents were well groomed and dressed to reflect individuality. Clothing viewed in the laundry room had been labelled with the each residents’ name or room number. Where a resident refuses an element of personal care, for example, shaving, this is recorded. The home is to be commended in this area of care provision. Grange Care Centre, The DS0000063541.V356876.R01.S.doc Version 5.2 Page 11 Information is obtained on admission or soon after regarding the wishes of the residents and their relatives in respect of end of life care. A new document has been introduced and is discussed with the resident by both a senior member of staff and the GP to fully ascertain their wishes, and everyone involved in the discussion signs the document. This information can be reviewed and changed at any time, should the wishes of the resident alter. As a residents condition deteriorates then a care plan for end of life care is formulated. Facilities are also available for relatives to stay at the home should they wish to stay close to their loved one in their final days. Grange Care Centre, The DS0000063541.V356876.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 & 15. Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. The activities provision is good and varied, and each residents’ right to choose to join in is respected, thus meeting their individual needs and wishes. The home has an 24 hour open visiting policy, thus encouraging residents to maintain contact with family and friends. Information regarding advocacy services is available, thus ensuring the residents’ right to independent representation is respected. The food provision in the home is good, offering variety and choice, with resident’s choices being respected. EVIDENCE: Activities were taking place in each unit, and staff are involved in carrying out activities with the residents every morning and afternoon. The activities programme is displayed throughout the home and in the bedrooms. The home employs 2 full-time and 1 part-time activities co-ordinators who arrange the individual activities programmes for each unit and also arrange the activities in the designated activity and games rooms, plus outings and entertainments. An art teacher attends the home 3 times a week and residents were seen thoroughly enjoying the art class in the designated art room, where examples of the residents’ artwork were on display, plus in the reception area. The home Grange Care Centre, The DS0000063541.V356876.R01.S.doc Version 5.2 Page 13 has internet facilities and residents can access this. The ‘Busy Lizzie’ café is on the first floor, and is open twice a week, so that residents and relatives can meet and enjoy refreshments together in a café style environment. The Registered Manager also stated that plans are in place for a cinema room and small bar area. The ethos of the home is to provide facilities within the home that residents from each unit can access and enjoy. Schoolchildren from a local school visit each week, supervised by a teacher, and do activities with the residents. A Christian meeting takes place every Thursday and any resident who wishes can join in. There are no equality and diversity issues at present in the home, and should residents with other religious and cultural needs be admitted, then appropriate religious representatives can be contacted by the home. Residents are asked about their interests and hobbies and if they would like to join in activities, and their choice is respected. The home is to be commended on their activity provision. The home has a 24 hour open visiting policy and visiting is encouraged. Visitors spoken with said that they are made very welcome at the home and refreshments are offered. Visitors commented about the homely atmosphere throughout, and one relative said that ‘it is like one big, happy family here’. Another described it as ‘a home from home’. Residents can choose to receive visitors in their own bedrooms or in one of the communal rooms, as they so wish. Information regarding advocacy services was displayed in the main entrance of the home. The home has contact with Age Concern, Alzheimers Concern and various advocacy services to provide financial advice. One Inspector viewed the kitchen. This was clean and tidy and all the records were up to date. Residents are offered a choice of meals and documentation to evidence this was available. There are two main meal choices for lunchtime, however for any meal alternatives can be and are provided. The menus are available and each dining room has a menu board where the choices for each meal are clearly written and displayed. Residents spoken with said that overall they do enjoy the food, and comments received were fed back to the Registered Manager in general terms. Soft diet and Pureed meals are well presented. The Inspectors sampled the lunchtime meal on both days of inspection and the food was well presented and tasty. Cakes are provided for all birthdays and special occasions. Relatives spoken with said that they are invited to partake of meals should they visit at these times, and also for celebrations such as Christmas. The Inspectors recommended that finger-foods be provided for residents who are restless and do not sit for the mealtime so that they can eat as they walk around. The Registered Manager said that she was already looking into various ways to provide an effective diet for these particular residents. Staff were available to assist residents with their meals as needed and have received training and are provided with guidelines to follow for any residents with eating difficulties, for example, swallowing problems. Grange Care Centre, The DS0000063541.V356876.R01.S.doc Version 5.2 Page 14 Drinks are provided in each bedroom and drinks and snacks are available throughout the 24 hour period. Grange Care Centre, The DS0000063541.V356876.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): 16 & 18. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home has clear complaints procedures in place to address any concerns raised by residents and their visitors. There is a robust system in place for the safeguarding of residents from abuse. EVIDENCE: The complaints procedure is displayed throughout the home and copies are available in the Statement of Purpose and Service User Guide. There had been 5 complaints in the last 12 months. These had all been fully investigated and responded to. A register of complaints is maintained and the documentation viewed was comprehensive. The Registered Manager has an ‘open door’ policy for residents, visitors and staff, and responds to any concerns raised. Residents, representatives and staff spoken with said that the Registered Manager is approachable and deals promptly with any issues. The home has adult protection policies and procedures in place that dovetail with the Ealing Safeguarding Adults documentation. Staff spoken with said that they had received POVA training and were clear to report any concerns. The Registered Manager and senior staff report any issues that might have a POVA element to them to the Ealing Safeguarding Adults Team, as well as informing CSCI. Grange Care Centre, The DS0000063541.V356876.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, 22 & 26. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is being well maintained, thus providing a clean, homely and safe environment for residents to live in. Procedures are in place for infection control and these are practiced, thus minimising the risk of infection. EVIDENCE: The home is purpose built and a tour of each unit was carried out. The premises are well maintained and residents are involved in colour choices for the décor. There is an ongoing programme of routine maintenance, redecoration and refurbishment and the Registered Manager carries out a 6 monthly environmental audit, from which the plan is formulated. Plans are in place to replace some of the furnishings that were showing signs of wear. Each unit has some rooms with flooring appropriate to meet continence care needs, and this can be arranged for other rooms should the need arise. The grounds are well-maintained and CCTV is in place on the outside of the building for security purposes. Grange Care Centre, The DS0000063541.V356876.R01.S.doc Version 5.2 Page 17 All the beds are profiling beds and each unit has moving & handling equipment appropriate to meet the needs of the residents. There are designated areas on each unit for the storage of such equipment and as a result of this other areas, such as bathrooms, are uncluttered and pleasant for residents to use. There are rails in the corridors and individual rails in the toilet facilities. One Inspector viewed the laundry facilities. The room was clean and the laundry was being well managed, to include personal clothing items. Good practice notices and laundering guidelines were on display. The washing machines have sluice programmes for infection control and there are 4 washing and 4 drying machines, all industrial standard. Protective clothing to include gloves and aprons was available throughout the home and goggles are provided in the laundry. Infection control procedures are in place and were being followed. The home was clean, bright and fresh throughout. Some of the bedrooms have flooring to assist with continence care needs and it was clear that the staff work very hard to maintain a good standard of cleanliness throughout the home. Grange Care Centre, The DS0000063541.V356876.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 & 30. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is appropriately staffed to ensure that the needs of the service users are met. Systems for vetting and recruitment practices are in place and protect residents. There is a comprehensive ongoing training programme, providing staff with the skills to meet the needs of residents, to include specialist care needs. EVIDENCE: At the time of inspection the home was appropriately staffed. Rosters evidence that where shortages occur with care staff either bank staff or agency staff are employed to cover the shifts concerned. The Registered Manager reviews resident dependency levels on an ongoing basis and adjusts the staffing accordingly to ensure the needs of the residents are met. The home also employs appropriate numbers of kitchen, domestic, activities, maintenance and administration staff to ensure the home runs effectively in all areas. 70 of care staff are qualified to NVQ level 2 in care or above and more staff are undertaking this training. As well as care staff, ancillary staff are also given the opportunity to study for an NVQ. The training matrix shows that all staff receive regular training and updates in topics relevant to the diagnoses and needs of the residents, and this was confirmed by staff spoken with. It was clear from the way staff care for residents that they have received effective training to carry out their work. Grange Care Centre, The DS0000063541.V356876.R01.S.doc Version 5.2 Page 19 Two sets of staff employment records were viewed. These contained all the information required under the Care Homes Regulations 2001. The home has 2 induction programmes. One is the Life Style general induction and the other meets the Skills for Care common induction standards. All staff complete both induction programmes and staff spoken with confirmed they had done so. Grange Care Centre, The DS0000063541.V356876.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, 36 & 38. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The Registered Manager has the skills, experience and acumen to manage the home effectively and promotes an atmosphere of openness and respect, thus making residents, visitors and staff feel valued. Systems for quality assurance are in place, thus providing an ongoing process of review and feedback. Resident’s monies are well managed and securely stored. Systems for the management of health and safety throughout the home are good, thus safeguarding residents, staff and visitors. EVIDENCE: The Registered Manager is a first level registered nurse with a mental health qualification and the Registered Managers Award, NVQ level 4. She has extensive experience managing care homes for older people and does so with a calm, open attitude, always holding as a priority the well-being of the Grange Care Centre, The DS0000063541.V356876.R01.S.doc Version 5.2 Page 21 residents in her care. Residents, visitors and staff spoken with said that the Registered Manager is very approachable and works hard to address any issues promptly and effectively. Comment was also made about the fact that the Registered Manager visits each unit frequently and there is a management hand-over every morning so that the Registered Manager keeps fully up to date with the condition of each resident. This is a very large care home and the Registered Manager is to be commended for her excellent management skills. The Deputy Manager also works very hard and effectively and supports the Registered Manager and staff well. The home has effective systems in place for quality assurance. A full home audit is carried out monthly and this covers all aspects of the home and the care provision. The Registered Manager and Operations Director are both involved in the home audits. Relatives meetings are held every 2 months plus the Registered Manager and senior staff are available for individual meetings with relatives. Staff meetings take place 1-2 monthly and unit meetings are held to address any specific issues. Residents meetings are held monthly on each unit, and there is a structure in the form of questions about food, care, activities and contact. Residents’ responses for each question are individually recorded and action taken to address any concerns raised. The home holds personal monies for some residents and clear computerised records are kept. Receipts are available for all income and expenditure. Residents and their families can choose either to leave some money with the home or to be invoiced for any expenditure for items such as hairdressing, chiropody, newspapers and outings. The records and amounts held for 4 residents were checked and found to be correct. There are clear systems in place for the management of any personal monies held on behalf of residents. There was evidence that all staff receive supervision on a regular basis. There is a supervision contract drawn up between the supervisor and supervisee and the sessions cover any practice issues, training & development and relevant other areas. Samples of servicing and maintenance records were viewed and those viewed were clear and up to date. The home employs two full time maintenance people. There is a maintenance book where staff report any repairs required, and once the repair has been done this is signed off in the book to evidence this. Fire drills were taking place for both day and night staff. The fire risk assessment had been reviewed in January 2008. Risk assessments for equipment and safe working practices were in place, with relevant copies in the kitchen and laundry areas. The training matrix evidenced that staff had received health & safety training to include moving & handling, fire awareness, food safety, first aid, COSHH, POVA and infection control. Staff spoken with said that they receive training in all health & safety topics, with regular updates being provided. Grange Care Centre, The DS0000063541.V356876.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 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 3 8 3 9 3 10 4 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 4 13 4 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X 3 X X X 3 STAFFING Standard No Score 27 3 28 4 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 4 X 3 X 3 3 X 3 Grange Care Centre, The DS0000063541.V356876.R01.S.doc Version 5.2 Page 23 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. 2. Refer to Standard OP7 OP15 Good Practice Recommendations That a separate care plan be formulated for each wound. That a menu be devised specifically to meet the needs of residents who wander and do not settle to eat a meal. Grange Care Centre, The DS0000063541.V356876.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection West London Local Office 11th Floor, West Wing 26-28 Hammersmith Grove London W6 7SE 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 Grange Care Centre, The DS0000063541.V356876.R01.S.doc Version 5.2 Page 25 - 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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