Care Home: Grange View

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What the care home does well Full assessments of needs were undertaken on all people to ensure their needs were identified and could be met. Risk assessments were in place and people were able to take risks as part of an independent lifestyle. Good community links were maintained and people were well integrated into the community. There was a good relationship maintained with the neighbours and the wider community that had a positive effect on people. The home had a good complaints procedure and a robust adult safeguarding policy. The environment was homely, and well maintained and the standard of cleanliness was good, providing a safe environment for the people that live there. Staff training was up to date, including NVQ training. Recruitment procedures were robust protecting people who lived at the home. What has improved since the last inspection? Care plans have all been rewritten the ones we looked at were comprehensive identified peoples needs and had measures in place to meet those needs. Reviewing officers from Rotherham Councils, Learning disability team had been involved in developing the new care plans. The plans were very good. Any actions from reviewes were captured in the care plans, which the manager told us would be regularly reviewed to reflect people`s changing needs. Community links and social activities had improved with peoples choices taken into consideration. The manager also told us this was being improved further to make it person centred ensuring peoples needs were met. The manager had again improved the meals in consultation with the people living at Grange view. The people took packed lunches to the day centres and had a main meal in the evening. This was the peoples choice and meets their needs. There was a good selection of food available at the time of the visit and plenty of fresh vegetables and fruit ensuring people received a balanced wholesome diet. What the care home could do better: The provider told us he had identified that the wiring although met the required standard was old, he therefore intented to have the house rewired as he had his other homes. This was in the homes maintenance and renewal plan to be carried out in the next four months. Key inspection report Care homes for adults (18-65 years) Name: Address: Grange View 69 Grange Lane Maltby Rotherham South Yorkshire S66 7DN     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home 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 full review a ‘key’ inspection. Lead inspector: Sarah Powell     Date: 0 7 0 1 2 0 1 0 This is a review of quality of outcomes that people experience in this care home. We believe high quality care should • • • • • Be safe Have the right outcomes, including clinical outcomes Be a good experience for the people that use it Help prevent illness, and promote healthy, independent living Be available to those who need it when they need it. The first part of the review gives the overall quality rating for the care home: • • • • 3 2 1 0 stars - excellent stars - good star - adequate star - poor There is also a bar chart that gives a quick way of seeing the quality of care that the home provides under key areas that matter to people. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Care Homes for Adults (18-65 years) Page 2 of 26 We review the quality of the service against outcomes from the National Minimum Standards (NMS). Those standards are written by the Department of Health for each type of care service. Copies of the National Minimum Standards – Care Homes for Adults (18-65 years) can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The mission of the Care Quality Commission is to make care better for people by: • Regulating health and adult social care services to ensure quality and safety standards, drive improvement and stamp out bad practice • Protecting the rights of people who use services, particularly the most vulnerable and those detained under the Mental Health Act 1983 • Providing accessible, trustworthy information on the quality of care and services so people can make better decisions about their care and so that commissioners and providers of services can improve services. • Providing independent public accountability on how commissioners and providers of services are improving the quality of care and providing value for money. Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report Care Quality Commission General public 0870 240 7535 (telephone order line) Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 26 Information about the care home Name of care home: Address: Grange View 69 Grange Lane Maltby Rotherham South Yorkshire S66 7DN 01709817963 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Moorcroft Care Homes Ltd care home 3 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 learning disability Additional conditions: The maximum number of service users who can be accommodated is: 3 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 category: Learning disability Code LD Date of last inspection Brief description of the care home Grange View is a small home providing personal care and accommodation for two adults who have learning disabilities. The house is situated on one of the main bus routes into Maltby. It is in walking distance of Maltby centre and has the advantages of a good selection of shops and supermarkets. The house is an end terraced property with two main bedrooms and two second bedrooms one of which is used as a staff sleeping in room and the other has been converted in to an activity room. The communal areas are a living room with TV, a separate dining room leading into a kitchen with a shower/WC adjacent. There is a bathroom on the first floor with WC. Residents have access to a rear garden that is fenced off from the neighbours. The Care Homes for Adults (18-65 years) Page 4 of 26 Over 65 0 3 Brief description of the care home fees at Grange View were £770 per week but this will vary depending on the needs of the people so for further information contact the home. The registered person makes information about the service available to residents and their families via the Statement of Purpose, and the Service User Guide. Care Homes for Adults (18-65 years) Page 5 of 26 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Individual needs and choices Lifestyle Personal and healthcare support Concerns, complaints and protection Environment Staffing Conduct and management of the home peterchart Poor Adequate Good Excellent How we did our inspection: The quality rating for this service is 2 star. This means that the people who use this service experience good quality outcomes. We have reviewed our practice when making requirements, to improve national consistency. Some requirements from previous inspection reports may have been revised or carried forward into this report as recommendations but only when it is considered that people who use services are not being put at significant risk of harm. In future, if a requirement is repeated, it is likely that enforcement action will be taken. This was an unannounced visit, which took place on 7th January 2010, commenced at 15:00 and finished at 19:00 hours. The purpose of the visit was to make sure that the home was operating and being managed in the best interests of people living there. Information has been used from Care Homes for Adults (18-65 years) Page 6 of 26 different sources for this report. These sources include Reviewing information that has been received about the home since the last inspection. The annual quality assurance assessment. The manager had completed an annual quality assurance assessment (AQAA). The AQAA focuses on how well outcomes are being met for the people using the service. It also gives us some numerical information about the service. The information in the AQAA was detailed and comprehensive Notifications (Regulation 37) relating to incidents in the home affecting people using the service. We spoke to the people living at Grange View and two members of staff. At the site visit one inspector spent 4 hours at the home. During this time observation of interactions between staff and residents and care practices took place. We spent time looking at care plans, medication records, staff rotas, looking at individual rooms and reviewing a selection of health and safety information, staff recruitment and training records and management. Full feed back was given to the manager during the visit and at the end of the visit full feedback was given to the providers. Care Homes for Adults (18-65 years) Page 7 of 26 What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details on page 4. Care Homes for Adults (18-65 years) Page 8 of 26 The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line 0870 240 7535. Care Homes for Adults (18-65 years) Page 9 of 26 Details of our findings Contents Choice of home (standards 1 - 5) Individual needs and choices (standards 6-10) Lifestyle (standards 11 - 17) Personal and healthcare support (standards 18 - 21) Concerns, complaints and protection (standards 22 - 23) Environment (standards 24 - 30) Staffing (standards 31 - 36) Conduct and management of the home (standards 37 - 43) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Adults (18-65 years) Page 10 of 26 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: 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 in. This tells the home all about them, what they hope for and want to achieve, and the support they need. People can decide whether the care home can meet their support and accommodation needs. This is because they, and people close to them, can visit the home and get full, clear, accurate and up to date information. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between the person and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People in the home had their needs assessed prior to moving into the home to ensure they could be met. Evidence: The two people that lived at Grange view had lived there many years, however the assessments of needs were available. These had been updated to ensure all people had a full up to date assessment of needs in their plans of care. The assessments were comprehensive and clearly detailed the needs of the person to ensure the home could meet peoples needs. The information from the placing authority was also available in the persons plan of care. Care Homes for Adults (18-65 years) Page 11 of 26 Individual needs and choices These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s needs and goals are met. The home has a plan of care that the person, or someone close to them, has been involved in making. People are able to make decisions about their life, including their finances, with support if they need it. This is because the staff promote their rights and choices. People are supported to take risks to enable them to stay independent. This is because the staff have appropriate information on which to base decisions. People are asked about, and are involved in, all aspects of life in the home. This is because the manager and staff offer them opportunities to participate in the day to day running of the home and enable them to influence key decisions. People are confident that the home handles information about them appropriately. This is because the home has clear policies and procedures that staff follow. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Each person in the home had a full assessment of needs, from which plans of care had been generated. People were treated with respect, were able to make some decisions about their lives and take risks as part of an independent lifestyle. Evidence: Each person had a plan of care generated from the assessments of needs. The plans were person centred and had been drawn up with the involvement of the person. The plans had been rewritten since the last key inspection and were very good. The care plans were comprehensive, had identified all needs and how to meet them. Risks had also been identified and risk management measures in place to ensure people were able to lead the life they wanted. Peoples limitations due to their disabilities were clearly recorded and people we spoke to told us that staff understood their problems and how to look after them. The plans were drawn up with the involvement of the person and their families, the Care Homes for Adults (18-65 years) Page 12 of 26 Evidence: plans were made available in formats that people were able to understand ensuring peoples goals and aspirations were included. This showed that people were able to make decisions about their lives. Staff we spoke to told us that the care plans were really good they understood what was written and how to meet peoples needs. They also told us that the recording of any changes was always carried out, this ensured peoples needs were identified and met. The manager had also included evidence that the mental capacity act had been taken into consideration, with regard to peoples capacity and choices this ensured peoples needs were identified and met allowing them to make choices and decisions regarding their care. Care Homes for Adults (18-65 years) Page 13 of 26 Lifestyle These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. 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. People are able to keep in touch with family, friends and representatives and the home supports them to have appropriate personal, family and sexual relationships. People are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. Their dignity and rights are respected in their daily life. People have healthy, well-presented meals and snacks, at a time and place to suit them. People have opportunities to develop their social, emotional, communication and independent living skills. This is because the staff support their personal development. People choose and participate in suitable leisure activities. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People had a say about how they lived their life and were supported to achieve goals and aspirations. This meant that people had a lifestyle they were happy with. Evidence: The two people attend day centres Monday to Friday from 9:00 until 16:00, this is an important part of their lives and well liked by both people. There was evidence to indicate that community links were maintained and that the people were well integrated into the community. There was a good relationship maintained with the neighbours and the wider community that had a positive effect on people. The manager told us one person still regularly saw her friend who lives further down the street. Staff told us friends and relatives were always made welcome and there were facilities Care Homes for Adults (18-65 years) Page 14 of 26 Evidence: for people to have visitors to the house, they were able to choose who to see and when to see them. One person sees her family every weekend, which maintains good family links for her. Another person with help from staff had recommenced contact with her family and she was enjoying the contact again, it was having a positive effect on her well being. Grange View is situated close to the village centre, people were able to walk or get a bus there for shopping trips, or visit for a meal or go to the pub. The people have enjoyed many trips out but staff told us shopping still remains the favourite activity for them. The manager told us she was improving the provision of one to one activities as this had been limited at previous visits. However she said staff were trying to get people interested in new social activities as they tended to want to do the same things. The one to one activities enabled people to do activities of their choice ensuring their needs were met. The manager had again reviewed the meals and menus and had improved the food provided. This had been in consultation with people and relatives to ensure peoples choices were considered. We looked at the menus they were much improved with fresh vegetables and meat used. There was fresh fruit and vegetable available on the day of the visit. The changes had also included the provision of a packed lunch each day the people attended the day centre, with the main meal in the evening. This was much preferred by the people and ensured the Manager and staff were able to monitor the peoples diet to ensure they received a wholesome nutritious diet. Care Homes for Adults (18-65 years) Page 15 of 26 Personal and healthcare support These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People receive personal support from staff in the 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 medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it in a safe way. If people are approaching the end of their life, the care home will respect their choices and help them to feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Personal support was sensitive and flexible and peoples health care needs were met. Medication policies and procedures were good. Evidence: Peoples health care needs were identified in their person centred care plan, we looked at both peoples care plans and their needs were identified and measures in place to ensure these were met. Staff we spoke to were able to tell us peoples needs and how these were met. People told us that staff were good and looked after them. We looked at medication procedures, these were good and safeguarded people. Medication was documented on receipt, administration and disposal. Medication totals including what was carried over from the previous month were recorded on the chart, this reduced errors and safeguard people. Staff we spoke to were aware of correct procedures to follow to ensure medication was administered when prescribed and the need for accurate records to be kept to ensure people Care Homes for Adults (18-65 years) Page 16 of 26 Evidence: received the correct medication. Care Homes for Adults (18-65 years) Page 17 of 26 Concerns, complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them, know how to complain. Their concern is looked into and action taken to put things right. The care home safeguards people from abuse, neglect and self-harm and takes action to follow up any allegations. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home had a good complaints procedure and a robust adult safeguarding policy, which protects the people living at Grange View. Evidence: There was a clear complaints procedure available in the home. The manager had received no complaint since the last visit. The systems in place in the procedure showed they would be dealt with appropriately and investigated ensuring people were listened to. There was a good policy and procedure on adult safeguarding. No safeguarding referrals had been received. Staff told us they were aware of the correct procedure to follow should an allegation be made to safeguard the people. Care Homes for Adults (18-65 years) Page 18 of 26 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, comfortable, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. People have enough privacy when using toilets and bathrooms. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Standard of cleanliness and environmental standards were good providing a homely, comfortable environment for the people that lived there. Evidence: The standard of cleanliness throughout the home was good the home was comfortable and homely. It was well maintained the manager told us all routine maintenance was carried out regularly to ensure the standards were maintained. One person showed us her bedroom, it was personalised and met her individual needs. Regular environmental audits were carried out and items requiring repair identified and rectified. This ensured people lived in a well maintained environment. Care Homes for Adults (18-65 years) Page 19 of 26 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent, qualified staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable. People’s needs are met and they are supported because staff get the right training, supervision and support they need from their managers. People are supported by an effective staff team who understand and do what is expected of them. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Staff were appropriately trained, the recruitment procedures were robust ensuring people were in safe hands at all times, had their needs met and were protected. Evidence: Staff training was up to date, the manager told us a training and development programme was followed. This ensured all staff received regular updates, ensuring peoples needs were met. The AQAA told us 75 of staff had achieved NVQ level 2 and three care staff had commenced level 3. This ensured people were supported by an effective staff team. Staff told us they received the training they needed to do their jobs. One new member of staff told us she had completed an induction and had completed all mandatory training apart from safeguarding, but this was booked for the following week. However she was able to tell us what adult safeguarding was and the procedures to follow if an alleged incident was reported. This ensured people were protected. The records we looked at showed that staff attended essential training. These included, first aid, food safety, fire safety, adult safeguarding, health and safety. Staff also received specialist training which helped them approach the more challenging elements of supporting people with confidence and competence. Care Homes for Adults (18-65 years) Page 20 of 26 Evidence: The recruitment procedures were robust. We looked at one staff file, it was well organised and contained evidence of all necessary checks being made. They included, criminal record checks, taking up references, interviews and verification of identification. This ensured the protection of people. Care Homes for Adults (18-65 years) Page 21 of 26 Conduct and management of the home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is run and managed appropriately. People’s opinions are central to how the home develops and reviews their practice, 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 practices are carried out. People get the right support from the care home because the manager runs it appropriately, with an open approach that makes them feel valued and respected. They are safeguarded because the home follows clear financial and accounting procedures, keeps records appropriately and makes sure staff understand the way things should be done. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Conduct and management of the home safeguarded people. Good health and safety policies and procedures were in place ensuring the safety of people who live at Grange View. Evidence: The registered manager is competent and qualified to run the home, she had completed her Registered Managers Award. The providers had good quality monitoring systems in place based on seeking peoples views. Regular meetings were carried out to ensure peoples views underpin development in the home. We saw minutes of these meetings and items identified during the meeting were actioned and resolved ensuring people were listened to. The home had a comprehensive health and safety policy. We were able to evidence that regular maintenance of equipment and systems was carried out. Risk assessments were carried out on all safe-working practises, regular audits were Care Homes for Adults (18-65 years) Page 22 of 26 Evidence: carried out on the building and all accidents were properly recorded and reported ensuring people in the home were safeguarded. Care Homes for Adults (18-65 years) Page 23 of 26 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Adults (18-65 years) Page 24 of 26 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No Refer to Standard Good Practice Recommendations 1 7 Now that the person centred plans have been completed carry out regular reviews to ensure peoples changing needs are identified. Staff to continue to get people to try more varied social activities and encourage people to try new activities. 2 13 Care Homes for Adults (18-65 years) Page 25 of 26 Helpline: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. 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