Care Home: Grangewood Care Centre

What the care home does well Staff showed a good understanding of the needs of the people in their care. Care staff knew which residents required help to eat or drink and could identify those people who needed to have their fluid intake recorded. We examined the fluid charts and these were properly filled in and showed that people were receiving enough to drink. Staff kept good records of the care needs of people. The care plans were person centred and reflected the actual care needs of the people who use the service. We examined the arrangements made to protect people from pressure sores. Risk assessments in the care plans were reviewed and updated and actions detailed within the individual plan. There were good links established with supporting health professionals. All of the residents, including those who were frail or ill, looked clean and well cared for. People wore clean, matching and appropriate clothes. All those spoken to confirmed that they were helped to bathe or shower regularly. We observed that staff responded quickly when residents rang their call bell. We spoke with a number of residents and families who told us that staff respond quickly wheneverthey required assistance. There are detailed nutritional risk assessments in place with residents at risk being identified and appropriate nutritional care plans implemented. Those at risk are encouraged to eat, are weighed as required and included the involvement of the general practitioner, this was all documented. Those residents requiring catheter care were receiving good support from health professionals but the care plan did not give enough instruction to staff or adequately record the fluid intake and output. Staff were observed to transfer residents safely, using appropriate equipement and providing encouragement and support giving residents reassurance during these transfers. Small groups of residents were enjoying a range of varied activities around the home and there was a good range and choice of things to do. The use of pictorial choice boards enabled staff to have a greater understanding of individual wishes. The home had a social activities worker and it was evident that care staff also provide one to one support as an integral part of their role. Breakfast was observed to be a pleasant and social occasion. Staff assisted residents to eat in an appropriate and sympathetic way. Staff sat alongside residents while they were eating and we noted that they gave plenty of time for the residents to take their meal. The cook was aware of the dietary needs of all residents, as well as their likes and dislikes and this is reviewed three monthly. Residents and families said that the food served is well cooked and presented. Complaints and safeguarding issues were properly recorded. These had been reported to the appropriate authorities, including CQC. Staff had received training and guidance in the management of complaints and the recognition and management of abuse, with the majority of staff completing refresher training in the safeguarding of vulnerable adults. The home was very clean and tidy, no mal odours and staff were observed using satisfactory hygiene practices. There were good numbers of staff on duty to care for the current needs of the residents. There had been minimal staff turnover and staffing levels were good. All staff had undertaken or were undertaking National Vocational Qualification in Care level 2 or above which enabled residents to have care provided by a skilled and consistent staff team. Staff had undertaken training in Yesterday, Today and Tomorrow which enabled them to provide support for people with dementias, this was evident in the practices observed and the environment. The manager of the home was on secondment but the deputy and staff team had a clear understanding of the need to ensure that residents health, safety and welfare are protected. The provider undertakes quality assurance audits and regulation 26 visits. There was amanagement overview of accidents with risk assessments being updated and actions documented within the care plans. All notifications had been appropriately reported to CQC. What the care home could do better: The care plan for residents requiring catheter care must give clear instruction to staff and ensure that an accurate fluid intake and output is recorded, this will help improve the health and welfare of the resident. Random inspection report Care homes for older people Name: Address: Grangewood Care Centre Chester Road Shiney Row Houghton le Spring DH4 4RB two star good service The quality rating for this care home is: The rating was made on: 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. This is a report of a random inspection of this care home. A random inspection is a short, focussed review of the service. Details of how to get other inspection reports for this care home, including the last key inspection report, can be found on the last page of this report. Lead inspector: Mary Blake Date: 1 1 0 6 2 0 1 0 Information about the care home Name of care home: Address: Grangewood Care Centre Chester Road Shiney Row Houghton le Spring DH4 4RB 01913856644 01913856688 grangewood@schealthcare.co.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Miss Melanie Dawn Clarke Type of registration: Number of places registered: Conditions of registration: Category(ies) : Southern Cross OPCO Ltd care home 50 Number of places (if applicable): Under 65 Over 65 25 10 50 4 dementia mental disorder, excluding learning disability or dementia old age, not falling within any other category physical disability Conditions of registration: 0 0 0 0 The maximum number of service users who can be accommodated is: 50 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: Old age, not falling within any other category - Code OP, maximum number of places: 50 Dementia, over 65 years of age - Code DE(E), maximum number of places: 25 Mental Disorder, over 65 years of age, excluding learning disability or dementia - Code MD(E), Care Homes for Older People Page 2 of 9 maximum number of places: 10 Physical Disability, over 65 years of age - Code PD(E), maximum number of places: 4 Date of last inspection Brief description of the care home Grangewood Care Centre is a purpose built detached home standing in its own grounds in what could be described as the centre of the local community of Shiney Row. It has a patio and shrubbery to 3 sides of the building and has its own driveway and parking spaces. The accommodation consists of 50 single bedrooms offered over the ground and first floors, all of which have their own en suite toilet and a range of communal facilities. A passenger lift offers easy access to the first floor and the rear of the home has a patio area. All areas of the home, including the entrance offers good disabled access. Personal care is provided to people over the ages 65 years, some people may also have a physical disability, diagnosed dementia or mental health. Easy access is available to the local shops, post office and the GP surgery is adjacent to the home. A local bus service, which offers access to the city centre, Chester le Street and Washington, is nearby. The home has developed a Service User Guide to inform interested people about the services offered. The range of fees charged are available from the home Additional charges are made for hairdressing, chiropody, newspapers and toiletries. Care Homes for Older People Page 3 of 9 What we found: The quality rating for this service is two stars. This means the people who use this service experience good quality outcomes. We have reviewed our practice when making requirements. Some requirements from previous inspection reports may have been deleted or carried forward to this report as recommendations. This will only happen when it is considered that people who use the service 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. The last key unannounced inspection of the home was in 2008. This inspection was carried out to ensure that the service was still operating at a good level. Before the visit we looked at information we received since the last visit to the home. This includes how the service dealt with any complaints, changes to how the home is run, the views of people who use the service and the managers views of how well they care for people. During the visit we talked with people who use the service, some staff and the deputy manager. We focused mostly on the personal and health care of people who use the service and checked staffs understanding of the care required by the people living in the home. We also looked at any previous requirements and recommendations to see if these had been met. Following the inspection feedback was given to the deputy manager. What the care home does well: Staff showed a good understanding of the needs of the people in their care. Care staff knew which residents required help to eat or drink and could identify those people who needed to have their fluid intake recorded. We examined the fluid charts and these were properly filled in and showed that people were receiving enough to drink. Staff kept good records of the care needs of people. The care plans were person centred and reflected the actual care needs of the people who use the service. We examined the arrangements made to protect people from pressure sores. Risk assessments in the care plans were reviewed and updated and actions detailed within the individual plan. There were good links established with supporting health professionals. All of the residents, including those who were frail or ill, looked clean and well cared for. People wore clean, matching and appropriate clothes. All those spoken to confirmed that they were helped to bathe or shower regularly. We observed that staff responded quickly when residents rang their call bell. We spoke with a number of residents and families who told us that staff respond quickly whenever Care Homes for Older People Page 4 of 9 they required assistance. There are detailed nutritional risk assessments in place with residents at risk being identified and appropriate nutritional care plans implemented. Those at risk are encouraged to eat, are weighed as required and included the involvement of the general practitioner, this was all documented. Those residents requiring catheter care were receiving good support from health professionals but the care plan did not give enough instruction to staff or adequately record the fluid intake and output. Staff were observed to transfer residents safely, using appropriate equipement and providing encouragement and support giving residents reassurance during these transfers. Small groups of residents were enjoying a range of varied activities around the home and there was a good range and choice of things to do. The use of pictorial choice boards enabled staff to have a greater understanding of individual wishes. The home had a social activities worker and it was evident that care staff also provide one to one support as an integral part of their role. Breakfast was observed to be a pleasant and social occasion. Staff assisted residents to eat in an appropriate and sympathetic way. Staff sat alongside residents while they were eating and we noted that they gave plenty of time for the residents to take their meal. The cook was aware of the dietary needs of all residents, as well as their likes and dislikes and this is reviewed three monthly. Residents and families said that the food served is well cooked and presented. Complaints and safeguarding issues were properly recorded. These had been reported to the appropriate authorities, including CQC. Staff had received training and guidance in the management of complaints and the recognition and management of abuse, with the majority of staff completing refresher training in the safeguarding of vulnerable adults. The home was very clean and tidy, no mal odours and staff were observed using satisfactory hygiene practices. There were good numbers of staff on duty to care for the current needs of the residents. There had been minimal staff turnover and staffing levels were good. All staff had undertaken or were undertaking National Vocational Qualification in Care level 2 or above which enabled residents to have care provided by a skilled and consistent staff team. Staff had undertaken training in Yesterday, Today and Tomorrow which enabled them to provide support for people with dementias, this was evident in the practices observed and the environment. The manager of the home was on secondment but the deputy and staff team had a clear understanding of the need to ensure that residents health, safety and welfare are protected. The provider undertakes quality assurance audits and regulation 26 visits. There was a Care Homes for Older People Page 5 of 9 management overview of accidents with risk assessments being updated and actions documented within the care plans. All notifications had been appropriately reported to CQC. 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 set out on page 2. Care Homes for Older People Page 6 of 9 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, Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 7 of 9 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, 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 1 8 15 The care plan must include 23/07/2010 clear instruction to staff of the management of catheter care, this must include an accurate fluid intake and output record. To ensure catheter management and improve the health and welfare of residents 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 Care Homes for Older People Page 8 of 9 Reader Information Document Purpose: Author: Audience: Further copies from: Inspection Report Care Quality Commission General Public 0870 240 7535 (telephone order line) Our duty to regulate social care services is set out in the Care Standards Act 2000. Copies of the National Minimum Standards –Care Homes for Older People can be found at www.dh.gov.uk or got from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. 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