Care Home: Grangewood Lodge

What the care home does well A warm and welcoming atmosphere was quite apparent within this home that was managed to a high standard. People living at the home were happy and clearly felt at home and comfortable. Comments made demonstrated this, such as " I love it here, the staff are very kind, the food is very good and there`s always something to do" and " it`s a marvellous place, I`m so glad I decided to come here, I hope I never have to leave, I don`t know what I`d do". The staff team were positive and enthusiastic within there work. They demonstrated a caring and considerate approach to the people they supported. Throughout the inspection there was many times when staff were seen having a laugh and a joke or a singsong with the people living at the home, and this was clearly welcomed. The staff worked well as a team and this was apparent within general observations and through comments made by the staff. " we have an excellent team, we all get on, it`s really good" The records held regarding each persons support needs was detailed and regularly updated. This ensured staff had the relevant information they needed to support individuals. The manager ensured the management approach of the home created an open and inclusive approach. Staff were given opportunities within their daily duties to professionally develop. There was strong evidence that the ethos of the home was open and transparent, which ensured the views of the people living at the home, their representatives and the staff team were listened to and valued. What has improved since the last inspection? All of the requirements and recommendations that were made at the last inspection have been met. The service continues to develop through its own quality assurance processes and continues to provide a high standard of care and where areas of improvement emerge the services recognises and manages them well. What the care home could do better: Although the medication practices in place ensured peoples medicines were given in a safe way, some good practices measures were not in place, but were addressed immediately at this inspection visit. However to ensure the home is not relying on an inspection visit to keep up to date in this area, they should give consideration as to how they will keep themselves up to date regardingmedication practices in relation to any new legislation and good practices measures. CARE HOMES FOR OLDER PEOPLE Grangewood Lodge Netherseal Swadlincote Derbyshire DE12 8BH Lead Inspector Angela Kennedy Unannounced Inspection 30th July 2008 10:00 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 Grangewood Lodge DS0000019996.V369389.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. Grangewood Lodge DS0000019996.V369389.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Grangewood Lodge Address Netherseal Swadlincote Derbyshire DE12 8BH 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) (01827) 373577 www.grangewoodlodge.co.uk Mr John Frederick Fisher Ms Amanda Fay Hatfield Care Home 30 Category(ies) of Dementia - over 65 years of age (15), Old age, registration, with number not falling within any other category (30) of places Grangewood Lodge DS0000019996.V369389.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The provider is registered to provide personal care and accommodation for service users whose primary needs fall within the following category: Old age not falling within any other category (OP) 30. Dementia aged 65 and over (DE(E)) 15. Plus three day care place not regulated by Commission for Social Care Inspection. The maximum number of persons to be accommodated at Grangewod Lodge is 30. 16th August 2006 2. 3. Date of last inspection Brief Description of the Service: Grangewood Lodge is a care home registered to provide personal care and accommodation for up to 30 people in the category of Older Persons. It is located near to the village of Netherseal. The Home has extensive grounds, a patio area, and a car parking area. Grangewood Lodge has 26 single rooms, of which 17 have en-suite facilities, and there are also 2 double rooms with en-suite facilities. A variety of lounges and dinning spaces are provided. There are sufficient bathing facilities to meet the needs of the Resident group. Residents’ accommodation is located on the ground and first floor of the Home, and there is a stairlift for access to the first floor. The Registered Person is currently working on a rolling programme in order to upgrade certain areas of the Home. The charges made for a room at Grangewood Lodge ranged from £385.00 for a room without en suite facilities to £395.00 a week for a room with en suite facilities. Rates for local authority funded individuals was dependent on the local authority rate and the assessed banding within that rate. The following services/ items were not included in the weekly fees: Toiletries and other personal requisites, newspapers and magazines, hairdressing services and private chiropody services. Grangewood Lodge DS0000019996.V369389.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 3 star. This means the people who use this service experience excellent quality outcomes. This key inspection was unannounced and took place over approximately seven hours. Key inspections take into account a wide range of information and commence before the site visit by examining previous reports and information such as any reported incidents. The site visit is used to see how the service is performing in practice and to meet with the people using the service. The focus of inspections undertaken by the Commission for Social Care Inspection is upon outcomes for individuals and their views on the service provided. This process considers the provider’s and registered manager’s capacity to meet regulatory requirements, minimum standards of practice; and focuses on aspects of service provision that need further development. An Annual Quality Assurance Assessment (AQAA) had been completed by the service. This is a self-assessment for providers, which is a legal requirement. This assessment gives the provider and registered manager an opportunity to let us know about their service and how well they think they are performing. The information provided in the AQAA is reflected within this report. At this inspection visit two people were case tracked. Case tracking is a method used to track the care of individuals from the assessments undertaken before they are admitted to a service through to the care and support they receive on a daily basis. This includes looking at care plans and other documents relating to that persons care, talking to staff regarding the care they provide and if possible talking to the individual. One person case tracked was able to express their views of the service and the support it provided. Several other people living at the home that were not case tracked were also spoken with. Their views of the service and the care and support provided are included within this report. Five members of staff were spoken with at some length and their views and opinions of the care provided, the support and training given to them is included within this report. The registered manager and senior members of staff were on duty on the day of this inspection and provided the relevant information requested. Grangewood Lodge DS0000019996.V369389.R01.S.doc Version 5.2 Page 6 What the service does well: What has improved since the last inspection? What they could do better: Although the medication practices in place ensured peoples medicines were given in a safe way, some good practices measures were not in place, but were addressed immediately at this inspection visit. However to ensure the home is not relying on an inspection visit to keep up to date in this area, they should give consideration as to how they will keep themselves up to date regarding Grangewood Lodge DS0000019996.V369389.R01.S.doc Version 5.2 Page 7 medication practices in relation to any new legislation and good practices measures. 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. Grangewood Lodge DS0000019996.V369389.R01.S.doc Version 5.2 Page 8 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Grangewood Lodge DS0000019996.V369389.R01.S.doc Version 5.2 Page 9 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 3,5. Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. The suitability of the home for each individual was determined by a needs assessment before admission was agreed. This ensured each persons needs could be met. People were able to visit and assess the quality, facilities and suitability of the home prior to making a decision about living there. EVIDENCE: The home was able to support the people because an accurate assessment of needs had been undertaken before admission. This enabled the home to determine that they were able to meet each person’s needs before admission was agreed. Both of the people case tracked had detailed needs assessment in place that had been undertaken prior to admission. This assessment covered all areas of health, personal and social care need, including any faith and cultural needs. Grangewood Lodge DS0000019996.V369389.R01.S.doc Version 5.2 Page 10 Both of the needs assessments seen had been signed and dated by all relevant parties. Such as the individual or their representative and the staff member that had undertaken the assessment and the manager of the home. As stated in the pre-inspection self-assessment information the home does not currently have any individuals from ethnic minority communities, but should this change it was confirmed that staff would be appropriately trained to ensure they could meet the needs of these individuals. It was confirmed in discussions with individuals that they were given an opportunity to look around the home before they made any decisions. One relative said, “ I just turned up, I didn’t make an appointment and the staff were very welcoming. I new this was the right place, it has a lovely atmosphere”. One of the people living at the home confirmed that they looked around before they made their decision to move in. They said “ its one of the best decisions I’ve ever made, its lovely here. I’m so happy, everyone is lovely and they staff are always about, whenever you need them, I’m very well looked after”. Grangewood Lodge DS0000019996.V369389.R01.S.doc Version 5.2 Page 11 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 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. Health, personal and social care needs are met and care plans are developed with individuals or their representatives. People are supported to take their medicines in a safe way and the support they get from staff is given in a way that maintains their dignity. EVIDENCE: Peoples health, personal and social care needs were met. Plans of care and risk assessments were in place for the two people case tracked. These plans demonstrated that the individual or their representative had been involved in the development of their care plan. The information within the care plans was detailed and provided staff with relevant information about how each person would like to be cared for, such as any preferences regarding the gender of staff that supported them in their personal care needs. Also included were individuals preferences regarding their Grangewood Lodge DS0000019996.V369389.R01.S.doc Version 5.2 Page 12 day-to-day lives and routines. This included people’s preferences on where they liked to take their meals and when and if they wished for staff to tidy their room or preferred to do this independently. Information was also in place regarding wishes in relation to arrangements regarding dying, resuscitation and death and the safe keeping of monies and financial transactions. All of this information provided staff with a comprehensive view not only of each persons support needs and preferences within their day to day lives but also their wishes and things that were important to them in the long term. Key workers were provided for each individual and as stated in the preinspection self-assessment information a responsible senior member of staff worked in the role of key worker supervisor to ensure key workers were well trained and had a support network. Key workers had reviewed the care plans seen each month. This ensured any changing needs could be identified and the appropriate action put in place to address these changes. The risk assessments seen for the two people case tracked were detailed and assessed all areas of risk identified and the actions that were required to minimise each risk, whilst retain individual’s independence as much as possible. This demonstrates that the home supports people in a safe way. Risk assessments seen included moving and handling assessments, tissue viability and skin integrity, falls assessments, environmental risks, weight records and nutritional and dietary assessments. Information in the pre-inspection self-assessment information stated that the home had good relationships with health care professionals and positive feedback regarding the ongoing care given, in relation to any areas where they had received advise from the health care professional. Records demonstrated that people’s health care needs were addressed and input from the relevant health care professionals was provided as required. This included, G.P, district nurse, optician, dentist and chiropodist. The optician was at the home on the day of this inspection visit. He stated that the home was well organised and maintained excellent communication with him regarding any concerns or queries they had. He stated, “ I enjoy coming here. It’s an excellent service and I have a good working relationship with the home, they are always very organised”. The comments made by people living at the home and their relatives regarding the support provided were very positive. Comments included, “they treat people as individuals” and “the care is excellent” and “they’re extremely kind and helpful, I can’t fault them”. Grangewood Lodge DS0000019996.V369389.R01.S.doc Version 5.2 Page 13 The medication practices demonstrated that people were supported to take their medicine in a safe way. The medication trolley demonstrated that each person’s medicine was stored correctly and the trolley was well organised and clean. Records of medication administration were accurately recorded. Only one controlled drug was kept within the home at the time of this inspection visit. This was stored correctly and records were kept of the receipt, administration, and disposal of this controlled drug. The controlled drug stored did not by law have to be recorded within a controlled drugs register. However as discussed with the manager and a senior member of staff, many controlled drugs must by law be recorded in a controlled drugs register and it is good practice to record all controlled drugs within a controlled drugs register. A controlled register was ordered during this inspection visit. Discussions also took place regarding the use of a pill counter for medication that was stored in the controlled drugs cabinet. This enabled staff to count medication as required without having to physically handle this medication; this ensured good practice hygiene measures were maintained. A pill counter was order during this inspection visit. Medication requiring cold storage was kept with a domestic style refrigerator. Although this refrigerator was only used for the storage of medication, it did not have a lock. This refrigerator was kept within an area that could be kept secure. However the lockable gate to secure this area was open and the manager confirmed that this was usually locked at night. As the people living at the home were able to access this area, it was requested that this gate be locked to ensure that no unauthorised access to the medication fridge was available. This was done immediately. A clinical fridge with lock was ordered during this inspection visit. Fridge temperatures were recorded each day to ensure medicines were being stored at the correct temperature. The minimum and maximum temperatures were not recorded, as a suitable thermometer was not in place to record these. Discussions took place with the manager regarding the use of recording minimum and maximum temperatures. This would ensure a good audit of the fridge temperatures was maintained and staff are alerted to any defaults in the temperatures maintained by the fridge, which could affect the potency of cold storage medication. Throughout the inspection staff were observed with several people that lived at the home. Interactions between the staff and individuals were positive, relaxed and friendly. It was clear that there was a good relationship between the staff team and individuals that lived at the home. There were many occasions when members of staff were seen socialising with individuals in a light hearted and familiar way. However this did not detract from the staff’s professional Grangewood Lodge DS0000019996.V369389.R01.S.doc Version 5.2 Page 14 conduct. All of the people spoken with confirmed that staff were respectful and ensured their privacy and dignity was maintained. Grangewood Lodge DS0000019996.V369389.R01.S.doc Version 5.2 Page 15 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 home supports people to follow their personal interests and keep in touch with family and friends. People are supported to lead their chosen lifestyle and have opportunities to make the most of their abilities. The meals provided are enjoyed and taken at a time and place to suit individual preferences. EVIDENCE: Each person was treated as an individual and the home was responsive to his or her needs. It was stated by the manager and within the pre-inspection selfassessment information that everyone’s birthday was celebrated in some way. The extent of the celebrations was dependent on individuals choices, some people requested a party whilst others preferred a small celebration with family and a birthday cake. This was confirmed with one person spoken with who said that it was her birthday at the weekend. This person confirmed that she didn’t like ‘a fuss’ but would have a Birthday cake and a visit from her family. A relative spoken with confirmed, “ they provided a lovely birthday party for my mum’s 90th Birthday” Grangewood Lodge DS0000019996.V369389.R01.S.doc Version 5.2 Page 16 The activities coordinator was spoken with and discussed the activities and events that took place at the home. Activities were advertised on the notice board. This included in house games such as bingo, which took place on the day of this inspection. Other games included hoop-la, skittles, giant snakes and ladders, word searches and crosswords. Activities also took place within the grounds of the home, when the weather permitted such as bowling on the lawn and gardening. It was stated that one person who was a keen garden enjoyed this and this supported him in retain the skills he had. People spoken with made positive comments about the activities provided, such as “ there’s plenty to join in with if you want to, I always do, I love it” and “ there’s always something to join in with if you want to, it’s very good” Fund raising activities were run weekly which were based on the national lottery bonus ball. The winner of the ‘bonus ball’ won a cash prize and the remainder of the money went into the amenities fund. Other fund raising activities included a sponsored walk that was undertaken by members of the staff team. Fetes, coffee mornings, clothes sales and gift and jewellery sales also took place throughout the year. External entertainers visited the home each month to provide a variety of entertainment, this varied from musicians, singers, magicians and ventriloquists. Discussions took place regarding the types of activities that were provided with people with Dementia that were unable to participate in the general activities that took place. It was confirmed that sorting games that used colours and shapes were used, and painting and craft activities. The activities coordinator confirmed that some people with dementia liked to undertake tasks such as folding serviettes and napkins, as this would be of a similar nature to domestic tasks they may have undertaken at home when folding laundry. This was therefore a meaningful activity to them and would give them a sense of familiarity. Outings took place to garden centres and other places of interest. One person liked to go clothes shopping and was supported by staff to do this. This person was spoken with and confirmed that this took place and was enjoyed. Another person talked about the trips out and said, “ I love the trips out they’re excellent”. People were supported to keep in touch and maintain relationships with family and friends. It was stated that staff were available to accompany people to family events such as weddings and birthday parties. The pre-inspection self-assessment Grangewood Lodge DS0000019996.V369389.R01.S.doc Version 5.2 Page 17 information stated that overnight stays have been undertaken by staff to offer support to individual’s attending weddings. Visitors spoken with confirmed that staff always made them feel welcome and were always available if they needed to discuss anything. The rapport observed between the staff team and visitors appeared friendly and welcoming. From discussions with individuals and from records seen within care plans, it was clear that people were encouraged to exercise choice and control within their daily lives. People were seen freely walking around the home, and stopping to chat with one another. Several people spoken with talked about their preferred daily routines, such as the time they chose to get up and go to bed each day, where they preferred to take their meals and when they chose to sit in the communal areas or have some time alone in their private accommodation. Information within the pre-inspection self-assessment information stated that meals were varied and individuals were free to choose from the three options available and were actively encouraged to order any alternatives or extras that can reasonably be provided. Discussions held about the meals were very positive. Everyone spoken with said that they enjoyed the meals. One person said, “ the only time I don’t eat all my meal, is because I’m too full, they give you plenty”. Another person said, “if you don’t want the choices on offer they get you something else, they’re excellent” Grangewood Lodge DS0000019996.V369389.R01.S.doc Version 5.2 Page 18 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 excellent. This judgement has been made using available evidence including a visit to this service. Concerns were looked into and actions were taken to put things right. The practices and policies in place ensured people were safeguarded from abuse. EVIDENCE: The home had received six complaints in 2007 and one complaint this year. The records held regarding these complaints was clear and the actions taken and outcomes of complaints were recorded. This provided the manager with a clear audit of complaints. Records demonstrated that an annual review of complaints was undertaken either by the manager or a delegated senior member of staff. These records showed that the home addressed any areas identified regarding care practices or the management of complaints. Information within the pre-inspection self-assessment information stated that senior staff have been trained in how to deal appropriately with complaints, how to record them appropriately, which to respond to themselves and which to refer to the manager. People spoken with were confident that if they had any concerns they would be addressed promptly. One person said, “I have no complaints at all, its first class here, but I know if I did that the manager would sort it quickly, she’s Grangewood Lodge DS0000019996.V369389.R01.S.doc Version 5.2 Page 19 very good” another person said, “ the manager always stops and chats with me, I have no worries but if I did she would sort it out for me” The complaints policy was seen and provided clear information about how to make a complaint. It also included the correct contact details for the Commission for Social Care inspection, should anyone wish to contact us. The home safeguards people from abuse and neglect. There was a Safeguarding Vulnerable Adults procedure that included a ‘Whistle Blowing’ policy in place, and copies of the Public Interest Disclosure Act and the Department of Health’s policy called ‘No Secrets’. This ensured that staff had all the relevant information to ensure the people living at the home were protected from abuse. The staff had undertaken training in Safeguarding Adults and certificates were seen to demonstrate this. Staff spoken were able to confirm that they had undertaken training in this area and knew the procedure to follow if they had any suspicion or evidence of abuse. The manager stated in the pre-inspection self-assessment information that new staff undertook Safeguarding adults training and this was organised by a delegated senior member of staff. It was confirmed in the pre-inspection self-assessment information and on the day of this inspection that there have been no referrals or safeguarding adults investigations at the home since the last inspection. It was also stated in the information within the pre-inspection self-assessment information that no reportable incidents or occurrences have been made, indicating a well trained staff team are in place that understand adult protection and are instrumental in ensuring that individual’s are well cared for, respected and protected via the systems in place. People living at the home confirmed that they felt safe and supported by the staff team. We have not received any complaints or Safeguarding referrals about this service since the last inspection visit. Grangewood Lodge DS0000019996.V369389.R01.S.doc Version 5.2 Page 20 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): 19,26. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People stay in a safe well maintained home that is clean, pleasant and hygienic. EVIDENCE: A tour of the building was undertaken; this was mainly of communal areas, bathrooms, the laundry, the kitchen and garden area All areas of the home appeared clean and tidy. It was noted that some carpeted areas within the main corridors looked stained. The manager confirmed that these carpets were reasonably new but due to their fibre content stained easily and plans were in place to re carpet the main corridor this year. Grangewood Lodge DS0000019996.V369389.R01.S.doc Version 5.2 Page 21 As stated in the information within the pre-inspection self-assessment an ongoing programme was in place to replace furniture and carpets throughout the home. The main lounge had been refurbished and new furniture and flooring had been installed. Information within the pre-inspection self-assessment information stated that the people living at the home had been consulted regarding the colour schemes and styles and were pleased with the results. The manager confirmed that the small lounge diner was due to be recarpeted, as were parts of the adjoining corridor. Following a professional fire risk assessment new fire doors were being fitted throughout the home. The majority of these doors had been fitted at the time of this inspection visit. The replacement of these fire doors included the fitting of new locks on bedroom doors. These locks enabled people to lock their doors both from the inside and the outside of their bedrooms. It was confirmed that all care and domestic staff had been provided with master keys to the bedrooms. This ensured that staff were able to access rooms in the event of an emergency and to provide cleaning services as required. A requirement from the last inspection was regarding the toilet by the office, as no lock was fitted to the door. This was seen and has now been repaired. The garden area was seen and provided a secure area with locked gates. People that were able to wander freely from the secure area had keys to the gate to enable them to leave the secure area. This ensured peoples liberty and freedom of movement was maintained when possible. Both people living at the home and their visitors provided positive comments about the standard of cleanliness and laundry service provided at the home. Comments included, “ my room is always kept clean and tidy” and “I’m quite happy with the laundry”. Grangewood Lodge DS0000019996.V369389.R01.S.doc Version 5.2 Page 22 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 excellent. This judgement has been made using available evidence including a visit to this service. A safe, competent staff team were provided in sufficient numbers to meet individual’s needs. EVIDENCE: The people living at Grangewood lodge had safe and appropriate support, as the rotas demonstrated that there was enough competent staff on duty at all times. Everyone spoken with, staff, people living at the home and their visitors indicated there was sufficient staff on duty to meet the needs of the people living there. Comments included, “there always seems to be staff around to deal with anything needed” and “ the staffing levels are good, they’re a nice group of staff”. From discussions with the staff team it was clear that the staff were supportive of each other and worked as an open and inclusive team. The recruitment records for two members of staff were looked at. They demonstrated that the correct checks that are required by law were Grangewood Lodge DS0000019996.V369389.R01.S.doc Version 5.2 Page 23 undertaken, before staff began their employment at the home. This ensures the safety of the people living at the home is maintained. The information within the pre-inspection self-assessment stated that individuals living at the home that were interested in attending staff interviews shared this job on a rolling basis. During the interviews they were free to ask questions and express their opinion with regard to the applicant. This was not discussed or confirmed with any individual’s on the day of this inspection visit. The training records seen included records of induction, these records demonstrated that a thorough staff induction took place to ensure staff had the relevant knowledge in areas such as, the working practices of the home, the principles of care, safe working practices and the needs of the people using the service. From discussions with the registered manager and members of the staff team it was confirmed that new staff were supported by senior members of the team in getting to know the people using the service before they provided any personal care. They then initially worked with an experienced member of staff when providing personal care support. This enabled new staff to get to know individuals and their specific needs before providing personal care support and endured individuals were comfortable with the support provided. Staff training records demonstrated that the staff team were provided with the relevant training to enable them to meet the needs of the people using the service and undertake their duties in a safe way. Records demonstrated that as well as mandatory training sessions, such as Health and Safety and Moving and Handling, training specific to the needs of the individuals was also provided, such as prevention of pressure sores and dementia care. Staff spoken with confirmed that the training provided to them was good, comments made included, “ there’s lots of training and its very good” and “ the training here is excellent the manager is always open to any training requests”. The information in the pre-inspection self-assessment records demonstrated that out of the fifteen care staff employed ten had achieved a National Vocational Qualification in care at level 2 or above. The other five care staff were working towards this qualification. Grangewood Lodge DS0000019996.V369389.R01.S.doc Version 5.2 Page 24 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): 31,32,33,35,38. Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. People living at the home can be confident because it is led and managed appropriately. Individual’s money that is managed by the home is done so in a way that safeguards their finances. The home is run in the best interest of the people living there and the practices in place ensure the environment is safe for everyone. EVIDENCE: The home is managed efficiently and effectively. The manager has the qualification, experience and competency required to run the home and meet its stated purpose, aims and objectives. The manager demonstrated that the management approach she uses creates an open, positive and inclusive atmosphere. Senior staff were delegated management tasks, which were Grangewood Lodge DS0000019996.V369389.R01.S.doc Version 5.2 Page 25 rotated at intervals. This ensured that they given opportunities to professionally develop in all areas of management and demonstrated that the manager’s commitment to empowering staff and promoting teamwork is commendable. Both the staff team, people living at the home and their visitors were extremely complimentary regarding the manager’s leadership skills and ability to run the home. Comments included, “ the manager is lovely, she’s very nice and always stops for a chat, a lovely woman” and “ Faye is very supportive, she provides good supervision and we all work really well together”. Supervision records were seen within the staff files looked at and demonstrated that detailed supervision was provided on a regular basis. This further demonstrates that staff are supported appropriately. The systems in place demonstrated that the home was run in the best interests of the people living there. Information within the pre-inspection selfassessment stated that the manager and senior team undertook quality assurance audits annually. These audits looked at areas that needed improvement and areas that are working but need to grow and develop. It was stated that this document was made available to the people living at the home and was produced after reviewing all relevant records. This document was seen at this inspection visit and demonstrated that a review had taken place of the new systems, documents and working practices since the last key inspection. Information within the pre-inspection self-assessment stated that individuals and their family and friends and the staff team were encouraged to air their views and be involved in the forward movement for the home. Records seen demonstrated that the views of the people living at the home were regularly sought, this included questionnaires, which were sent out three times a year and residents meetings which were held three times a year. Staff questionnaires were sent out annually and visitors usually received a questionnaire approximately 2 months after the admission to the home of their relative/ friend. Following audits from the quality assurance practices undertaken, the home produces an annual development plan. The homes annual plan for 2008 was seen at this inspection visit. The monies held and financial transaction records for the two people case tracked were checked and were accurate. This demonstrates that the home safeguards the financial interests of the people living at the home. Some of the health and safety practices undertaken at the home were examined. This included a sample of service certificates for equipment and records of fire safety practices including a fire risk assessment and fires alarm Grangewood Lodge DS0000019996.V369389.R01.S.doc Version 5.2 Page 26 tests and the policy, organisation and arrangements for maintaining safe working practices in the Home. All areas examined were found to be up to date and demonstrated that the environment was safe for the people living at the home, staff team and visitors as the appropriate health and safety practices are carried out. Grangewood Lodge DS0000019996.V369389.R01.S.doc Version 5.2 Page 27 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 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 4 8 4 9 2 10 4 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 4 13 4 14 4 15 4 COMPLAINTS AND PROTECTION Standard No Score 16 4 17 X 18 4 3 X X X X X X 3 STAFFING Standard No Score 27 4 28 4 29 4 30 4 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 4 4 4 X 4 X X 4 Grangewood Lodge DS0000019996.V369389.R01.S.doc Version 5.2 Page 28 Are there any outstanding requirements from the last inspection? NO STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard OP9 Good Practice Recommendations A thermometer that records the minimum, maximum and actual temperature should be in place for the refrigerator that stores medication requiring cold storage. Grangewood Lodge DS0000019996.V369389.R01.S.doc Version 5.2 Page 29 Commission for Social Care Inspection Eastern Region Commission for Social Care Inspection Eastern Regional Contact Team CPC1, Capital Park Fulbourn Cambridge, CB21 5XE 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 Grangewood Lodge DS0000019996.V369389.R01.S.doc Version 5.2 Page 30 - 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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