Care Home: Grasmere Nursing Home

What the care home does well People who use the service have a comprehensive assessment prior to admission. Personal and nursing care is offered in a dignified and respectful manner. Nutritious meals are offered in pleasant surroundings. People who use the service receive care from a dedicated staff. What has improved since the last inspection? New nursing beds and pressure relieving equipment have been purchased. The garden has been landscaped and the garden and patio refurbished with the addition of new tables and chairs, patio heaters and lights. What the care home could do better: The home is operating well in all areas. CARE HOMES FOR OLDER PEOPLE Grasmere Nursing Home 51 Manor Road Worthing West Sussex BN11 4SH Lead Inspector Sheila Gawley Unannounced Inspection 6th March 2008 09:30 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 Grasmere Nursing Home DS0000043632.V358084.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. Grasmere Nursing Home DS0000043632.V358084.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Grasmere Nursing Home Address 51 Manor Road Worthing West Sussex BN11 4SH 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) 01903 201281 F/P 01903 201281 grasmerenh@btinternet.com Kargini Care Services Limited Miss Yvonne Barbara Evans Care Home 21 Category(ies) of Old age, not falling within any other category registration, with number (21) of places Grasmere Nursing Home DS0000043632.V358084.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 11th January 2007 Brief Description of the Service: Grasmere is a care establishment providing nursing care for twenty-one older people. Grassmere is situated in a residential area approximately one mile from the town centre of Worthing with its shops, train station and other amenities. It is a two story detached property and the accommodation is arranged in twenty-one single rooms. There is a passenger lift, which makes most rooms accessible. Some other rooms can be reached by a stair lift. Facilities include a lounge and dining room on the ground floor and a quiet room on the second floor. There is a patio garden at the side of the house, which is accessible to and used by the service users. The fees charged range between £500 and £675 Grasmere Nursing Home DS0000043632.V358084.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 2 stars. This means the people who use this service experience good quality outcomes. This site visit as part of the inspection process was carried out on 06/03/08. The Registered Manager facilitated the inspection and the provider was also available. Staff and people who use the service spoken to stated that they were happy in the home. Prior to the visit the service file was reviewed as were any comments or complaints received by the Commission for Social Car inspection. The Home had sent us their Annual Quality Assurance Assessment for the inspection, which gave us the information we needed on the home. Any records or documents required on the day were made available. The home has met the requirements of the last inspection. What the service does well: People who use the service have a comprehensive assessment prior to admission. Personal and nursing care is offered in a dignified and respectful manner. Nutritious meals are offered in pleasant surroundings. People who use the service receive care from a dedicated staff. Grasmere Nursing Home DS0000043632.V358084.R01.S.doc Version 5.2 Page 6 What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Grasmere Nursing Home DS0000043632.V358084.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Grasmere Nursing Home DS0000043632.V358084.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 1,3, Standard 6 is not applicable People who use this service experience good outcomes in this area, as there is a clear assessment and admission process. This judgement has been made using available evidence including a visit to this service. EVIDENCE: There is an up to date and comprehensive Service User Guide and Statement of Purpose available to people who use the service and their residents or representatives to enable them to have information and make choices about the home. Grasmere Nursing Home DS0000043632.V358084.R01.S.doc Version 5.2 Page 9 People who use the service have their needs assessed prior to admission. These assessments were seen in the care plans inspected. People who use the service spoken to confirmed that they had this assessment. Grasmere Nursing Home DS0000043632.V358084.R01.S.doc Version 5.2 Page 10 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): 7-10 People who use this service experience good outcomes in this area because all needs are assessed and met, set out in a plan and residents are treated with respect. Medicines are handled appropriately. This judgement has been made using available evidence including a visit to this service EVIDENCE: All residents had a plan of care. Three people who use the service were case tracked. The care plans inspected contained information on health, personal, nursing and social need. The care plans were drawn up following an assessment of these needs. This included nutritional assessments, mobility, hygiene, continence, and pressure areas, and risk assessments. The risk assessments covered mobility, falls, nutrition and pressure area risk. The care Grasmere Nursing Home DS0000043632.V358084.R01.S.doc Version 5.2 Page 11 plans were up to date and had evidence of monthly review. Weight is monitored. Access to specialist health support is available as required including the general practitioner practice nurse. and outpatient appointments. A dental service and a chiropodist visit the home. Staff were observed offering care in a respectful and encouraging manner and people who use the service spoken to stated that they are treated with respect. People who use the service and relatives spoken to stated that care is offered as assessed. Medicines are received, stored, administered and recorded appropriately. Medicine administration charts inspected were up to date. The Registered Manager is researching the purchase of a new drug fridge. Grasmere Nursing Home DS0000043632.V358084.R01.S.doc Version 5.2 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12-15 People who use this service experience good outcomes in this area, because lifestyle in the home meets their expectations. Activities and events provided satisfy social, cultural and recreational needs. There is a variety of nutritional food on offer. This judgement has been made using available evidence including a visit to this service EVIDENCE: There is an activities programme in place, which includes in house activities such as cards, knitting, movies and some external entertainers who provide arts and crafts and reminiscence. People who use the service spoken to stated that they were happy with daily life in the home. The home held a large garden party for a 100th birthday, which the Mayor attended. Visitors are welcome in the home and religious needs are met as requested. Grasmere Nursing Home DS0000043632.V358084.R01.S.doc Version 5.2 Page 13 People spoken to also stated that they could receive visitors as they choose. People spoken to stated that they have freedom in daily routines such as when to go to bed and where to take meals. The cook was spoken to. There is varied menu in place and choice is offered to residents. The meal seen prepared and served today appeared nutritious and people who use the service said they enjoyed it. A recent Environmental Health Department inspection praised the standard of hygiene practiced in the kitchen. Two visitors were spoken to and they stated that the meals served always appear nutritious and appetising. Grasmere Nursing Home DS0000043632.V358084.R01.S.doc Version 5.2 Page 14 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 People who use this service experience good outcomes in this area, as there are policies and procedures in place for complaints and safeguarding adults. This judgement has been made using available evidence including a visit to this service. EVIDENCE: There is a clear and accessible complaints procedure in place which residents spoken to stated that they were aware of, although all stated that they did not have reason to complain. There is the facility to record any complaints. There have not been any complaints since the last inspection. There are policies and procedures in place regarding safeguarding adults and whistle blowing. Staff spoken to were clear about the procedures to follow in safeguarding adults allegations. Training records show that staff have training in safeguarding adults policies and procedures. Grasmere Nursing Home DS0000043632.V358084.R01.S.doc Version 5.2 Page 15 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 19,22,25,26 People who use this service experience good outcomes in this area because they live in a safe and well-maintained environment. This judgement has been made using available evidence including a visit to this service. EVIDENCE: There is a comfortable lounge and a dining room. The home was neat and clean throughout and was free from offensive odours. People who use the service spoken to stated that they were happy with their rooms and facilities. Rooms can be personalised as people wish. Bedroom doors have now been fitted with automatic door closure devices and radiators are covered. The Grasmere Nursing Home DS0000043632.V358084.R01.S.doc Version 5.2 Page 16 home has purchased new pressure relieving beds and equipment and other new furniture was seen throughout the home. The garden had recently been landscaped and has attractive lawn and patio area. Patio heaters are available for cooler days. The kitchen was clean and the recommendations of a recent Environmental Health Department inspection have been met. The report praised the standard of hygiene practiced in the kitchen. The laundry is sited away from where food is prepared, stored or served and has suitable washing temperatures to prevent the spread of infection there are sluicing facilities. Grasmere Nursing Home DS0000043632.V358084.R01.S.doc Version 5.2 Page 17 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): 27-30 People who use this service experience good outcomes in this area because needs are met by a staff trained and qualified to do so. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The rota showed sufficient numbers of staff on duty to meet the needs of people who use the service. There is sufficient domestic support. The home is recruiting a kitchen assistant at present and an extra carer was on duty to fulfil this function. Agency staff have been used to cover some shifts of late. Six of the ten care staff have completed the National Vocational Qualification Level 2 in care and a further two are working towards this. All mandatory training on fire safety, moving and handling. Infection control, first aid and health and safety is in place and training records were seen. There is further training on conditions, nutrition and diet and challenging behaviour. There is a robust recruitment procedure in place and staff files inspected had all the required documentation; two written references, Criminal Records Bureau Clearance and POVA check, application form including employment history and terms and conditions. Grasmere Nursing Home DS0000043632.V358084.R01.S.doc Version 5.2 Page 18 Induction training is in place and staff spoken to confirmed training is in place. All stated the home is a happy supportive place to work. Grasmere Nursing Home DS0000043632.V358084.R01.S.doc Version 5.2 Page 19 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31,33,35, 36,38 People who use this service experience good outcomes in this area because the home is run in the home is run in the best interests of the residents. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The Registered Manager has been in post for 14 years and is a Registered Nurse. She is completing the last unit of the Registered Manager Award. Staff supervision is in place and staff spoken to confirmed this. Supervision records were seen in staff files. Quality assurance systems are in place, staff Grasmere Nursing Home DS0000043632.V358084.R01.S.doc Version 5.2 Page 20 meetings, surveys for relatives and people who use the service. Comments are actioned such as a request to paint a strip in the steps for easy visibility and the provision of more curries. Comments on surveys seen were all positive such as “ very good here”, “well cared for”, “we are able to express views”. The money held for people who use the service is held separately, securely admission is recorded and receipted. The health and safety of people who use the service and staff is protected by the homes policies and procedures and the provision of trailing. Records to show the maintenance of utilities, electrical equipment and the lift were available. The register provider visits the home frequently in accordance with regulation 26 and as such is aware of and deals with any maintenance issue. Grasmere Nursing Home DS0000043632.V358084.R01.S.doc Version 5.2 Page 21 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 3 X 3 X X X HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X 3 X X 3 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 3 X 3 Grasmere Nursing Home DS0000043632.V358084.R01.S.doc Version 5.2 Page 22 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. Refer to Standard Good Practice Recommendations Grasmere Nursing Home DS0000043632.V358084.R01.S.doc Version 5.2 Page 23 Commission for Social Care Inspection Aylesbury Office Cambridge House 8 Bell Business Park Smeaton Close Aylesbury Buckinghamshire HP19 8JR 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 Grasmere Nursing Home DS0000043632.V358084.R01.S.doc Version 5.2 Page 24 - 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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