Care Home: Gratia Limited

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What the care home does well Staff members have access to detailed information about the people they support (see below). This enables them to meet people`s individual needs. People who use the service are encouraged to make decisions about their lives. They are also involved in the running of the home. A monthly meeting is held at which people have an opportunity to raise any issues. Records indicate that action is taken to address these issues, wherever possible. People who use the service live in a comfortable and safe environment. They indicated that the home is always fresh and clean. Staff members are well trained. Information provided prior to the visit indicated that twenty of the twenty-three members of staff have completed National Vocational Qualification level two or above and that two are working towards such an award. Records indicate that staff members have received training on a range of issues relevant to their work. People who use the service are happy with the support they receive. When asked what the home does well, they stated: `I`m very happy here. I have a lovely bedroom and I`ve just had a new posh floor. I`ve got lots of friends here`; `We all are one big happy family`. What has improved since the last inspection? Person centred plans, communication passports and health action plans have been completed since the date of the last inspection. These documents contain detailed information about each person, including their likes & dislikes, anycultural needs that have been identified and the people who are important to them. What the care home could do better: A chain should be fitted downstairs to enable a box containing medication to be secured when out of the office. The home should ensure its medication cabinet complies with the Misuse of Drugs (Safe Custody) (Amendment) Regulations 2007. CARE HOME ADULTS 18-65 Gratia Limited 472 Groby Road Leicester Leicestershire LE3 9QD Lead Inspector Martin Hefferman Unannounced Inspection 20th August 2008 10:30 Gratia Limited DS0000058192.V370419.R01.S.doc Version 5.2 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 Gratia Limited DS0000058192.V370419.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 Adults 18-65. 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. Gratia Limited DS0000058192.V370419.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Gratia Limited Address 472 Groby Road Leicester Leicestershire LE3 9QD 0116 2311640 0116 2332724 smith.mg@sky.com www.gratiacare.co.uk Gratia Limited 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) Mr Matthew Phillip Smith Mrs Janet McDermott Care Home 21 Category(ies) of Dementia (4), Learning disability (21), Learning registration, with number disability over 65 years of age (9), Physical of places disability (5) Gratia Limited DS0000058192.V370419.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. 4. 5. 6. No person to be admitted to Gratia Limited in categories LD, LD(E), DE or PD when 21 persons in total of these categories/combined categories are already accommodated in Gratia Limited. No one falling within category LD(E) may be admitted into Gratia Limited where there are 9 persons of category LD(E) already accommodated within Gratia Limited. No person falling within category DE may be admitted to Gratia Limited unless that person also falls within category LD ie dual disability. No person to be admitted to Gratia Limited in categories LD and DE ie dual disability when 4 persons in total of these categories/combined categories are already accommodated in Gratia Limited. No person falling within category PD may be admitted to Gratia Limited unless that person also falls within category LD - ie dual disability. No person to be admitted to Gratia Limited in categories LD and PD ie dual disability when 5 persons in total of these categories/combined categories are already accommodated in Gratia Limited. 20th July 2006 Date of last inspection Brief Description of the Service: Gratia Care Home provides care for up to twenty-one adults who have learning disabilities, some of whom may have additional needs. The home is situated on the main Groby Road leading to the city of Leicester, where people who use the service have access to shops, transport links and other amenities. The property consists of two floors. A lift is provided to enable access to the first floor. There are a variety of aids and adaptations throughout the home enabling people to be more independent. The home has nineteen single bedrooms, eight with en-suite facilities. There is one double room without an en-suite facility. An adequate number of toilets and bathrooms are situated on both floors. A garden is located to the rear of the building. A room within the garden area has been developed into a snoezelum facility, with light effects and beanbags to enable people to relax. At the time of the inspection, fees ranged from £340 to £500 per week. Gratia Limited DS0000058192.V370419.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. A visit to the home took place on 20th August 2008, lasting approximately five and a quarter hours. The main method of inspection used on that day was ‘case tracking’ which involved selecting two people who use the service and tracking the care they receive through review of their records, discussion with them (where possible) & staff and observation of care practices. Four people who use the service were spoken to during the course of the visit. This inspection has also taken into account all information received since the date of the last visit, including the home’s annual quality assurance assessment. Comment cards were received from nine people who use the service. What the service does well: What has improved since the last inspection? Person centred plans, communication passports and health action plans have been completed since the date of the last inspection. These documents contain detailed information about each person, including their likes & dislikes, any Gratia Limited DS0000058192.V370419.R01.S.doc Version 5.2 Page 6 cultural needs that have been identified and the people who are important to them. 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. Gratia Limited DS0000058192.V370419.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR 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) Scoring of Outcomes Statutory Requirements Identified During the Inspection Gratia Limited DS0000058192.V370419.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 1&2 Quality in this outcome area is good. Assessment practices are effective, ensuring that individual needs are identified before people move in. This judgement has been made using available evidence including a visit to this service. EVIDENCE: People who use the service indicated that they had received enough information about the home to decide it was the right place for them. A copy of the home’s brochure was available at the time of the visit. The registered manager agreed to update the home’s terms & conditions, which are set out within the brochure, to reflect changes to the regulation of the home. Two of the people who were chosen for the purposes of case tracking had moved to the home since the date of the last inspection. Care management assessments were available for both of them. The home had also completed its own assessment of each person’s needs. Records indicate that individual needs have been kept under review. Gratia Limited DS0000058192.V370419.R01.S.doc Version 5.2 Page 9 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7 & 9 Quality in this outcome area is good. Staff members have access to the detailed information they require to meet individual needs. People who use the service are encouraged to make decisions about their lives wherever possible. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Individual plans were available for the people who were chosen for the purposes of case tracking. The plans that were inspected had been kept under review. Person centred plans, communication passports and health action plans have been completed since the date of the last inspection. These documents contain detailed information about each person, including their likes & dislikes, any cultural needs that have been identified and the people who are important to them. Individual plans also set out the measures that need to be taken to minimise any risks that have been identified. People who use the service indicated that they could make decisions about what they do each day. It was evident on the day of the visit that they are able to make full use of communal areas and their bedrooms. A monthly meeting is held at which people who use the service have an opportunity to raise any Gratia Limited DS0000058192.V370419.R01.S.doc Version 5.2 Page 10 issues. Records indicate that action is taken to address these issues, wherever possible. Gratia Limited DS0000058192.V370419.R01.S.doc Version 5.2 Page 11 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 15, 16 & 17 Quality in this outcome area is good. People who use the service enjoy a lifestyle, which reflects their individual needs & expectations. This judgement has been made using available evidence including a visit to this service. EVIDENCE: People who use the service attended different daytime activities on the day of the visit, including day services for people aged 18 to 65 and older people. They also undertook activities with staff at the home, including board games & crafts. People stated that they enjoy going to the local pub, shops and the park. The comments cards that were received indicated that people could choose what they wanted to do during the day, in the evening and at the weekend. Comments included ‘I go out with my sister and mum every weekend’ and ‘I’m always busy’. Records confirm that people who live at Gratia are in regular contact with their families & friends. People who use the service stated that they enjoy the food that is provided. One of the people who were chosen for the purposes of case tracking assisted staff with the preparation of desserts for the evening meal. Gratia Limited DS0000058192.V370419.R01.S.doc Version 5.2 Page 12 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19 & 20 Quality in this outcome area is good. Action is taken to ensure that people’s personal and healthcare support needs are met. This judgement has been made using available evidence including a visit to this service. EVIDENCE: People who use the service stated that they are happy with the support they receive from staff members. The individual plans that were inspected detailed the personal care each person requires. Health action plans set out details of any healthcare needs that have been identified and of any action that is felt to be necessary as a result. Records indicate that people who use the service are in contact with a range of healthcare professionals where appropriate. None of the people who were chosen for the purposes of case tracking manage their medication. Records of the medicines administered to them generally met relevant requirements. The registered manager agreed to speak to the pharmacist about the printed information on one of the records that were inspected. Staff members have received medication training. A locked box containing medication was not secured to the wall for part of the visit. A recommendation has been made that a chain should be fitted downstairs to enable the box to be secured when out of the office. The home should also ensure its medication cabinet complies with the Misuse of Drugs (Safe Custody) (Amendment) Regulations 2007. Gratia Limited DS0000058192.V370419.R01.S.doc Version 5.2 Page 13 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 22 & 23 Quality in this outcome area is good. People who use the service are protected by the home’s arrangements for handling complaints and responding to allegations of abuse. This judgement has been made using available evidence including a visit to this service. EVIDENCE: People who use the service indicated that they know how to make a complaint. One person stated ‘I tell staff if I’m not happy and they sort it out’. Information received prior to the visit indicates that the home has received one complaint during the last twelve months, which was not upheld. The registered manager agreed to amend the home’s complaints procedure to reflect changes to our (the Commission for Social Care Inspection) address. The home has policies and procedures on the protection of vulnerable adults and whistle blowing. Staff members indicated that they are aware of the action they should take in the event of an allegation or suspicion of abuse. Records relating to people’s individual finances were not available at the time of the visit. Gratia Limited DS0000058192.V370419.R01.S.doc Version 5.2 Page 14 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 24 & 30 Quality in this outcome area is good. People who use the service live in a comfortable and safe environment. This judgement has been made using available evidence including a visit to this service. EVIDENCE: People who use the service stated that they are happy with their rooms and the environment in which they live. They indicated that the home is always fresh and clean. The areas of the home that were inspected were decorated and furnished to a satisfactory standard. People are able to personalise their rooms with possessions and pictures. Work was underway at the time of the visit to solve a leak in an upstairs bathroom. The registered manager stated that areas affected by the leak would be redecorated as soon as the work had been completed. Gratia Limited DS0000058192.V370419.R01.S.doc Version 5.2 Page 15 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 34 & 35 Quality in this outcome area is good. People’s individual needs are met by welltrained staff. This judgement has been made using available evidence including a visit to this service. EVIDENCE: People who use the service indicated that they are treated well by staff and that the latter listen to & act on what they say. There appeared to be a positive relationship between the people who use the service and the staff who were present at the time of the visit. The records relating to three members of staff were inspected. Whilst one indicated that appropriate pre-employment checks had been carried out, the second contained two references from the same person. No explanation was recorded in a third for a gap in the applicant’s employment history. These issues were brought to the attention of the registered manager. New members of staff complete in-house induction training. Information provided prior to the visit indicated that twenty of the twenty-three members of staff have completed National Vocational Qualification level two or above and that two are working towards such an award. Records indicate that staff members have received training on issues such as communication, dementia, person centred planning, risk assessment and safe working practices. A senior Gratia Limited DS0000058192.V370419.R01.S.doc Version 5.2 Page 16 member of staff stated that she had recently completed a fourteen-week course on equality & diversity. Gratia Limited DS0000058192.V370419.R01.S.doc Version 5.2 Page 17 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. 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 are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39 & 42 Quality in this outcome area is good. People who use the service benefit from a well run home. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The registered manager has a Diploma in Management Studies and has worked in the care sector for over twenty years. He stated that quality assurance questionnaires are sent to people who use the service, their relatives and other people with an interest in the home. Completed copies were available from a survey conducted in 2007. He reported that questionnaires had been sent out more recently but that they had yet to be returned. Staff members have received training on a range of safe working practices, including first aid, fire safety, food hygiene, infection control and moving & handling. Records indicate that fire tests & drills take place at the required frequency. Gratia Limited DS0000058192.V370419.R01.S.doc Version 5.2 Page 18 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 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 3 2 3 3 X 4 X 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 3 25 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 X 34 2 35 3 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 4 3 X 3 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 X 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 2 X 3 X 3 X X 3 X Gratia Limited DS0000058192.V370419.R01.S.doc Version 5.2 Page 19 Are there any outstanding requirements from the last inspection? N/a STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. 2. Refer to Standard YA20 YA20 Good Practice Recommendations A chain should be fitted downstairs to enable a box containing medication to be secured when out of the office. The home should ensure that its medication cabinet complies with the Misuse of Drugs (Safe Custody) (Amendment) Regulations 2007. Gratia Limited DS0000058192.V370419.R01.S.doc Version 5.2 Page 20 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 Gratia Limited DS0000058192.V370419.R01.S.doc Version 5.2 Page 21 - 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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