Care Home: Gretton House

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What the care home does well What has improved since the last inspection? CARE HOME ADULTS 18-65 Gretton House 3 High Street Gretton Northants NN17 3DE Lead Inspector Chris Wroe Unannounced Inspection 9th September 2008 10:30 Gretton House DS0000067626.V371236.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 Gretton House DS0000067626.V371236.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. Gretton House DS0000067626.V371236.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Gretton House Address 3 High Street Gretton Northants NN17 3DE 01536 770325 01536 770205 kathrynclarke@btconnect.com www.consensussupport.com Consensus Support Services Ltd 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) Miss Sharon Main Care Home 23 Category(ies) of Learning disability (23), Mental disorder, registration, with number excluding learning disability or dementia (20) of places Gretton House DS0000067626.V371236.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. Gretton Care Home is registered to provide personal care to male and female service users who fall within the following categories:Mental Disorder excluding dementia (MD) 20 No person falling within the category of Mental Disorder should be admitted to Gretton House unless that person also falls within the category Learning Disability, LD ie. Dual Disability 2. Learning Disability (LD) 23 The maximum number of persons to be accommodated within Gretton House is 23 12th September 2006 Date of last inspection Brief Description of the Service: Gretton House is registered to accommodate 23 people with a learning disability, which may include mental health problems. The home offers a specialist service for people who have a condition called Prader-Willi syndrome. The home is in the village of Gretton in Northamptonshire. The home owns five vehicles, which are used to enable access to the nearby towns of Corby and Uppingham. Most people have their own bedroom in the home. There are shared dining and lounge areas, and bathrooms. The house is set in a large garden, which people who live in the home can use. Fees for living in Gretton House range from £793.51 to £2256.22. Gretton House DS0000067626.V371236.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 included a visit to the service. We visited the home on 9th September 2008. The registered manager, Sharon Main, and staff in the home helped us during the visit. The visit started at 10:30am and lasted for six hours. As well as the lead inspector, Chris Wroe, another of our inspectors, Catherine Perrins, visited the home. As part of our inspection, we sent out surveys to some people who live in the home, to some members of staff who work in the home and to other professionals who are involved working alongside the home. We received seven responses from people who live in the home, all giving us very positive answers to our questions. One person told us: “[The staff] are kind and polite and look after us really well”. We also received four surveys from members of staff. They gave us positive responses to our questions, telling us they received good training and that were well supported by the manager. We got back two responses to our surveys from professionals involved with the home. Again, their experience of the home was very good. One person told us: “I feel they provide an excellent service to their residents and work hard at allowing them to lead their own lives within… a ‘care home’ whilst giving them full respect as individuals. The main method of inspection we used was ‘case tracking’. This means looking at the care given to people in different ways. The ways this was done are: • talking to people who live in the home • talking to staff and the manager • watching how people are given support • looking at written records. During this inspection, we checked all the standards that the Commission for Social Care Inspection has decided are ‘key’ standards. Under some sections, we may have checked additional standards – this will be detailed in the main report. The information below is based only on what we checked in this inspection. We have kept details about individual people out of the report, to make sure it is kept confidential. Gretton House DS0000067626.V371236.R01.S.doc Version 5.2 Page 6 What the service does well: Gretton House provides good information for people who want to come to live at the home, to tell them what it will be like. People who might want to live at Gretton House can talk about what their needs are and the managers will assess whether the service can meet their needs. People who want to live here can be confident that their needs will be met and that staff will understand their wishes about how they would like to live their life. This is partly because staff have good training to help them support people well. There are good written records in the home, which tell about people’s needs and the kind of support that is most helpful for them. People can prepare person centred plans with staff if they want to, to give more detail about their likes and dislikes and how they want to live their daily lives. Staff help people to do what they want to do. Staff carry out risk assessments, which help to work out how to let people to live as independently as they can whilst staying safe. People who live in Gretton House are supported to have a very good lifestyle. People are able to choose different things they want to do, either in the home or outside. People can go to college to do courses, – or do some of the activities that are put on at the home, like learning in the nature garden, or doing pottery or music. People are supported to have contact with family and friends, and to be part of their local community. Staff support people to keep links with their own culture and community if they want to, and people can choose to go to church or other religious events if they would like to. Good attention is paid to people’s diet in Gretton House. People who live in this home have the chance to be involved in cooking if they would like to, and they can have food hygiene training so they know how to handle food safely. Menus are changed regularly and there is a good variety of food, with a lot of focus on health eating. Staff support people who live in Gretton House to keep themselves healthy and well. People can have regular check-ups to make sure they are physically well. Each person is given individual care and attention. Staff are well trained to make sure they give out medicines properly. People who live in Gretton House know how to make a complaint if they want to. People told us that they feel listened to and that they are treated with respect by staff. Everyone who works in the home has had training to help them to understand how to keep people safe who may be vulnerable. The manager makes sure that reports are sent to us about any serious incidents in the home, and that staff follow the rules about how to safeguard people who live in the home. When we visited Gretton House we found that it is decorated well and is clean and fresh. People who live in the home tell us that this is always how it is. Gretton House DS0000067626.V371236.R01.S.doc Version 5.2 Page 7 Gretton House is a large old manor house, and it has a homely and comfortable feel. Each person who lives in the home can make their bedroom their own space, with their own personal things. We saw how much people have enjoyed doing this. Members of staff in this home get very good training, both when they start working in the home and as they carry on. The owner makes sure that all the proper checks are done for new members of staff to make sure they are safe to work with people in the home – for example checks with the Criminal Records Bureau. Staff who work in the home told us that they feel well supported. There is a good management system within the home, to make sure that all jobs are done well. The Registered Manager has a lot of training and experience, and communicates well with staff and people who live in the home. The owner often checks out how things are running to make sure standards are high. Surveys are given to people who live in the home to find out their views. We saw that people are very satisfied living in this home. Staff are trained to make sure they carry out their work safely, and the manager makes sure tests are done on equipment to keep it safe for use. What has improved since the last inspection? At the last inspection, we did not ask for any improvements in the home. The manager has told us about some things which have improved, including: The written information for people who move into the home has been looked at and changed to improve it. All care staff have had training about person centred planning, which helps support people who live in the home to say what they want and need in living their daily lives. Staff keep everything up to date in care plans and make sure they properly include information about what people’s needs are. More attention is given to making sure that people’s needs in relation to their culture are met – as well as other aspects which are important to them. There is e mail and internet access in the home, which means staff have better access to information. People who live in the home can also use these to keep in contact with families and friends. There are more opportunities for employment for people who live in the home, including work within the home, such as in the kitchen and in the offices. Gretton House DS0000067626.V371236.R01.S.doc Version 5.2 Page 8 The home has improved the way it keeps people safe. A local community police officer is linked with the home and comes in to talk to people who live in the home when it would be helpful. There have been some improvements to the home to continue to provide a safe and pleasant living environment – for example new security systems on the outside doors, and fire safety improvements. The ‘induction’ training for staff when they start working at Gretton House has improved. This includes some reading and learning and some time working alongside an experienced staff member. New staff can have a ‘buddy’ to support them until they feel confident to work alone. All members of staff now have a training plan so they can decide what kind of training they need, as well as doing the training they have to do. Each member of staff gets good written information to help them understand their job and what they can expect. These are some of the things the manager has told us that they have improved as a result of listening to people who live in the home: • Improved the way they display daily menus for people who live in the home • Improved choices on daily food menus • Bought a pool table for people to use • Improved choices relating to holidays, so they are more individual to people’s wishes and choices. • Got SKY TV in the communal lounge • Given more choices in social activities for people • Accessed more employment opportunities for service users, including working with Rutland County Council Employment and Development Officer • Increased leisure and social activities throughout the summer break by introducing a new summer timetable • Introduced more entertainment shows in the home • Included a person who lives in one of the Gretton Homes to give staff training in Person Centred Planning • Involved people who live in the home in employing new members of staff to work in the home • Introduced training courses for people who live in the home, in subjects like food hygiene awareness and infection control Gretton House DS0000067626.V371236.R01.S.doc Version 5.2 Page 9 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. Gretton House DS0000067626.V371236.R01.S.doc Version 5.2 Page 10 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 Gretton House DS0000067626.V371236.R01.S.doc Version 5.2 Page 11 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, 3 Quality in this outcome area is excellent This judgement has been made using available evidence including a visit to this service. People who come to live in this home can make a proper choice about whether they would like to live here and be confident their needs will be met. EVIDENCE: People who live in the home told us that they had been given information about the home before they moved in. They told us they were able to choose whether they wanted to move into the home. One person told us “I watched a video about the place… I came to visit the house and they gave me information”. We saw the Service User Guide, which is information given to people who want to move into the home – this was written in plain English and gave good details about life in the home. We talked with the manager and staff and looked at written records. We found that when people come to move into the home, their needs and wishes are looked at to see whether the home can offer them the right kind of support. Information from other people, like social workers and families is used to help make this decision. Gretton House DS0000067626.V371236.R01.S.doc Version 5.2 Page 12 Staff in the home have training to help them to understand the needs of people living in the home, and to do their job well. They keep up to date with learning, so that they can understand the best ways to support people – for example senior staff have had training about the Mental Capacity Act, which makes sure that people have rights to make choices in their own lives. One person who comes in to the home to work with people who live there told us: “Gretton House and its staff appear up to date with current health issues and are regularly training staff in aspects of health, and actively encourage visitors (for example, me) to join the Prader Willi Syndrome Association.” Staff showed us that they communicate with people who live in the home well, and are sensitive to their needs and wishes. Gretton House DS0000067626.V371236.R01.S.doc Version 5.2 Page 13 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 excellent This judgement has been made using available evidence including a visit to this service. People who live in this home have their individual needs and choices very well met. EVIDENCE: We found that each person who lives in this home has a plan of care, which tells about what their needs are and what kind of support they should get from staff. These are checked regularly to make sure they still give the right information or when something important happens. Staff told us they feel they are given good information to help them to understand the support that each person needs. One member of staff told us: “Myself and my manager have a good working relationship and she always updates me on any changes immediately”. People who live in the home are involved in making sure their own care plans are right. Those people who want to are having person centred care plans made. These look at what someone needs from their own point of view, and what choices they would make in their daily life. Gretton House DS0000067626.V371236.R01.S.doc Version 5.2 Page 14 From the information we read, we could see that people who live in this home are given choices about how they want to live their lives. People who live here also told us that this is true. They told us that they were able to make decisions about what they do each day, and that they generally do what they want to during the day, in the evening and at weekends. They told us they feel the staff treat them well. One person told us “They are kind and polite and look after us well”. Another said “They are well commended on behalf of the residents on the care we have”. We watched when we visited the home and we saw that staff do treat people who live there well and that they listen to them. We talked to staff and to the manager and they showed us that they know what is important for each person who lives in the home and understand what they need. Other professionals who come to see people who live at the home told us they feel that staff meet people’s care needs well. One person told us: “The staff team appear to be caring and honest…all [people who live in the home] are treated and respected as individuals…” Two members of staff told us that it would be good if they could have more one to one time with some people who live in the home. This is something that we know (from written information we have received) that the manager has recognised too, and something the she wants to improve. People who live in the home can have the support of an advocate if they want to, who can help them to speak up for themselves. Staff can help people to manage their money if they need support. We did a check on how people’s money is managed in the home and found that there were proper systems in place to make sure money was safeguarded. We saw that there are risk assessments written, which tell about how people can be supported to do different things whilst being kept safe. There are ways in which some people in this home particularly need to be looked after by the care staff, and helped to take care of themselves safely – and there is good written information to show how staff do this, whilst giving each person the right to live their life as much as they choose as possible. The fact that staff have good training helps to make sure that people’s rights are protected and that they are kept safe. We saw that staff keep good records to make sure that anything they have to do to keep someone safe is properly written down. Gretton House DS0000067626.V371236.R01.S.doc Version 5.2 Page 15 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 and 17 Quality in this outcome area is excellent This judgement has been made using available evidence including a visit to this service. People who live in this home benefit from a very good lifestyle. EVIDENCE: We found that people who live in the home are supported to take part in many different activities. We saw from written records that staff have found out about the kinds of things that each person likes to do, and everyone has their own daily planner showing what they get involved in. Some of the activities include bowling, going out to the pub, playing snooker, and going for walks. When we visited the home, some of the people who live there were away on a fishing holiday. The home has use of five vehicles to take people out. People who live in the home can go to one of three local colleges if they would like to, to do courses like pottery and woodwork. The home also buys in Gretton House DS0000067626.V371236.R01.S.doc Version 5.2 Page 16 courses, because there is now a limit as to how long people can go to college. The home has an allotment and people help to grow plants and produce. One person who comes in to the home to work with people told us: “Staff give exceptional support to residents to help them live the life they choose…” Some people who live in the home have paid jobs, such as delivering leaflets for the local council. People who live in the home can also attend churches or other places of worship if they want to, and they are involved in local church groups. Staff support people to choose what they want to do. People who live in the home told us about the different things they do and how they like to spend their time. Each person has their own things in their bedroom that are special to them. People told us about how they are supported to be involved with their families and friends, having visitors in the home or going out to see people. The manager told us that staff have realised that they need some training about how to support people to make choices and have relationships – and on the day we visited the home, this training was being given to some members of staff. There is a catering manager who is in charge of all the food preparation in the home. She told us about how she looks after people’s different diet needs, and pays special attention to issues related to Prader Willi Syndrome. There is a menu, which changes regularly – and everyone who lives in the home can give their ideas about what they would like to eat. Staff support people to have a healthy diet, and the menus include seven portions of fruit or vegetables each day. People who live in the home are encouraged to help to prepare food if they would like to, and staff give support to people to prepare meals from a range of cultures and communities. People who live in the home can do training in food hygiene, to give them an understanding of how to handle food safely. Gretton House DS0000067626.V371236.R01.S.doc Version 5.2 Page 17 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 This judgement has been made using available evidence including a visit to this service. People who live in this home benefit from health and personal care which pays good attention to their needs. EVIDENCE: We found that people who live in the home are encouraged and supported to take care of their health and wellbeing. People are given support to carry out personal care if they need it, and enabled to be independent if they choose. We saw from care records that staff pay attention to each individual’s needs. People are able to choose to have a male or female member of staff to help them to carry out personal care. We saw during our visit that staff were sensitive in how they supported each person. People who live in the home told us that they feel well cared for. They told us that staff help them to look after themselves. Staff told us that they feel they are given enough information and training to help them to give the right kind of support to people. Gretton House DS0000067626.V371236.R01.S.doc Version 5.2 Page 18 Everyone who lives in the home can have a regular health check if they choose. Staff in the home understand the importance of paying attention to physical health in relation to Prader Willi Syndrome. We found that people are having different kinds of health checks, and are supported by other professionals, like psychiatrists and GPs. One professional who supports people in the home told us what they thought staff did well in helping people to take care of themselves: “ [promote] healthy eating, healthy lifestyle; choices/opportunities…; [they]work well with others eg. community team for people with learning difficulties; seek advice and guidance for clients; allow clients independence with professionals…”. The manager and staff help other people to better support people who live in the home. We saw that medication is looked after properly and there are safe ways of giving medication to people. We found two things in medication records that could be improved, but they were not issues that would cause a risk to people, because we saw that there are other ways staff check and make sure medicines are given and recorded safely. Every member of staff who gives out medicines has been given training. Gretton House DS0000067626.V371236.R01.S.doc Version 5.2 Page 19 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 excellent This judgement has been made using available evidence including a visit to this service. People who live in this home benefit from well-trained staff who listen to them and look out for their safety and well-being. EVIDENCE: We found that the manager and staff gave information to people who live in the home about how to make a complaint. People we spoke to during our visit said that they felt able to talk to the manager or to staff about anything they were not happy about. Other people who live in the home also told us the same thing in the surveys they sent to us. They told us they know how to make a complaint. One person said: “I know I can fill a form out and hand it to staff”. People who live in the home also told us that when they do raise any concerns they feel listened to. One person told us: “The carers listen to us if we have any problems that we face”. Another said “If we are upset they listen to us then we will sort our problems out.” The manager and members of staff in the home have all done training about how to keep people who live in the home safe. We saw during our visit that staff showed respect to people who live in the home, and were protective of their wellbeing. Staff we spoke to showed us that they understood how important it is to keep people who could be vulnerable safe. Every care service has to report to us about any serious things which happen, which might affect people who use the service. The manager and staff in this Gretton House DS0000067626.V371236.R01.S.doc Version 5.2 Page 20 home are very good at reporting any incidents like that to us. We also found that they make sure they involve other people, like social workers, or the police, where this is important to protect people. Sometimes meetings have been held to discuss issues, and when the manager and staff have been asked to make any changes, they have done this. For example, on the day we visited the home, some staff were receiving training about how to support people who live in the home to have relationships safely. This is very positive work. One person who comes into the home to work alongside the staff commented to us: “Any matters raised are dealt with quickly and efficiently in the appropriate manner… I feel [staff] treat residents very well in a very humane and caring fashion.” Gretton House DS0000067626.V371236.R01.S.doc Version 5.2 Page 21 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, 25, 30 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. People who live in this home benefit from having a homely, clean and well looked after environment. EVIDENCE: We looked around parts of the home during our visit, and we asked people who live there what they thought about the home. We found that all parts of the home looked clean and were very well decorated and furnished. Although the house is large, it had a comfortable and homely feel. The areas that people share, like the lounge and dining room, are bright and light, with vases of flowers and pictures on the walls. Most people who live in the home have their own bedroom, and there is one bedroom which is shared by two people. Some people showed us their bedrooms, and we saw that everyone has their own personal things, and Gretton House DS0000067626.V371236.R01.S.doc Version 5.2 Page 22 makes their room their own, with things like pictures or posters, and their own choice of room colour or bedding. People who live in the home enjoyed telling us about what was special to them in making their room their own space. Most of the rooms were a good size. There are a couple of smaller rooms, and some bedrooms do not have their own en suite facilities - but the owner is planning to make some improvements in the home to improve this. There are shared bathrooms and toilets, which again, we saw to be homely and well decorated. We also found all parts of the home we looked at to be fresh and clean, and people who live in the home told us that this is always the case. There are domestic staff working in the home who do cleaning, and one of the managers is responsible for overseeing their work. There is a laundry room in the home, where people may do their own washing if they want to, or staff can help with this. We saw that there are enough machines for the needs of the service. Staff told us about the procedures in the home to help them make sure cleaning and washing is done safely. There are also large, well-kept gardens around the home, which include a nature area and a putting green. People who live in the home told us how they enjoy sitting in the garden in the nice weather. We saw that the home is made safe for people to live in - for example we saw that there are window restrictors on all of the upstairs windows, meaning they can only be opened a safe distance. Safety checks are carried out in the home, and we saw written records of all kinds of checks that are made, and of ongoing maintenance of the property. Gretton House DS0000067626.V371236.R01.S.doc Version 5.2 Page 23 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 excellent This judgement has been made using available evidence including a visit to this service. People who live in this home benefit from having a very well trained and well supported staff team. EVIDENCE: People who live in this home have told us they feel well supported and cared for by staff. Some people are being given the chance to be involved in the employment of new staff. They can meet with people who want to work at the home during a visit, and can ask them questions. We found that all the proper checks are made for new staff who come to work in the home to make sure that they are safe to work there. This includes Criminal Record Bureau checks. No one works in the home without proper checks and supervision. New staff ‘buddy up’ with staff who have worked in the home for longer during their induction training and until they feel confident. Gretton House DS0000067626.V371236.R01.S.doc Version 5.2 Page 24 Most staff working in Gretton House have been there for a long time, which gives good continuing care for people. The home has a lot of relief staff, who can help out when there is staff sickness, or new staff. This is good because it means there are always staff who understand the needs of people living in the home, and means the service does not need to use agency staff. Staff told us they feel well supported by their managers. Each member of staff gets supervision from their manager, to make sure that they feel supported, that they are doing their job in the right way, and that they have the training they need. One member of staff told us: “I always enjoy my support and supervision within Gretton homes as this makes me feel more valued.” As well as the registered manager, Sharon Main, there are other managers in the home who are responsible for different tasks. The main offices for the Gretton Homes group of homes is also in the grounds of the house, and so staff have ready access to training and personnel support. We learnt that new staff have good ‘induction’ training when they first start working at the home. This includes some reading and learning and some time working alongside an experienced staff member. Topics that new staff learn about during their induction include moving and handling, first aid, person centred care, equality, medication, fire safety and sexuality. Staff also completed the Learning Disability Awards Framework (LDAF), which is particular training about supporting people who have learning disabilities. We also saw that staff have good ongoing training to help them continue to do their job well. Each staff member has a training plan. The training includes how to respond to challenging behaviour, keeping vulnerable adults safe, and how to give out medication safely. Members of staff told us that the training they receive was good. One staff member said, “You can’t fault the training.” Sixteen members of staff (out of twenty-two) have achieved their National Vocational Qualification (NVQ) Level 2 in care, and four more are working towards it. One member of staff told us: “I am currently doing NVQ 3 and the support I am receiving is brilliant!” We found that the manager makes sure that staff keep aware of new areas of training which would help them to do their job well, for example senior staff have had training about the new Mental Capacity Act, and what this means about the rights of people who live in the home. Gretton House DS0000067626.V371236.R01.S.doc Version 5.2 Page 25 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 excellent This judgement has been made using available evidence including a visit to this service. People who live in Gretton House benefit from having a very well managed and run home. EVIDENCE: The Registered Manager, who has overall responsibility for the home, has many years experience working in the home and has had all the required training to help her do her job well. We saw when we visited that she communicates well with staff and with people who live in the home. People told us that she is supportive. There are also other managers in the home who oversee different parts of the running of the home. There are two care managers, who look after the Gretton House DS0000067626.V371236.R01.S.doc Version 5.2 Page 26 support workers, and there is a deputy manager, a catering manager and a domestic manager. This team works together well to make sure the home runs smoothly. The owner also carries out checks to make sure that staff are working to high standards, and that people’s needs are being met. We were given information about how the service finds out about the views of people who live in the home. There are meetings held often so that people can give their views. People are given surveys that they can fill in – and we saw from these that people are very satisfied living in this home. These are some of the things the manager has told us that they have improved after listening to people who live in the home: • Improved the way they display daily menus for people who live in the home • Improved choices on daily food menus • Bought a pool table for people to use • Improved choices relating to holidays, so they are more individual to people’s wishes and choices. • Got SKY TV in the communal lounge • Given more choices in social activities for people • Accessed more employment opportunities for service users, including working with Rutland County Council Employment and Development Officer • Increased leisure and social activities throughout the summer break by introducing a new summer timetable • Introduced more entertainment shows in the home • Included a person who lives in one of the Gretton Homes to give staff training in Person Centred Planning • Involved people who live in the home in employing new members of staff to work in the home • Introduced training courses for people who live in the home, in subjects like food hygiene awareness and infection control The staff have also been asked in a questionnaire about their views about how the home runs. We saw from records that the manager and staff pay good attention to safe ways of working in the home. There are policies, which have information for staff about how to work safely – for example, how to stop infection spreading by using safety equipment and good standards of cleaning. Staff carry out checks of equipment to make sure it is safe. Members of staff also have training about how to work safely, for example fire safety training, to make sure they know how to help people get out of the building safely if there is a fire. The manager makes sure that all safety tests are done that are required by law. Gretton House DS0000067626.V371236.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 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 4 3 4 4 X 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 4 23 4 ENVIRONMENT Standard No Score 24 4 25 3 26 X 27 X 28 X 29 X 30 4 STAFFING Standard No Score 31 X 32 4 33 X 34 4 35 4 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 4 3 X 4 X LIFESTYLES Standard No Score 11 X 12 4 13 4 14 X 15 3 16 4 17 4 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 4 4 3 X 4 X 4 X X 4 X Gretton House DS0000067626.V371236.R01.S.doc Version 5.2 Page 28 No Are there any outstanding requirements from the last inspection? 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 YA20 Good Practice Recommendations It is recommended that written clarification/instruction is obtained from the GP where someone regularly misses medication, so that staff can ensure that people’s health is maintained. Gretton House DS0000067626.V371236.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 Gretton House DS0000067626.V371236.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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