Care Home: Grimston House

What the care home does well The home is well managed. The care, health and safety of the service users is promoted and upheld at all times and all the staff have received the necessary training to undertake their roles. The care staff are aware of the assessed needs and work in accordance with the care plans. All staff spoken to are motivated and positive and reported that they enjoy working at the home. They said that they get the support and guidance they need to undertake and fulfil their roles. The home has a good working relationship with other professionals working in the community. Grimston House provides a homely, comfortable friendly environment for service users to live in and for staff to work in. The premises are clean, pleasant and maintained to a high standard. It was observed that the staff and service users have good positive relationships with each other. Service users are treated with dignity and respect and staff interact and communicate effectively. What has improved since the last inspection? This was the first inspection since registration of the current provider. What the care home could do better: There were no requirements or recommendations identified at this visit. CARE HOMES FOR OLDER PEOPLE Grimston House 16 Grimston Gardens Folkestone Kent CT20 2PU Lead Inspector Geoff Senior Unannounced Inspection 24th June 2008 10:30 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 Grimston House DS0000071529.V365346.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. Grimston House DS0000071529.V365346.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Grimston House Address 16 Grimston Gardens Folkestone Kent CT20 2PU 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) 01303 244958 marcella.permall@btopenworld.com Rosemere Care Home Ltd Manager post vacant Care Home 21 Category(ies) of Old age, not falling within any other category registration, with number (0) of places Grimston House DS0000071529.V365346.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The registered person may provide the following category/ies of service only: Care home only - (PC) to service users of the following gender: Either Whose primary care needs on admission to the home are within the following categories: 2. Old age, not falling within any other category (OP). The maximum number of service users to be accommodated is 21. First inspection since registration of current provider. Date of last inspection Brief Description of the Service: Grimston House is registered to provide 24-hour residential care for up to 21 older people. The Home is a large detached three-story building, situated in a quiet residential road, close to all local amenities and public transport services. There are spacious communal areas that include a lounge, which leads on to a conservatory and a dining area which also offers the extra facility as a private quiet, comfortable space which can be used by service uses and their friends and relatives. There are 17 single and 2 double bedrooms.All but one are fitted with en-suite facilities. The Home provides a passenger lift to all floors. The garden is a pleasant and well maintained having the provision of a wheelchair ramp and facilities for service users to sit out-side. The home is owned by Rosemere Care Home Ltd and is Managed on a daily basis by an unregistered manager who is assisted by team leaders, care workers and ancillary staff. The providers of the home are frequently on site and available for the service users and staff when necessary. The fees range from a minimum £340. The quality rating for this service is 2 star. This means that people who use this service experience Good quality outcomes. Grimston House DS0000071529.V365346.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. We undertook an unannounced visit to the premises on 24th June 2008 as part of the Key Inspection of Grimston House. The visit lasted about 5 ½ hours. The inspection considers information obtained from talking with residents, staff, management and providers. We also examined a range of records and documentation kept in the home. An accompanied tour of the premises was made. The home provided information in a completed Annual Quality Assurance Assessment that was returned when we asked for it. The home strives to maintain and improve the quality of care provision. Service Users expressed their satisfaction with the care provided and commented on the commitment of manager and staff. Staff spoken with expressed a positive attitude and appeared dedicated to their task. The Providers are supportive of the staff and management and are committed to providing education and training support to the staff group. What the service does well: The home is well managed. The care, health and safety of the service users is promoted and upheld at all times and all the staff have received the necessary training to undertake their roles. The care staff are aware of the assessed needs and work in accordance with the care plans. All staff spoken to are motivated and positive and reported that they enjoy working at the home. They said that they get the support and guidance they need to undertake and fulfil their roles. The home has a good working relationship with other professionals working in the community. Grimston House provides a homely, comfortable friendly environment for service users to live in and for staff to work in. The premises are clean, pleasant and maintained to a high standard. It was observed that the staff and service users have good positive relationships with each other. Service users are treated with dignity and respect and staff interact and communicate effectively. Grimston House DS0000071529.V365346.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. Grimston House DS0000071529.V365346.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 Grimston House DS0000071529.V365346.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): 1,3,4,5. People who use the service experience good quality outcomes in this area. The home ensures that a detailed assessment of needs is carried out for all prospective service users. The service users and their representatives know that the home will be able to meet their needs. The home does not offer intermediate care placements This judgement has been made using available evidence including a visit to this service. EVIDENCE: People who are interested in living at the home are invited first of all, to visit for lunch or a cup of tea. They may use the opportunity to meet and spend time with the existing residents and staff, view the accommodation and find out about the lifestyle and routine they could expect to experience at Grimston Grimston House DS0000071529.V365346.R01.S.doc Version 5.2 Page 9 House. Written information about the home is already available but the new owners are producing an updated brochure. Prior to any admission to the home the manager undertakes a full assessment that explores all the relevant areas of care including social needs, medical history, mobility and mental cognition to determine suitability for living at Grimston House. Information is gathered from hospital staff, care managers and relatives. . All the information is brought together to decide whether or not the home will be able to meet the service users assessed needs. This then forms the basis for developing the care plan. The home tries to avoid emergency admissions. There is a good mix of youth and experience in the staff team who have the skills, knowledge and experience to meet the assessed needs of the service users in their care. Staff were seen to communicate well with the service users and the atmosphere was relaxed. The service users spoken with were happy and content with the home and felt that their needs were being met. Specialist services are available to any of the service users as the need arises Grimston House DS0000071529.V365346.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): 7,8,9,10. People who use the service experience good quality outcomes in this area. Health personal and social needs are met and set out in a care plan, which is available to all staff. There are working practises in place, which enable service users to have a good experience of care provision This judgement has been made using available evidence including a visit to this service. EVIDENCE: Service users said that the staff care for them very well “I feel safe and can relax knowing there are people here to help when I need it”. They also confirmed that they are asked as to how they like to be cared for and consulted about their preferred routine. The care plan format is being changed in line with the other homes in the organisation. Examples were seen of both original and ones that have been Grimston House DS0000071529.V365346.R01.S.doc Version 5.2 Page 11 updated. They identify the needs of the service users and how the care staff are expected to meet them, taking into account the preferences of the service users. Risks are identified and there are guidelines in place to explain how they are to be minimised. Each care file contains a profile and pen picture and includes information pertaining to the individual. Reviews are carried out regularly and the service users are reportedly involved throughout the process. There was however no indication on file of service user involvement or comment. There are regular visits from the chiropodist, optician and dentist. Continence advice is sort as the need arises. The local Older Peoples Mental Health team is also accessed as necessary. The service users are encouraged to exercise and to mobilise around the home and go out for local walks. The Home uses a monitored dose cassette system for administering medication. Only staff that have received the appropriate training can administer medication and a list of these staff and their signatures has been compiled. All training being refreshed/ updated by the organisations’ training manager. Arrangements for storage are satisfactory and records seen were up to date. Procedures for the administration of P.R.N. are in place, so staff administering the P.R.N medication have guidelines and instructions on when to give the medication to the service users. There are currently no service users who self medicate. The option, and storage facilities in own rooms, is available if required and appropriate. Staff were observed assisting and responding to service users in a friendly, non patronising and calm manner. They were also seen to be friendly and welcoming of visitors All rooms have locks should service users wish to use them and visitors can be entertained in the individuals room or in quiet communal area in the dining room. Most of the rooms have telephones so that calls can be made privately. Grimston House DS0000071529.V365346.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): 12,13,14,15. People who use the service experience good quality outcomes in this area. Service users are encouraged to maintain contact with relatives and friends. The dietary needs of the service users are well catered for with a balanced and varied selection of food available that meets service users tastes and choices. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Visitors are welcome within the home at all reasonable times and no restrictions are imposed. Staff respect the wishes of the service users should they not wish to see someone. Service users are able to receive their visitors in the privacy of their own rooms or in the quiet communal area. It was noted Grimston House DS0000071529.V365346.R01.S.doc Version 5.2 Page 13 that staff took time to chat and reassure/ help visitors as they arrived and as they departed. Service users are encouraged to be involved with the local community and the manager tries to ensure that any one who wishes to go out receives the support and assistance to do so. There is however no transport other than staff cars. The Manager will stagger staff hours on the rota to enable service user inclusion in any activities that may be taking place. ‘Sing for your life’ at the Salvation Army is very popular. A weekly Garden centre lunch and walk, The Leas promenade is nearby for walks, views and bandstand, as is a place for pub lunches. Service users confirmed they can join in or decline as they wish; they have plenty to occupy them inside and out and are never bored. Service users are supported to attend church and to receive communion in the home. Service users have a choice of menu and of when and where to eat. Some prefer rooms; others like to mix in the dining room. No special dietary needs are catered for currently. The staff do however, cater for particular tastes and preferences. Menus are compiled on a weekly basis and provide a range of that all Service Users said they enjoy. All the service users spoken to said the food was very good. Service Users are provided with three meals a day, with the main meal being taken at lunchtime. Service Users also felt that they could ask for extra drinks and snacks at any time. Grimston House DS0000071529.V365346.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): People who use the service experience good quality outcomes in this area. The complaints process is available within the home. The rights of the service users are acknowledged upheld and staff are trained in the protection of vulnerable people from the risk of abuse. This judgement has been made using available evidence including a visit to this service. EVIDENCE: . Each service user has a copy of the complaints procedure displayed in their rooms and the service users spoken to are aware of what they had to do if they wished to make a complaint. There is a copy of the complaints procedure on display in entrance hall which contains all the relevant information and how to contact the CSCI, and an assurance that the complaint will be responded to within 28 days. There have been no complaints made in the past 12 months. The manager is aware of the requirement to keep records of complaints, details of the investigations and action taken. The home has the appropriate Adult Abuse policies in place and also a Whistle Blowing Policy. The new owners are AP trainers and have instructed all staff in Grimston House DS0000071529.V365346.R01.S.doc Version 5.2 Page 15 protecting vulnerable adults. The staff spoken to were aware of the appropriate action to take if they had concerns. The robust employment process undertakes checks on potential staff prior to commencement of duties. Grimston House DS0000071529.V365346.R01.S.doc Version 5.2 Page 16 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 19,26. People who use the service experience good quality outcomes in this area. The Home provides a clean, pleasant and safe environment for the service users. This judgement has been made using available evidence including a visit to this service. EVIDENCE: During an accompanied tour of premises all areas were seen to be clean, tidy and free from undue odours. There is an ongoing redecoration programme and all rooms are decorated and re-carpeted as they become vacant. Each room may be furnished with service user’s own belongings if preferred. One room was almost completely furnished with occupier’s own whilst others were seen to prefer just to bring a few mementos. All may have their own key. Grimston House DS0000071529.V365346.R01.S.doc Version 5.2 Page 17 There are adequate facilities for laundry and catering. Externally there is an enclosed garden that service users enjoy using or looking at from their room. One of the owners is a trainer for Health and Safety, Risk Assessment, and Infection Control and gives staff the required instruction. Maintenance contracts ensure rapid response for repairs and maintenance and safety checks. Grimston House DS0000071529.V365346.R01.S.doc Version 5.2 Page 18 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 27,28,29,30. People who use the service experience good quality outcomes in this area. Staff morale is high amongst the majority of staff employed by the home. Resulting in an enthusiastic workforce that works positively with the service users. Staff have received the required induction and training to ensure a clear understanding of their roles. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home employs a total of 17 care staff working to a rota which allows for 4 Carers and the Manager on duty in the morning, The staff rota was seen, evidencing that 3 to 4 staff on are on duty daily, plus the Manager, with 2 waking staff at night. In addition to this, the Home employs a cook and a housekeeper. The Home does not rely on agency staff at present and has a generally stable and static workforce. All the service users spoken to said that there are enough staff on duty at any one time to meet their needs. Grimston House DS0000071529.V365346.R01.S.doc Version 5.2 Page 19 A robust recruitment process ensures appropriate checks and references are sought before employment is commenced and this was verified from looking at the staff files. All staff receive a comprehensive and thorough induction. The home has the services of a Training Manager who undertakes training needs assessment with all the staff and liaises with Manager to arrange appropriate courses. A training timetable and matrix on display in office indicated that mandatory training was up-to date for all members of staff and was on-going. Specialist training is in place to ensure that all service users needs are met. 11 of the 17 staff employed by the home have now obtained NVQ level 2 or above. The providers have a background of teaching in the nursing and care fields and staff competency and education is high on their agenda. Grimston House DS0000071529.V365346.R01.S.doc Version 5.2 Page 20 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): 31,33,35,38. People who use the service experience good quality outcomes in this area. The unregistered manager manages the home to a standard that aims to ensure that the needs of the service users are met at all times. The views of the residents are sought and their best interest considered, when decisions are made about the running of the home. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Grimston House DS0000071529.V365346.R01.S.doc Version 5.2 Page 21 The providers and management team have long experience of providing care in a residential setting. They also have qualification and skills in nursing and lecturing in the nursing and general care studies field. The unregistered manager presents as a well-motivated and informed individual who has worked hard to maintain an open and inclusive atmosphere in the home. She is seeking to enrol and complete NVQ 4 in Care and is also keen to promote appropriate and relevant training for her staff. She is developing the skill of delegation in order that she can spend a reasonable amount of time at floor level as well as ensure the completion of administrative and supervisory tasks. She is well supported by the providers who visit the home daily. They and the manager are clearly committed to maintaining standards and seeking ways to improve the service. Residents and staff stated that they are regularly consulted and have ample opportunity to contribute to the decision making process. Quality assurance surveys are carried out and issues acted upon. The home is also subject to quality audits from a care homes association. The health, safety and welfare of all is promoted and protected. The staff feel that the home is run in the best interests of the people who live there. Grimston House DS0000071529.V365346.R01.S.doc Version 5.2 Page 22 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 3 3 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 X X X X 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 X X 3 Grimston House DS0000071529.V365346.R01.S.doc Version 5.2 Page 23 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 Grimston House DS0000071529.V365346.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Maidstone Office The Oast Hermitage Court Hermitage Lane Maidstone ME16 9NT 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. 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