Care Home: Grovewood House

What the care home does well The needs and wishes of each person living at Grovewood House have been properly assessed before they moved into the Home. This meant that staff knew about the needs of each person and what care and support they required. Plans of care and risk assessments are in place for each person. This meant staff had the information they needed to support each person. People`s health care needs are met by good care practice and effective joint working with health professionals. People are encouraged and supported to make decisions about their daily lives and preferences so that they retain their independence and individuality. People living at Grovewood House are encouraged and supported to maintain contact with their friends and family. The relationships between staff and people living at the home were good and personal support was provided in such a way as to promote and protect privacy and dignity. Complaints procedures are clear and people living in the home are made aware of them. Staffing levels are adequate and appropriate training is provided to ensure that staff have the skills and knowledge to provide high quality care. What has improved since the last inspection? A system is in place evaluating the quality of the service and this is being developed and maintained. Care planning for individuals is generally good and has improved since the last inspection, although the standard of recording does sometimes vary and this could affect the quality of care provided to residents. A new shower room has been provided on the ground floor that provides good access for people with disabilities. CARE HOMES FOR OLDER PEOPLE Grovewood House Main Street South Charlton Alnwick Northumberland NE66 2NB Lead Inspector Anne Urwin Brown Key Unannounced Inspection 24th June 2008 09:00 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Grovewood House DS0000000641.V366824.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. Grovewood House DS0000000641.V366824.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Grovewood House Address Main Street South Charlton Alnwick Northumberland NE66 2NB 01665 - 579249 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) no email Mr Bakr Mrs Bakr Mrs Linda Steele Care Home 34 Category(ies) of Dementia - over 65 years of age (26), Old age, registration, with number not falling within any other category (8) of places Grovewood House DS0000000641.V366824.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 25th June 2007 Brief Description of the Service: Grovewood House is located in the village of South Charlton, a few miles north of Alnwick. The house is set in its own grounds and has been converted and extended to accommodate up to thirty-four elderly people. There are attractive gardens to the front and side of the building with ramped level access to the front entrance and garden entrance. The accommodation is arranged on two floors and stair lifts are fitted. Public transport is very limited and the main links are by bus from Alnwick or train from Alnmouth. Fees are from £414.72 to £409.40 per week for accommodation. A copy of the Statement of Purpose is available at the home that provides clear information about the facilities and services provided by Grovewood House. Grovewood House DS0000000641.V366824.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating of this service is 2 star. This means that people using this service experience good quality outcomes. How the inspection was carried out Before the visit: We looked at: • Information we have received since the last visit on 25th June 2007. • How the service dealt with any complaints & concerns since the last visit. • Any changes to how the home is run. • The provider’s view of how well they care for people. • The views of people who use the service & their relatives, staff & other professionals. The Visit: An unannounced visit was made on 24th June and a further visit was made on 3rd July 2008. A total of eight hours was spent at Grovewood House. During the visit we: • • • • • • Talked with people who use the service, relatives, staff, the manager & visitors. Looked at information about the people who use the service & how well their needs are met, Looked at other records which must be kept, Checked that staff had the knowledge, skills & training to meet the needs of the people they care for, Looked around the building/parts of the building to make sure it was clean, safe & comfortable, Checked what improvements had been made since the last visit. We told the manager/provider what we found. What the service does well: The needs and wishes of each person living at Grovewood House have been properly assessed before they moved into the Home. This meant that staff knew about the needs of each person and what care and support they required. Plans of care and risk assessments are in place for each person. This meant staff had the information they needed to support each person. Grovewood House DS0000000641.V366824.R01.S.doc Version 5.2 Page 6 People’s health care needs are met by good care practice and effective joint working with health professionals. People are encouraged and supported to make decisions about their daily lives and preferences so that they retain their independence and individuality. People living at Grovewood House are encouraged and supported to maintain contact with their friends and family. The relationships between staff and people living at the home were good and personal support was provided in such a way as to promote and protect privacy and dignity. Complaints procedures are clear and people living in the home are made aware of them. Staffing levels are adequate and appropriate training is provided to ensure that staff have the skills and knowledge to provide high quality care. 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 Grovewood House DS0000000641.V366824.R01.S.doc Version 5.2 Page 7 contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Grovewood House DS0000000641.V366824.R01.S.doc Version 5.2 Page 8 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Grovewood House DS0000000641.V366824.R01.S.doc Version 5.2 Page 9 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 3 and 6 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Clear information and assessments processes enable residents to make a positive and informed choice before moving into the home. The home does not offer intermediate care. EVIDENCE: The care plans contain comprehensive pre-admission assessments, which are completed by the Manager or the senior staff. Care management assessments are also available. The information from these documents is used to develop individual care plans. All of the care plans looked at had these in place. The assessments are person centred and focus on individual needs. Three residents said that they felt staff knew about their needs when they came to live at Grovewood House. Intermediate care is not provided at Grovewood House. Grovewood House DS0000000641.V366824.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): Standards 7, 8, 9 and 10 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The standard of care planning is good and provides clear information for staff to support them in meeting peoples’ needs and goals. People are supported to make decisions about their lives so that they can maintain their independence. Health care needs are met by using a multi agency approach. EVIDENCE: Each resident has an individual plan of care that is based on the admission assessment and this is added to during the placement. Care plans contain relevant information and systems are in place for regularly assessing individual needs for nutrition, skin care, moving and assisting, and continence promotion as well as a dependency rating. There are still some variations in the quality of recording and in some plans more information would have shown more clearly how individual needs are met. More consistent monitoring of care planning is needed to ensure all care plans maintain the same standard of recording. Four people said that they are very satisfied with the care they Grovewood House DS0000000641.V366824.R01.S.doc Version 5.2 Page 11 receive, and that staff are caring and kind. Seven relatives responded positively, one relative said, “ Mum’s condition is deteriorating and the staff have shown great flexibility and personal attentiveness in keeping track of her changing needs.” Staff are well informed about individual needs and demonstrated this during the inspection. Peoples’ health care needs and any specific treatments are recorded and clear information was available about how staff support individuals. Visits by the doctor, district nurse and other health care professionals are recorded in individual records showing any treatment provided or advised. People said that they could see the doctor when they needed to. A hoist and other equipment is available for those who need it. Residents said that the staff are aware of their health needs. Seven relatives and three residents said they were satisfied that there is access to the health services that needed. The systems for managing medicines in the home are being reviewed to in line with safe working practice guidelines. The records relating to the administration of medicines are well kept and staff are clear about the procedures. Staff training has been provided for all staff involved in giving out medicines. Storage arrangements for medicines are satisfactory. Systems are in place for risks to be assessed if people want to manage their own medicines and lockable storage is provided. Residents said that the staff knew what help they needed individually. They said that they could make choices about their lifestyle and were supported by staff to do this. Staff had a good rapport with residents. Evidence was available from care plans and relatives’ questionnaires to show that people’s individual needs are identified and met. No specific staff training in equality and diversity has been provided, but some elements have been covered within other training opportunities. Grovewood House DS0000000641.V366824.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): Standards 12, 13, 14 and 15 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People living at Grovewood have a good lifestyle that suits their needs and preferences. The home supports them to maintain their independence and make the most of their abilities as well as encouraging contact with friends and family. EVIDENCE: People living at Grovewood House said that they are able to make choices about their daily routines, like when they get up, go to bed and what they do with their time. Individual routines are identified within care plans. There is a programme of activities. Records show what peoples’ interests are and how they like to spend their time. During the inspection it was observed that people are encouraged to make choices about where and how they spend their time. There are videos, music tapes, newspapers and books available. Two people said they much preferred spending time in their rooms where it was quiet and they could read or watch television. Grovewood House DS0000000641.V366824.R01.S.doc Version 5.2 Page 13 People living in the home said that they have regular visitors and this was also evident from the Visitors Book. Information about arrangements for visiting is provided for people before they move in. Seven relatives’ questionnaires were received and these were very positive about the support provided to people living in the home and individual attention paid to meeting their needs. One relative said “Mum is becoming confused, but having long term staff who treat her with respect, friendship and real affection is doing a great deal towards slowing this process.” Relatives said that the home always supports people to live the life they choose. People are encouraged to continue to manage their finances for as long as they are able and this was evident from care plans. Staff encourage people to bring in furniture, ornaments and pictures from their previous homes. Rooms are personalised and reflect peoples’ interests and taste. People are able to follow their own religion and local ministers visit the home regularly. The menu shows that a varied diet is provided. Peoples’ likes and dislikes are recorded and staff ask for comments about the food. Positive comments were made by people living in the home about the quality of the food and they said that they are able to have an alternative if they do not like the food available. During the inspection six residents said that they were happy with the food and the choice provided. Staff have completed Food Hygiene training. Records show that there are regular cleaning routines and temperature checks of food and fridges. Grovewood House DS0000000641.V366824.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): Standards 16 and 18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People living in the home are protected by Grovewood House policies and procedures for dealing with complaints and allegations. EVIDENCE: Guidance is available for dealing with complaints and staff are aware of how to assist people living in the home to make a complaint. Systems are in place for recording any complaints. People living at Grovewood House said that they knew how to make a complaint and that they felt able to speak to the owners, Manager or the staff if they have any concerns. One person said that “the staff are always here and I can tell them if I have any concerns.” Four people said that they would feel able to talk to the staff about their concerns or complaints and were satisfied that their concerns would be treated seriously. No complaints have been made in the past year. Relatives said in the questionnaires that they were satisfied that they could raise any concerns with the management of the home. Staff guidance provides clear information for staff about protecting people living in the home from harm. A copy of the Local Authority Safeguarding guidance is available in the home. People using the service are made aware of what abuse is and the safeguards in place for their protection. Access to external agencies is promoted. Staff were clear about the procedures to be Grovewood House DS0000000641.V366824.R01.S.doc Version 5.2 Page 15 followed if an allegation is made. Training has been provided staff in safeguarding vulnerable people. Grovewood House DS0000000641.V366824.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): Standards 19, 20, 21, 23 and 26 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Grovewood House provides a safe environment that encourages independence. The home is comfortable, clean and generally well maintained. Some refurbishment has improved the environment for people living at Grovewood, however further work is still needed in the assisted bathroom. EVIDENCE: Maintenance systems are in place and records are available of work carried out. The home is decorated and furnished in a homely style and some rooms have been repainted in the last year. The garden is well maintained and there is a secure fenced area that is safe for residents and they can go out through the sitting room. Sitting areas are comfortably furnished to suit residents’ needs. In each sitting room the lighting is good and is sufficient for reading and other activities. Grovewood House DS0000000641.V366824.R01.S.doc Version 5.2 Page 17 There are an adequate number of toilets and bathrooms, although three bathrooms are quite shabby, with baths stained and marked. One of the existing bathrooms on the ground floor has been fitted out as a shower room and this is well used by people living in the home. The other ground floor bathroom has a manual hoist fitted so that residents can be helped to bath, however the layout of the bathroom is not ideal for people with mobility problems. The bath is only accessible from one side making it difficult for staff to easily assist residents. At the last inspection a recommendation was made that this bathroom was refitted to provide better access for people living in the home. The manager said that this has not happened because priority was given to the provision of a shower room, but it is planned to undertake this work. People living at the Grovewood have access to all public and private areas of the home. A shaft lift is fitted in the extended part of the building and a stair lift is available for the first floor of the original building. Ramps are available to allow people to access the garden and front of the house. Records showed that individual assessments are carried out when it is identified that equipment or aids are required. There are grab rails and other aids in corridors, bathrooms and toilets to suit peoples’ needs. Call system points are fitted throughout the home as necessary. The laundry is suitably equipped. Written guidance is in place for the control of infection. One member of staff attends meetings as the link worker for Infection Control and passes information on to staff to ensure that there is an up to date and consistent approach to Infection Control. There is no sluice fitted and the risks of cross infection are increased as commodes are in regular use. This was a requirement of the last inspection report and the manager says that the sluice will be installed in the next twelve months. Grovewood House DS0000000641.V366824.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): Standards 27, 28, 29 and 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Sufficient numbers of trained and experienced staff are available to meet the needs of the people living at Grovewood House. People are protected by the robust recruitment procedures. EVIDENCE: The service has appropriate numbers of staff to support the needs of the people living at Grovewood House. There is a settled staff team who work well together and support each other. Staff said that communication is good and that there are enough staff to meet peoples’ needs. Staff members’ roles and responsibilities are clearly defined and understood. People who use this service and their relatives spoke highly of the staff and one relative said, “They have a very friendly environment. Visitors are always welcome and nothing is too much trouble for the staff.” Another relative said “The care home staff look after service users extremely well in a caring way.” Staff training is targeted and prioritised to allow staff to undertake training beyond basic requirements. 89 of staff have completed national qualifications in care and other staff are working towards completing qualifications. Staff said that they get enough training opportunities. Records show that mandatory training is provided as appropriate. Induction training is Grovewood House DS0000000641.V366824.R01.S.doc Version 5.2 Page 19 provided for all new staff and staff said that new staff are well supported to ensure that they are competent to meet residents’ needs. Staff have completed elements of equality and diversity training as part of other training courses, but no specific training has been provided. Staff records show that appropriate reference and Criminal Records Bureau checks are completed as well as an application form for all new staff. Staff recruitment policies and procedures are in place and have been updated since the last inspection. Grovewood House DS0000000641.V366824.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): Standards 31, 33, 35, 36 and 38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home has consistent management and health and safety systems to protect people living there. Peoples’ views are sought as part of the quality review system in place to make sure the home is run properly. EVIDENCE: The manager is experienced in the care of older people and has the Registered Manager’s award. She undertakes regular training to keep up to date. A new system for auditing of the quality of the service is in place. These audits together with questionnaires provide evidence of a suitable quality assurance system that is customer focussed. The manager said that there are plans to Grovewood House DS0000000641.V366824.R01.S.doc Version 5.2 Page 21 further develop the use of the auditing system. Questionnaires from relatives show that they feel able to approach staff and the manager at any time with any issues they may have about the care of their relative. Formal supervision for care staff is up to date and staff said that they are well supported by the management team. They said they feel able to raise issues at any time and that handovers provide good opportunities to put ideas forward. Staff meetings are held and staff said they are encouraged to contribute. There are effective systems in place for safeguarding and managing money held on behalf of people living in the home including clear records. People using the service or their relatives have access to the records whenever they wish. Records show that training in health and safety matters is provided and individual training records reflect this. Staff said that they receive this training. Health and Safety checks are regularly undertaken and records were available to show good standards are maintained. Policies, procedures and risk assessments for safe working practices are in place to promote and protect residents and staff. Staff said that appropriate induction training is provided for new staff and records are in place to confirm this. Full details of accidents are kept in an appropriate form. Grovewood House DS0000000641.V366824.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 X X 3 X X N/A 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 3 2 X X X X 2 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 3 3 X 3 3 X 3 Grovewood House DS0000000641.V366824.R01.S.doc Version 5.2 Page 23 Are there any outstanding requirements from the last inspection? Yes 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. 1. Standard OP26 Regulation 13 (3)23 (2) (k) Requirement Sluice facilities need to be provided to prevent the risks of cross infection as commodes are in regular use. This requirement was made in the last inspection report. Timescale for action 31/10/08 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 OP21 OP7 Good Practice Recommendations The ground floor bath should be replaced with an assisted bath that can easily be accessed on either side. More consistent monitoring of care planning is needed to ensure all care plans maintain the same standard of recording. Grovewood House DS0000000641.V366824.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection North Eastern Region St Nicholas Building St Nicholas Street Newcastle Upon Tyne NE1 1NB 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 Grovewood House DS0000000641.V366824.R01.S.doc Version 5.2 Page 25 - 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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