Care Home: Ravelston Grange Care Home

What the care home does well Ravelston Grange provides residents with a comfortable and homely environment, and support is offered in such a way that independence is promoted, and residents are able to make choices. Visitors are welcome at any time, and the residents spoken with were very positive and they said `the staff are very good`. What has improved since the last inspection? The home has addressed the requirements listed following the last inspection. The care planning system has been reviewed and a new system has been introduced to improve the care plans that are reviewed and updated as the residents needs change. A separate storage facility for controlled drugs has been installed. Staffing levels have been reviewed and the person responsible for the care plans has been allocated more time to do this. The quality assurance system has been reviewed and the manager assesses all aspects of the services and facilities monthly. What the care home could do better: There have been no requirements made following this inspection. However some concerns were raised and these have been included in the body of the report, these include ensuring the daily records reflect the support provided for resident;, the development of activities that meet the specific needs of all residents, and the provision of training for staff with regard to the support needs of people with a dementia type disability. Inspecting for better lives Key inspection report Care homes for older people Name: Address: Ravelston Grange Care Home 10 Denton Road Eastbourne East Sussex BN20 7SU     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Kathy Flynn     Date: 2 3 0 4 2 0 0 9 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop 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 Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Older People Page 2 of 23 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Care Homes for Older People Page 3 of 23 Information about the care home Name of care home: Address: Ravelston Grange Care Home 10 Denton Road Eastbourne East Sussex BN20 7SU 01323728528 01323728528 office@cumberlandcourt.co.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): PJP Care Ltd Name of registered manager (if applicable) Mr Michael Crotty Type of registration: Number of places registered: Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 old age, not falling within any other category Additional conditions: The maximum number of service users to be accommodated is 24 The registered person may provide the following category 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 category : Old age, not falling within any other category (OP) Date of last inspection Brief description of the care home Ravelston Grange is a Care Home registered for twenty-four older people. It is a threestorey building with a lift to the upper floors. The home is situated in The Meads, an attractive residential area of Eastbourne. The home is close to local shops, and a short drive away from the main town centre, shops, buses and the main railway station in Eastbourne. 0 Over 65 24 care home 24 Care Homes for Older People Page 4 of 23 Brief description of the care home There is a homely, safe comfortable and friendly atmosphere provided by the home. There are fourteen single and five double bedrooms, which are individually furnished to reflect personal taste and preferences. Double rooms are offered to married couples or those who make a positive choice to share. At the current time these rooms are generally being used as singles meaning that the numbers of those accommodated generally peaks at around 19 persons. PJP CARE LTD [Mr P and Mrs. J Piercy] owns the home as part of a group of two homes for older people, the other home being in St Leonards-on-Sea. Information on the range of fees charged is within the homes current statement of purpose/service user guide and ranges from 359 to 443 pounds per week. The higher rate of fee is based on room size and facilities. Charges for extras include personal items beyond the basic toiletries and activities provided by the home. Such items include newspapers, perfumes, chiropody, and hairdressing. Inspection reports are not routinely sent out to families and advocates after each publication although a copy is kept on display in the reception area of the home and can be obtained via the manager. A service user guide containing the most recent inspection report is sent to any interested person [or their representatives] looking to move into the home. Care Homes for Older People Page 5 of 23 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: The quality rating for this service is 2 star. This means the people who use this service experience good quality outcomes. The reader should be aware that the Care Standards Act 2000 and Care Homes Regulation Act 2001 often use the term service user to describe those living in care home settings. For the purpose of this report those living at Ravelston Grange will be referred to as residents. This was a key inspection that included an unannounced visit to the home. A tour of the premises was undertaken and a range of documentation was reviewed including care plans, medication charts, recruitment files, and the menus. Care Homes for Older People Page 6 of 23 The provider, manager, deputy manager, care staff and cook were happy to discuss the support they provide. They were very positive and felt they could meet the residents needs. Surveys were sent to the home for completion by residents and their relatives as well as staff. Five resident and four staff surveys were returned. The information received has been incorporated into the report, with the comments received from residents and staff on the day of the inspection. Feedback during the inspection and from the surveys was positive, the staff are very understanding and caring and the food is good. The Annual Quality Assurance Assessment (AQAA) was completed by the manager, within the required timescale, and identified areas where improvements have been made, and where others are planned for the benefit of residents. What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line –0870 240 7535. Care Homes for Older People Page 8 of 23 Details of our 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) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 9 of 23 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. A pre-admission assessment is completed for all but emergency admissions to the home, prior to the offer of a place. Evidence: The manager confirmed that all prospective residents are assessed to ensure the home can meet their needs. This is then confirmed in writing and a place is offered at this time. Assessments viewed showed that residents needs are assessed, and the manager and provider confirmed that they are aware of the needs that the home can meet. Care Homes for Older People Page 10 of 23 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The Care Planning system provides staff with sufficient information to enable them to provide support and care that meet the residents individual needs. Training is provided for staff with regard to medication to ensure residents are protected. Evidence: A considerable amount of work has been done at the home to improve the care planning system, and the system is much clearer and easier for staff to use now. They include personal risk assessments for mobility, falls, stairs, lift and medication, as well as information about how the residents needs are met, their life history and mental health capacity. Staff record the support provided to residents in a tick box format as well as completing the daily records. This information is kept in the lounge area, and the supporting information is kept in a separate care plan folder near the deputy managers desk. However the daily records for two of the five care plans viewed did not actually reflect the support that was being provided, in effect the staff were not following the homes Care Homes for Older People Page 11 of 23 Evidence: own daily report policy when completing them. Daily records, when well written, help ensure a consistent approach and good quality of care for residents. It is in the homes interests to be able to show what they have done, along with providing the evidence on which to base the monthly review, and to record that they are following the assessment of needs. Visits from GPs, District Nurses and other allied health professionals are recorded in the care plans, and included any action staff should take to support residents. Staff were noted to treat residents with respect, with communication between them relaxed and friendly. Medication Administration Record (MAR) charts were viewed and found to be completed appropriately. A separate locked cupboard has been installed for the storage of controlled medicines, although no residents had been prescribed these at the time of the inspection. The manager confirmed that there are times when residents needs changed and the home can no longer meet them, in these situations alternative accommodation is organised. Care Homes for Older People Page 12 of 23 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Activities are available for residents to join if they wish. The food is good, offering choices and meeting residents specific dietary needs. Evidence: The staff advised that a range of activities are provided for residents to join in if they wish. A quiz was organised for residents in the lounge before lunch, and some residents clearly enjoyed taking part in this. Other activities are provided by outside entertainers and include exercises, singing and musical sessions. A high tea had been organised the previous Saturday and there will be a garden party and barbeques when the weather improves. However there was no evidence that activities for residents who may have a dementia type disability are provided, this was discussed with the manager and he confirmed that staff training will address this. Feedback from staff on the day of the inspection was positive, they said they think the residents have a good range of activities. However feedback from staff surveys was that the home should do more stimulating activities for residents. Residents are able to make choices about all aspects of their day to day lives, they Care Homes for Older People Page 13 of 23 Evidence: choose to remain in their rooms or sit in the lounge, and they use the dining room for meals if they wish. The meals at the home are good, choices are available, the residents individual dietary needs can be met and staff assist residents if required. Residents spoken with said the food is very good, and they can have something different from the menu if they want. Care Homes for Older People Page 14 of 23 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The homes complaints policy provides residents and visitors with details of who they can raise any concerns with. Staff have attended training in the protection of vulnerable adults, and the manager arranges further training as required. Evidence: There have been no complaints to the home or the Commission since the last inspection. Appropriate policies and procedures are in place. Training in protecting vulnerable adults is provided for staff and all but one of those spoken with have attended this. The manger confirmed that further training has been arranged to make sure that all staff are up to date with regard to all mandatory training. Care Homes for Older People Page 15 of 23 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Ravelston Grange offers residents a comfortable and homely environment. The homes policies for infection control and the training provided for staff protect residents. Evidence: Ravelston Grange is a converted older building that has kept some of its original features, and provides residents with a comfortable place to live. There are attractive gardens to the rear, and although there are no parking facilities at the home there is ample parking in the streets nearby. There is a large lounge, that leads out to the rear garden, and dining room on the ground floor that are well furnished and used daily by the residents. The home was clean and well maintained, and a shaft lift enables residents to have access to all parts of the home. Control of infection training is provided for staff, and those spoken with have attended this and are aware of the appropriate use of gloves and aprons. Care Homes for Older People Page 16 of 23 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Robust recruitment procedures protect residents, and staff training ensures the needs of residents can be met. Evidence: The manager and staff advised that they feel the number of staff working in the home is appropriate to meet the needs of the residents. The feedback from those spoken with was positive, they said the home offers a good level of support for the residents, and the residents who expressed an opinion said the staff are very good. The manager confirmed that all new staff have to complete the induction programme in line with Skills for Care, and staff are encouraged to work towards National Vocational Qualifications (NVQ) in care when they have completed this. The staff spoken with have completed NVQ courses or are working towards them. Robust recruitment procedures are used, two staff files were viewed and contained relevant material. Including application forms, two references, Protection of Vulnerable Adult (POVA) and Criminal Record Bureau (CRB) checks. The manager arranged specific training in care for people who have dementia for staff during the inspection, to ensure that the needs of all of the residents at the home care Care Homes for Older People Page 17 of 23 Evidence: be met. Care Homes for Older People Page 18 of 23 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The management processes encourage residents and staff to be involved in development of the services at the home. Relevant staff training is provided to protect residents. Evidence: The manager has considerable experience in looking after older people and has registered with the Commission as manager of the home since the last inspection. The management ethos is to encourage residents, their representatives and staff to be involved in the development of the services offered at the home. Regular residents meeting encourage this and a newsletter is produced to ensure that everyone is informed about what is happening at Ravelston Grange. The manager and provider confirmed that quality assurance systems are in place. The provider completes regulation 26 visits monthly, in addition to working at the home Care Homes for Older People Page 19 of 23 Evidence: several days each week, and the manager completes his own audit of services and facilities monthly. The home does not take responsibility for residents finances, although the manager said they hold money for some residents, if they or their family requests this. Records are kept of payments and deposits, they are audited regularly, and kept secure in the office. The health and safety of residents, visitors and staff is protected through appropriate mandatory training, including moving and handling, fire training and first aid. It was noted that some residents doors are propped open using wedges, the provider agreed that advice concerning keeping doors open safely would be obtained from the Fire Service and the details forwarded to the Commission. Care Homes for Older People Page 20 of 23 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 21 of 23 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations Care Homes for Older People Page 22 of 23 Helpline: Telephone: 03000 616161 or Textphone: or Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. Care Homes for Older People Page 23 of 23 - 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. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!