Care Home: Scarsdale Grange Nursing Home

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What the care home does well People using the service are involved in decisions about their lives. The staff at Scarsdale Grange help the people to play an active role in planning and receiving their care. The people receive a varied and nutritious diet. The physical design and the layout of the home encourages people to be independent and safe. The staff rostered on each shift are in sufficient numbers to support the people who use the service, in line with their terms and conditions, and to support the smooth running of the service. What has improved since the last inspection? The people who may wish to use the service including their representatives have the information they need in the form of a service user guide to help make an informed decision about the home. The manager and the senior staff accept new admissions only if they are able to meet the people`s needs. Most people who use the service are able to express their concerns and they have access to a complaints procedure. The manager has formalised specials diet arrangements by issuing a list of names and the type of diet required by the people. The training and supervision of staff protects the people from abuse. The day to day management of the home focuses on the best interests of the people using the service. The management promote the health, safety and welfare of the people who live and work at the home through training, supervision and monitoring of the workforce. What the care home could do better: The staff need to update individual care plans based on the daily progress reports. When care staff identify problems in the daily reports these must be included in the care plan and details of the action need to be documented to promote continuity of care. The full needs assessments carried out by the management should be reflective of the needs of the individual so that the staff are able to deliver person centred care. The people living on the first floor who wish to stay there receive their hot meals from a dinner trolley. The temperature of the food in the trolley should be recorded at the point of service by staff in compliance with Environmental Health standards.The management should have evidence that the people employed to work at the home physically and mentally fit for the purpose. This could be achieved by ensuring staff complete their medical declaration. The provider needs to make suitable provisions for storage for the purposes of the home. So that the wheelchairs, hoists and aids used for the people using the service can be stored away. Inspecting for better lives Key inspection report Care homes for older people Name: Address: Scarsdale Grange Nursing Home 139 Derbyshire Lane Sheffield South Yorkshire S8 9EQ     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: Marina Warwicker     Date: 0 2 1 2 2 0 0 8 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 26 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.csci.org.uk Internet address Care Homes for Older People Page 3 of 26 Information about the care home Name of care home: Address: Scarsdale Grange Nursing Home 139 Derbyshire Lane Sheffield South Yorkshire S8 9EQ 01142580828 01142580828 scarsdalegrange@onetel.com Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Mr John Martin Foster Name of registered manager (if applicable) Mr Hassen Jeetoo 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: Three service users aged 60 years and over may be accommodated at the home. Date of last inspection Brief description of the care home Scarsdale Grange is a purpose built home, able to provide nursing care for up to 40 older people. The home is in a residential area of Sheffield, with good access to public services and amenities, such as public transport, shops and public houses. The home has two floors, accessible by a passenger lift. Each floor has communal lounge, dining rooms and bathing facilities. All of the bedrooms are single with en-suite toilet facilities. The home has a garden to the rear and a car park to the front. The weekly charges range from #355 to #481. These figures were obtained on the day of the site visit. Additional charges included newspapers, hairdressing and private chiropody. 0 Over 65 40 care home 40 Care Homes for Older People Page 4 of 26 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 2star. This means that the people who use this service experience good quality outcomes. We have reviewed our practice when making requirements to improve national consistency. Some requirements from previous inspection reports may have been deleted or carried forward into this report as recommendations but only when it is considered that people who use the services are not being put at significant risk of harm. In future if a requirement is repeated, it is likely that enforcement action will be taken. An inspection of this care home was carried out on Tuesday 2nd December 2008 Care Homes for Older People Page 5 of 26 between 10 am and 3:30 pm. The staff the management and the people using the service were not informed of our visit and therefore it was unexpected. Six people who use the service were consulted and most staff on duty were spoken with. A further five people using the service, ten staff and three professionals who came into contact with the people were contacted by post to obtain feedback about the service. Comments received from the surveys have been included in the body of the report. Any comments received after the publication of this report will be shared with the management of the home. Time was spent observing and chatting with staff, the visitors and the people using the service. The manager and the co-partner of the service were present during the inspection. We fed back as we completed each section of the inspection. The premise was inspected, which included bedrooms of people using the service, the communal areas and the service areas such as the kitchen and the laundry. Twenty-two people were using the service on the day of the site visit. Samples of records such as the care plans, staff recruitment and training files were checked. We would like to thank the people who live at Scarsdale Grange, their relatives, the staff, the manager and the co-partner for their contribution towards this process. What the care home does well: What has improved since the last inspection? What they could do better: The staff need to update individual care plans based on the daily progress reports. When care staff identify problems in the daily reports these must be included in the care plan and details of the action need to be documented to promote continuity of care. The full needs assessments carried out by the management should be reflective of the needs of the individual so that the staff are able to deliver person centred care. The people living on the first floor who wish to stay there receive their hot meals from a dinner trolley. The temperature of the food in the trolley should be recorded at the point of service by staff in compliance with Environmental Health standards. Care Homes for Older People Page 7 of 26 The management should have evidence that the people employed to work at the home physically and mentally fit for the purpose. This could be achieved by ensuring staff complete their medical declaration. The provider needs to make suitable provisions for storage for the purposes of the home. So that the wheelchairs, hoists and aids used for the people using the service can be stored away. 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.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 240 7535. Care Homes for Older People Page 8 of 26 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 26 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. The people who may wish to use the service including their representatives have the information they need to make an informed choice about the home. The manager and the senior staff accept new admissions only if they are able to meet the peoples needs. Evidence: To check this outcome area we spoke to the manager and two staff. They informed us that the statement of purpose and the service user guide has been updated and were available to people who request them. We saw information about the home in the front entrance of the home. We checked with three people using the service they were happy with the admission process. We also checked the feedback from the surveys. One person commented that their family found a place at the home and that s/he was not involved in choosing the home, but was settled and did not have any complaints. Three people said that they had received useful information about this home before Care Homes for Older People Page 10 of 26 Evidence: they decided that it was the right place for them. The manager confirmed that all the people using the service had copies of contracts. Four surveys from people using the service confirmed this. Four care plans were checked and there was evidence that the people have had their needs assessed before moving into the home. However the information gathered during the assessments needed to be person centred and reflect the individuals special needs, likes, dislikes, social & medical history. Such information enables staff to deliver individualised person centred care. Four staff, a relative and three people using the service corroborated that opportunities were given to people to visit the home or move in on a trial basis to find out for themselves whether the service was suitable for them. Care Homes for Older People Page 11 of 26 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. Individuals are involved in decisions about their lives, and the staff at Scarsdale Grange involve the people using the service to play an active role in planning and receiving their care. Evidence: The two inspectors checked four care plans. Six people using the service, two care staff and two nurses were consulted. Feedback from surveys was also considered. The care plans had information on individuals needs, reviews and involvement of the people using the service and in some cases their relatives had taken place. Following case tracking of the people the management were informed of the following. The people using this service will benefit by having a person centred care programme approach to the care they receive. This will not only help those who deliver care to view the individual in a holistic way rather than treating the identified needs; but also help the person and their relatives to be able to relate to the care plan and have a Care Homes for Older People Page 12 of 26 Evidence: good understanding of the care programme. The management agreed to review the present system. We found in two care plans staff had mentioned noticing marks on persons bodies in the daily records but there were no follow up in the care plans. When questioning staff they were able to inform us how they may have happened how they were dealing with it. However we did not evidence any follow up on the individuals daily record. The provider was made aware of this during feedback and agreed to look into this. During our direct observation we noted staff entering peoples bedrooms after knocking at the bedroom door and explaining to the residents who they were. We also noted staff being familiar with people and interacted in a friendly and respectful manner. A positive comment from the general practitioner was received to inform us that the weekly surgery at the home has been useful and that the staff were helpful during the surgery. Some staff have had formal training on palliative care. During staff interview they said that they were sensitive and compassionate to the persons and their relatives wishes. Care Homes for Older People Page 13 of 26 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. The people who use the service are able to make choices about their life style, and receive support from the staff to restore or maintain their life skills. The people receive a varied and nutritious diet according to their needs. Evidence: Seven people using the service and three staff were consulted. Feedback from the surveys, the care plan and the direct observation on the day of our site visit were taken into account when concluding this outcome area. There was a list of activities displayed at the entrance to inform the people living at the home and the visitors. We observed staff and the people using the service involved in small group activities. The care staff spent time chatting with those who were unable to join in. We saw the activities person encouraging people to play Bingo on the ground floor dining room. Some people who were unable to join in were seen enjoying watching the others playing dominos. We observed visitors made welcome by the staff. Visitors joined in with the activities and supported the people using the service. We spoke with people who were in their Care Homes for Older People Page 14 of 26 Evidence: rooms watching TV, resting or reading, as this was their choice. One person said that when the weather was warm the care staff took them out on trips. Four people said that they were offered plenty of food and drinks at mealtimes. We observed staff serving drinks during the day. One of the residents commented that snacks with the drinks would be welcome. During our discussions with the management it was ascertained that some people might be forgetful; however it was agreed that the staff would show the residents the boxes of snacks instead of asking. This is to help those who are infirm and have difficulty conveying what they actually mean. We visited the kitchen where the cook had a five weekly menu. There was a list for those people who needed special menus (such as soft diet). This had been prepared by the manager to help the cook. We were informed that the menus were decided on the peoples likes and dislikes by the staff and the management. On the day of the site visit the staff were seated with the people during lunchtime, helping those who needed assistance in a discreet manner. The people were offered a choice of meals and the mealtime was unhurried. Four people said, that the meals were good and they could have what they wanted. There was a comment from the staff of a misunderstanding between the cook and the care staff, which resulted in care staff having to purchase food for some residents in the evening on the day before our visit. There were also concerns raised by the care staff of the times cooks worked and having lack of support at teatime from the kitchen staff. We passed these comment to the provider and the manager. They said that they would look into the comments and also were aware of the previous days event. Care Homes for Older People Page 15 of 26 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. Most people who use the service are able to express their concerns and they have access to a complaints procedure. The people are protected from abuse by the local policies, training & supervision of staff and support from the management. Evidence: The homes complaints policy was displayed at the entrance hall. Three staff interviewed said that they were confident in what to do in the event of a formal complaint. One person said that they would listen to the complainants and put things right straight away if possible to stop it escalating. The management had maintained the records of formal complaints. There had been four complaints since the last inspection. They had been investigated appropriately and records kept by the manager. The staff we interviewed have had training on Protection Of Vulnerable Adults. They were able to verbalise what they would do if they were to witness any type of abuse. We checked four staff files (both day and night workers) training records and all four staff have had training and updates this year. Care Homes for Older People Page 16 of 26 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. The physical design and the layout of the home encourage people to be independent and safe. Evidence: The tour of the premise was carried out with the help of a provider. This included communal areas, bedrooms, bathrooms, service areas such as the kitchen, sluice room and the laundry room. The following observations were made on the day of the site visit. General cleanliness and tidiness was very good. Routine maintenance and decoration was in progress. The annual programme for renewal and maintenance was to be formalised by the provider. The outdoor grounds were kept tidy and safe. There was provision for gritting the front to keep it safe during the bad weather. Empty rooms were being redecorated. We were informed that the people using the service were given an opportunity to have their rooms decorated if they were happy to move into one of the empty rooms. Some people had used the opportunity. People were making good use of the communal areas and we observed staff interacting with them. The sluices were in working condition therefore maintaining control of infection. We saw several wheelchairs stored in one of the sluice rooms. We spoke with the manager to find a way of relocating them. During our visit we witnessed used toiletries stored in a bathroom. It was agreed that peoples own toiletries must be kept in their own rooms or in an identified space in the bathroom to avoid communal use of toiletries. Care Homes for Older People Page 17 of 26 Evidence: There were aids, adaptations and hoists found on each floor helping people with their independence. The staff said that they had enough hoists for their use. Bedrooms were centrally heated and people were able to use the windows to naturally ventilate their rooms if they so wish. The laundry was sited away from the kitchen. During our visit the laundry was manned and there were enough machines for washing and drying of clothes. Care Homes for Older People Page 18 of 26 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. The staff in the home are trained, skilled and in sufficient numbers to support the people who use the service, in line with their terms and conditions, and to support the smooth running of the service Evidence: We spoke with the people using the service, staff on duty and the management regarding this outcome area. We also checked the feedback from our surveys. We were informed that there was ample staff on duty and that the people were able receive good standard of care and attention. We can confirm that the management operate a rigorous recruitment process, which ensures people using the service are protected. We checked four staff recruitment files with the help of the manager. Most of the information required by the Care Homes Regulations 2002 was seen on the documents. However the application form did not include staff declaration of health. Four staff training files were checked and staff on duty were interviewed to find out the effectiveness of the training and development of the staff. The manager informed us that the induction training of new staff was being reviewed so that it would be inline with the standards of Skills for Care. The staff said that they had both in house and outside training. One relative and two people using the service said that the staff knew Care Homes for Older People Page 19 of 26 Evidence: what they were doing and that they had every confidence in the staff. Care Homes for Older People Page 20 of 26 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 day to day management of the home ensures that the service is focused on the best interest of the people using the service. The management promote the health, safety and welfare of the people who live and work at the home through supervision and monitoring. Evidence: The registered manager is responsible for the running of the home. The nurses and the carers take an active role in delivering the care to the people using the service. The management informed us that they had carried out staff and residents surveys and that they had changed some of their practices. During staff interviews they said that they had received some positive feedback from the relatives and residents and commented how much they felt appreciated. The administrator at the home dealt with the financial issues and we were informed that the providers audited the records relating to the finance. During this visit we did not check the written records of the financial transaction between the people using the service at the home. Care Homes for Older People Page 21 of 26 Evidence: Four staff records evidenced that the staff received regular supervision. Two care staff said that they liked having 1:1 supervision with the senior staff and they found the time very useful. One person said that it gave him/her the opportunity to talk about the problems they encounter when looking after some of the people and find out ways of coping with problems. We also observed staff supported by their peers. During the tour of the premise we noticed that the management had systems in place to maintain health, safety and the welfare of the people. The environment was free of hazards so that the people were not put at risk of harm. Care Homes for Older People Page 22 of 26 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 23 of 26 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 1 29 7 The management must be able to evidence that the person employed to work at the home is physically and mentally fit. So that the person employed to work at the home is physically and mentally fit for the purpose. 12/02/2009 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 1 7 12 The staff must update individual care plans based on the daily progress reports. When care staff identify problems in the daily reports these must be included in the care plan and details of the action to be taken need to be documented to promote continuity of care. 19/01/2009 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 24 of 26 1 3 The full needs assessments carried out by the care home management should be reflective of the individuals personal needs. So that the staff are able to deliver person centred care. Suitable provisions should be made for storage for the purpose of the home. The Wheelchairs, hoists and aids used for the people using the service need storage away frm the people. 2 19 Care Homes for Older People Page 25 of 26 Helpline: 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 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). 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