Care Home: The Grange

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What the care home does well The care home is warm and people have the bedding they prefer. People are generally well supported with access to health care professionals as required. People receive good food and those that have problems with eating are referred torelevant professionals. People say that staff are caring and help them to do what they can. What the care home could do better: The home should develop more pro-active, personalised care plans focused on preventing pressure sores and identifying nutritional problems where people are identified at risk. The provider should have some sit on scales so staff can accurately monitor weight. The provider must inform the commission of the managememnt arrangements of the service in the absence of the registered manager. Random inspection report Care homes for older people Name: Address: The Grange Kerry Lane Bishops Castle Shropshire SY9 5AU two star good service 14/07/2009 The quality rating for this care home is: The rating was made on: 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 review of the service. We call this review a ‘key’ inspection. This is a report of a random inspection of this care home. A random inspection is a short, focussed review of the service. Details of how to get other inspection reports for this care home, including the last key inspection report, can be found on the last page of this report. Lead inspector: Pat Scott Date: 2 2 0 1 2 0 1 0 Information about the care home Name of care home: Address: The Grange Kerry Lane Bishops Castle Shropshire SY9 5AU 01588638708 Telephone number: Fax number: Email address: Provider web address: mayfair4care@yahoo.co.uk Name of registered provider(s): Type of registration: Number of places registered: Conditions of registration: Category(ies) : Mayfair Care Ltd care home 24 Number of places (if applicable): Under 65 Over 65 0 24 dementia old age, not falling within any other category Conditions of registration: 24 0 The maximum number of service users who can be accommodated is: 24 The registered person may provide the following category of service only: Care Home Only (Code PC); To service users of the following gender: Either; Whose primary care needs on admission to the home are within the following categories: Dementia (DE) 24, Old age, not falling within any other category (OP) 24 Date of last inspection Brief description of the care home The Grange is a privately owned Care Home situated in Bishops Castle. The Proprietors are Mr Geoffrey Tilling and Miss Taylor. Miss Taylor is responsible for the care management at the home and has many years experience in a care setting. The home stands in its own grounds, in close proximity to the centre of the small rural market town of Bishops Castle. The main building, formerly The Old Police Station, has been Care Homes for Older People Page 2 of 8 1 4 0 7 2 0 0 9 Brief description of the care home adapted and extended to its present form and additional accommodation is available across the courtyard in two separate self-contained bungalows. These are The Grange Lodge and The Vine, accommodating two and three service users respectively. The home makes their services known to prospective service users in: The Statement of Purpose, Service User Guide and web site which also contain their contact e mail address. The inspection report is mentioned in the statement of purpose and summarised in the service user guide. It is also on display in the entrance hall. Fees are reviewed annually and are in the service users guide. Care Homes for Older People Page 3 of 8 What we found: Concerns had been raised with us regarding the general welfare of people living in the home. In particular, there were concerns around people not receiving nourishment or adequate pressure area monitoring, that the bedrooms and communal areas were cold and that the bedding was not satisfactory for people. Concerns were also raised about the lack of availability of management in the home. We found the home to be warm and individual bedrooms were warm. People whom we talked to spoke highly of the food, that it was nice and always plenty of it. One person said they had eaten roast lamb and numerous vegetables on the previous day and snacks are always available when wanted. The home accomodates some very frail people at the moment due to their problems, however, other people that we saw in the lounge and the dining room looked well nourished. We spoke to staff who talked about the local suppliers that they use, so food provision is not a problem. Staff are well aware of peoples likes and dislikes, preferred portion size and the outcomes of the latest Environmental Health Office visit did not note any issues. People in the lounge said that they do occasional quizzes or bingo but the room was dark and dismal which does not assist people who would want to read a newspaper or book. The bedrooms we looked at were satisfactory. There was a lack of hot water in first floor bathroom, which combined with work being done on the ground floor bath/shower means that staff are using the staff bathroom to provide baths. Care plans we looked at had good basic detail but were not personalised. Staff write about what is required rather than how the person wishes or likes care to be delivered. A bath list is on display in the office which does not reflect personalised care. People who are nutritionally vulnerable are identified and referred approriately but the manager does not use a robust assessment tool to demonstrate how problems are identified. People who can use stand on scales are weighed but given the frailty of many people the accuracy of these weights is doubtful. Care plans do not contain information for preventing pressure ulcers. When problems are noted then appropriate help is sought. There is no direction for staff to monitor the whole person once problems are being addressed and further breakdowns may be missed. Staff have received training in pressure ulcer care but the lack of supervision and management of staff does not ensure that staff are competent to deal with problems. The deputy manager is left in charge most of the time with the manager absent. The proprietors are not managing effectively and the deputy manager is struggling to cope without support. The overall management and review of peoples care is not being provided consistently well. What the care home does well: The care home is warm and people have the bedding they prefer. People are generally well supported with access to health care professionals as required. People receive good food and those that have problems with eating are referred to Care Homes for Older People Page 4 of 8 relevant professionals. People say that staff are caring and help them to do what they can. 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 2. Care Homes for Older People Page 5 of 8 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, Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 6 of 8 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, 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 31 38 (3). The provider must specify the arrangements made for the running of the home in the absence of the manager. The proprietors are not managing effectively and the deputy manager is struggling to cope without support and the overall management of the home is something we want reassurances about. 28/02/2010 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 1 8 The provider should develop more pro-active, personalised care plans focused on preventing pressure sores and identifying nutritional problems where people are identified at risk. The provider should have some sit on scales so staff can accurately monitor weight. 2 8 Care Homes for Older People Page 7 of 8 Reader Information Document Purpose: Author: Audience: Further copies from: Inspection Report Care Quality Commission General Public 0870 240 7535 (telephone order line) Our duty to regulate social care services is set out in the Care Standards Act 2000. Copies of the National Minimum Standards –Care Homes for Older People can be found at www.dh.gov.uk or got 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 Helpline: Telephone: 03000 616161 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) Care Quality Commission (CQC). 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