Care Home: The Grange

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What the care home does well People who move to the home have their needs assessed in detail by social or healthcare workers and the manager so that everyone is sure that this is the right place for them to live. This is very important where people have complicated needs that require well-managed and agreed ways of supporting them. Staff help people to have more interesting lives, they help make sure that people can take part in activities they like and they help them to find and try new ones. The staff and manager help people to make choices about their lives and support them to be as safe as possible when they want to do something risky. Peoples` bedrooms are private and they make them their own with furniture and possessions if they want to. The home is warm and comfortable with a number of different areas for people to use during the day. The home has been given an `Investors in People` award in recognition of the amount and approach to staff training and development that has taken place in the past year.The GrangeDS0000007510.V377021.R01.S.docVersion 5.2 What has improved since the last inspection? All of the bedrooms and most of the home has been redecorated with stylish furniture, soft furnishings and ornaments. All care plans now have enough detail to show the actions that staff are to take to make sure that peoples` needs are met and to guide the way they are to work. Reviews of peoples` plans now show how progress that has been made to meet these goals. The way that medication is stored and given out has improved. There is now an accurate record of the amount of medication held and administered at the home to make sure that people get the treatment that they have been prescribed. Where staff decide that people living at the people need to have medication or not, the way that they make that decision is written down. The bathrooms have been improved so that they are suitable with hot water that is safe for people to use; repairs are better organised so that specialist equipment is repaired quickly. People are now consulted about their view of the quality of the service and those who support or represent those who live at the home are included; and records show that peoples` views help to improve the home in their best interests. Staff working at the home are now training in preventing and dealing with fires so that people are protected in the event of an incident. What the care home could do better: There are now no areas which have been assessed that fall below the National Minimum Standards for Care Homes. However the manager and owners have shown that they are committed to further improving the service for the benefit and best interests of the people who live there.The GrangeDS0000007510.V377021.R01.S.docVersion 5.2 Key inspection report CARE HOME ADULTS 18-65 The Grange The Grange Redworth Road Shildon Durham DL4 2JT Lead Inspector Steve Tuck Key Unannounced Inspection 30th July 2009 10:00 The Grange DS0000007510.V377021.R01.S.doc Version 5.2 Page 1 This report is a review of the quality of outcomes that people experience in this care home. We believe high quality care should: • • • • • Be safe Have the right outcomes, including clinical outcomes Be a good experience for the people that use it Help prevent illness, and promote healthy, independent living Be available to those who need it when they need it. We review the quality of the service against outcomes from the National Minimum Standards (NMS). Those standards are written by the Department of Health for each type of care service. Copies of the National Minimum Standards – Care home adults 18-65 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 mission of the Care Quality Commission is to make care better for people by: • Regulating health and adult social care services to ensure quality and safety standards, drive improvement and stamp out bad practice • Protecting the rights of people who use services, particularly the most vulnerable and those detained under the Mental Health Act 1983 • Providing accessible, trustworthy information on the quality of care and services so people can make better decisions about their care and so that commissioners and providers of services can improve services. • Providing independent public accountability on how commissioners and providers of services are improving the quality of care and providing value for money. The Grange DS0000007510.V377021.R01.S.doc Version 5.2 Page 2 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report Care Quality Commission General Public 0870 240 7535 (telephone order line) Copyright © (2009) Care Quality Commission (CQC). 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 CQC copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address The Grange DS0000007510.V377021.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service The Grange Address The Grange Redworth Road Shildon Durham DL4 2JT 01388 775764 01388 771040 highleahomes@aol.com 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) Highlea Homes Ltd Thomas Johnson Care Home 19 Category(ies) of Learning disability (19), Physical disability (19) registration, with number of places The Grange DS0000007510.V377021.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 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: Learning disability - Code LD, maximum number of places: 19 2. Physical disability - Code PD, maximum number of places: 19 The maximum number of service users who can be accommodated is: 19 24th November 2008 Date of last inspection Brief Description of the Service: The Grange provides care for up to 19 adults in ground floor accommodation on the outskirts of Shildon. The home was previously a school and has been adapted. The home is suitable and accessible to people with mobility problems. The home has communal lounges, a dining area, a small kitchen area for service users to make snacks and drinks, a conservatory and a leisure room. Highlea Homes Ltd owns the home. The company head office is based on the upper floor of The Grange. Toilet and bathing facilities are available throughout the home, many of which are adapted to support the service users accommodated. At the time of this inspection fees charged ranged from £378.50 and £425.23 per week. The costs of newspapers, hairdressing, and toiletries are not included in the fees. Fees vary depending on people’s circumstances, further details can be found in the homes Service User Guide. Payments for nursing care is set nationally and is added to the fee rate. Fees for private chiropody and hairdressing are in addition to these charges. The Grange DS0000007510.V377021.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection took place over three days and was a scheduled unannounced inspection. Before the visit: We looked at: • Information we have received since the last Key Inspection. • How the service dealt with any complaints & concerns since then. • Any changes to how the home is run. • The views of people who use the service, the people who have arranged for them to live at the home and the staff who support them by questionnaire. • The provider’s view of how well they care for people. We asked them to examine their own service and write to us with the results. • The findings of previous additional Random inspections which took place on 24th November 2009 which were to check on progress made at the last key inspection and make sure that the home was able to store and administer peoples’ medication properly. The Visit: An unannounced visit was made on 30th July 2009. During the visit we: • Talked with the people who use the service, the staff and the manager. • Observed life in the home. • 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 parts of the building to make sure it was clean, safe & comfortable. • Checked on what improvements had been made since the last visit. We told the manager what we had found. 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 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. The Grange DS0000007510.V377021.R01.S.doc Version 5.2 Page 6 The quality rating for this service is two stars good service. This means the people who use this service experience Good quality outcomes. Nine people who live at the home returned questionnaires. They said things like, What people who live there said about the home. “I think everything’s done well here.” “Everything’s OK.” “I love all the staff here” “I am getting on alright here.” “Everything’s fine.” What staff said about the home “The work is often very busy and challenging but I think we are making progress.” What the service does well: People who move to the home have their needs assessed in detail by social or healthcare workers and the manager so that everyone is sure that this is the right place for them to live. This is very important where people have complicated needs that require well-managed and agreed ways of supporting them. Staff help people to have more interesting lives, they help make sure that people can take part in activities they like and they help them to find and try new ones. The staff and manager help people to make choices about their lives and support them to be as safe as possible when they want to do something risky. Peoples’ bedrooms are private and they make them their own with furniture and possessions if they want to. The home is warm and comfortable with a number of different areas for people to use during the day. The home has been given an ‘Investors in People’ award in recognition of the amount and approach to staff training and development that has taken place in the past year. The Grange DS0000007510.V377021.R01.S.doc Version 5.2 Page 7 What has improved since the last inspection? What they could do better: There are now no areas which have been assessed that fall below the National Minimum Standards for Care Homes. However the manager and owners have shown that they are committed to further improving the service for the benefit and best interests of the people who live there. The Grange DS0000007510.V377021.R01.S.doc Version 5.2 Page 8 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 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. The Grange DS0000007510.V377021.R01.S.doc Version 5.2 Page 9 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection The Grange DS0000007510.V377021.R01.S.doc Version 5.2 Page 10 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 1 and 2 People using the service experience Good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Each persons needs are assessed before they move in which helps to make sure that these can be met at the home and inappropriate admissions are avoided. EVIDENCE: The home has written information called the Service Users Guide which gives all of the important details that people need to know about what it is like to live there. This includes information about how to make a complaint and the most recent Inspection report. The Service User Guide for this home has been drawn up in ways which help people to understand what the information means and staff also help to explain it. This includes the amount of money the home presently charges so that people know how much their care may cost. Each persons needs are assessed before they move to the home by a team of workers such a social worker, a community nurse, a psychologist, as well as the manager. This is to make sure that the home is suitable for meeting the The Grange DS0000007510.V377021.R01.S.doc Version 5.2 Page 11 needs of people who are going to live there. The manager has shown that he has a leading role to make sure that the home is able to successfully support people before they move there. Records show that the manager and staff have found out about the cultural and lifestyle needs of people who wish to move to the home to make sure that these can be met. All peoples’ assessment information is detailed enough to helps staff to plan the ways that they are going to support them. This is important where people have complicated needs which require a lot of insight and well-organised support. The Grange DS0000007510.V377021.R01.S.doc Version 5.2 Page 12 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 6 7 and 9 People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Each person has an individual plan of care, which sets out their preferences and how their assessed needs will be met. These plans describe the measures which staff use so that they can consistently meet peoples needs EVIDENCE: All people living at the home have a plan of care, which gives a description of how their physical, emotional and lifestyle needs are to be met. Some people at this home have needs which require the staff to respond to them in particular ways for example to give them support to feel confident and help them to manage their anxieties. The Grange DS0000007510.V377021.R01.S.doc Version 5.2 Page 13 People get support from staff which is individual and tailored to their specific needs so that they can live as valued citizens within their community. Care is carried out in ways that arranged so that individuals are at the centre of a network of support and tailored so that people have individual lifestyles. Staff have a good understanding of people’s background, needs and preferences which they need to support people. They also work closely with other community based health and social support staff to make sure that their care is properly organised. The way that care plans are written down does show that peoples needs are clearly identified. Care plans are well organised, contain all of the relevant information that staff will need in enough detail that helps them to support people consistently. The way that they are to be supported is written down in enough detail and there are reviews to see if their needs have changed. There are examples of where a great deal of thought consideration and care has gone into this planning. For example how people whose behaviour may lead them to challenge staff or other people living at the home. Care plans demonstrate that people living at the home are supported by staff in ways that helps them to feel in control and confident. Care plans have developed since the last inspection and training is taking place which should support staff to improve the way that their best practice is recorded. People living at the home are treated with respect by staff who know them well. Relationships between people and with staff are relaxed, friendly and informal which helps them to feel comfortable. People appeared to be at ease and happy with the support they get from staff. Staff meet together at the start of each shift where they talk to each other about peoples needs so that they remain up to date, work well as a team and remain consistent. All people living at the home have access to someone outside of the home who can speak on their behalf and help to make decisions in their best interests. The manager and staff have worked with people to help to expand their opportunities and lifestyles. To make this happen the manager and staff have helped people to be as independent as they can and to take measured risks if they wish. The manager and staff have shown that they take steps to support people and help reduce risks so that that there is a balance between promoting peoples independence and rights and making sure that they are safe. The Grange DS0000007510.V377021.R01.S.doc Version 5.2 Page 14 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): This is what people staying in this care home experience: 12 13 14 15 16 and 17 People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are encouraged and supported by the staff to make choices about their lifestyle so that they can lead fulfilling and interesting lives and staff help people stay in touch with their circle of family and friends so that they can keep links with people outside of the home. EVIDENCE: People living at this home have lifestyles, with their own routines and activities many of which occur outside of the home. Most people have the opportunity to attend day services provided by other organisations. The staff help people to choose activities that they would like to take part in or to try out and an The Grange DS0000007510.V377021.R01.S.doc Version 5.2 Page 15 activities co-ordinator has been appointed who has brought lots of ideas about what people can do during the day. Examples of opportunities include work placements (voluntary), shopping, fruit picking and planned days out to places of interest. One person who lives at the home said, “I’m going to see my friend this evening.” Another said, “We’re arranging to go to Newcastle later in the week.” Staff at the home were very busy planning how individual support for service users is to take place so that all of their choices could be met. Some people who live at the home have had the opportunity to take part in activities and become more independent. Staff and the manager have supported them by making sure that the risks that people take have been reduced and where possible safeguards are put in place. This can help people who wish to become more independent and, for some people, to move on to a more independent lifestyle. Staff are good at finding out about opportunities or activities which are taking place in the local and wider community and making sure that support and transport is available for those people who want to take part. These are detailed in peoples care plans and photographs of people taking part in activities and during visits are displayed. For example there were photographs of the places that people have visited and when celebrations have been held. Staff help people to keep in touch with friends and relatives and some people visit each others homes. Some people have taken college courses where they have an interest or skill and several certificates are displayed. The manager would like people to have more opportunities to study in this way. People living at the home are also involved in training with staff in areas such as first aid and food hygiene. Several choices of meals are offered at all times and people help to plan their meals. Attempts to offer a balanced diet whilst still responding to peoples choices were noted. There is a cook employed at the home so that care staff do not have to take time away from their duties. And people living at the home have their own domestic kitchen where they can make drinks or snacks during the day with support from staff if this is needed. Mealtimes are pleasant sociable events at the home where people meet and share each others company. One person said he liked the, “Fresh Food.” Another said, “Meals are good.” The Grange DS0000007510.V377021.R01.S.doc Version 5.2 Page 16 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 18 19 and 20 People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Peoples personal and health care needs are identified and arrangements are in place to help make sure that they can have a healthy lifestyle. EVIDENCE: Records of peoples healthcare needs are kept by staff in care plans. These show that staff look out for changes in their physical or emotional state which may need the involvement of specialist healthcare workers from outside the home. This has promoted joint working with healthcare staff and helped home staff make sure that people get the healthcare support that they are entitles to and also to put in place approaches for people whose needs are difficult to meet. The Grange DS0000007510.V377021.R01.S.doc Version 5.2 Page 17 People are registered with healthcare facilities for example their general practitioner or dentist and are supported to attend appointments if they wish. Any personal care is carried out in private with staff encouraging people to be discrete where this is required. Due to their levels of need, some people living at the home are not able to administer their own medicines, and designated staff therefore assist in this area. Staff at the home have also worked with healthcare staff so that people at the home are supported to need less prescribed medication than they previously did. A number of people have also been able to safely take responsibility for their own medication which fits in better with their lifestyle in particular when they are spending time away from the home with relatives or friends. The manager has weighed up the risks and taken steps to minimise the likelihood of harm. Medication is securely stored, well organised and recorded which should help to minimise mistakes. Medication is checked by the manager and the senior manager visits to make sure that the home is supporting people successfully including their medication. Records and storage of medication were thoroughly checked at this inspection and showed that the way these are stored and administered is robust. The manager confirmed that staff at the home have been trained to help them to be able to administer medication. Some people’s Doctors have prescribed them medication that they can take if they are upset or stressed. Staff can describe the techniques they use to divert or resolve peoples’ anxieties so that they only have to use this medication when it is absolutely necessary; and this is written down in their care plan so people get their medication at the right time. The Grange DS0000007510.V377021.R01.S.doc Version 5.2 Page 18 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 22 and 23 People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who live at this home and their families can make a complaint if they are unhappy, have a grievance or dispute which helps them to have control over their lives and there are measures in place which protect people from being harmed which helps to promote their safety and security. EVIDENCE: There is a clear complaints procedure in place at the home, which tells people how to complain, and the length of time a response will take. Observations of the staff’s day-to-day practices show that they ask for the views of service users all the time and help people to make real choices and decisions. When asked one person who lives at the home said that he would tell the manager if he had a complaint. Since the last inspection there have been no instances where abuse was suspected at the. The homes adult protection procedure is robust and complies with the Public Disclosure Act and the Department of Health The Grange DS0000007510.V377021.R01.S.doc Version 5.2 Page 19 There is a staff guide, which gives clear instructions about the actions which they must take if abuse is disclosed or witnessed. All staff spoken to are knowledgeable of these practices and have had training either with their National Vocational Qualification (NVQ) or specific courses. The Grange DS0000007510.V377021.R01.S.doc Version 5.2 Page 20 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 24, 27 and 30 People using the 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 house is homely, well equipped and clean and provides people who live there with a comfortable environment in which to live. EVIDENCE: People who live at the home are encouraged to keep their own rooms tidy and they are helped by staff when this is needed. Staff take effective steps make sure that the home is fresh and pleasant. The Grange DS0000007510.V377021.R01.S.doc Version 5.2 Page 21 The home was previously a school and has had adaptations made so that it is suitable for its present use and has been designed so that the people who live there can have safe access to the house and garden without restricting their rights, freedoms or independence. There are two lounges one of which is very large, two dining areas and a conservatory where people can spend their time. And people are able to lock their bedroom doors so that they can have privacy. There is evidence that repairs and maintenance carried out and the senior manager has drawn up a refurbishment programme to improve the home. Since the last inspection there has been a lot of decoration and refurbishment carried out to improve and upgrade the home. Almost all of the main public areas have been redecorated with pastel paintwork and improved lighting has made these areas much more attractive. The bedrooms are pleasant attractive areas, which have a range of furniture, and fittings which are comfortable and suitable for people to use. All bedrooms have been refurbished and now include ‘designer’ type wardrobes, wallpaper, carpets and artwork. This work has been completed to a good standard and shows that the home has benefited from well thought out interior design. People have also decorated their rooms with their items, photographs and keepsakes and some have bought their own furniture and soft furnishings. One person living at the home said, “I’m really pleased with the way my room has been done out.” There are bathrooms spread around the home which is convenient for people to use. The bathrooms have been refurbished and all bathing facilities are now maintained in a good state of repair and if any faults to the hot water system are found when weekly checks are carried out, then repairs are made straight away. The home is inspected by the Fire Prevention Service and overseen the local authority to make sure that risks from an accidental fire are lessened and a safe and healthy environment is promoted for the people who live and work there. The laundry is well organised and equipped with modern machinery so that people can be confident that their clothing and personal linen is hygienically cleaned within a reasonable space of time. Mistakes are rare. A redesign of the laundry has taken place and new machinery has been installed. The Grange DS0000007510.V377021.R01.S.doc Version 5.2 Page 22 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 32 33 34 and 35 People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. There are enough staff at the home to support the people who live there. And they have the skills, training and support from the manager so that they can meet peoples needs. EVIDENCE: Information from the manager shows that staff have received training relevant to their job roles and the specific needs of people living at the home. A training programme is in place which encourages staff to develop their skills which helps to improve the quality of the service. This covers National Vocational Qualifications (NVQ) as well as specialist courses which address the needs of the people who live at the home. Over half of care staff have NVQ Level 2 or above and workers who have undertaken NVQ Level 2 training are being encouraged to continue their training to Level 3. New staff are given extra training which links with national training organisation standards so that they The Grange DS0000007510.V377021.R01.S.doc Version 5.2 Page 23 have sufficient skills to support people and work effectively with other team members. Highlea Homes, who run The Grange, has recently achieved a “Certificate of Recognition” as an Investor in People in recognition of the development and training work which the company arranged for staff. Care workers are organised so that shift patterns can respond to the demands of people living at the home and records show that sufficient staff have been working there. Arrangements are in place so that staff can be available if circumstances change. For example if people are not at usual day time opportunities then more staff can be brought in to offer additional daytime support. Staff have regular contact with the manager who works alongside them. The manager has records which show that regular supervision takes place where staffs performance and the work they do with individuals is thoroughly discussed. Morale is good at the home and staff are motivated about the work they do. There is a good atmosphere and staff appear to enjoy their work. Staff demonstrate that they have an in depth knowledge of peoples needs and the strategies and approaches they use to support them. By watching what staff do, we could see that they are competent in their role as carers and this is reflected in the good standard of practice when they support and interact with people One person who lives at the home said, “The staff here are very attentive to less able residents.” The manager confirmed that all new staff have had checks carried out before starting work to make sure that they are suitable to work with vulnerable people. The Grange DS0000007510.V377021.R01.S.doc Version 5.2 Page 24 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. 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 are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 37, 38, 39, 41 and 42 People using the 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 manager at the home makes sure that people who live there are supported properly and give leadership and direction to staff so that the quality of the service they give is improved EVIDENCE: The manager has worked at this home for over two years and has been assessed by the Commission to make sure that he has the skills qualities and The Grange DS0000007510.V377021.R01.S.doc Version 5.2 Page 25 experience to be able to be registered there. Before coming to this home, he worked in senior positions in several homes and as registered manager for around two years. He has a National Vocational Qualification (NVQ) in care at Level 4 and is completing the NVQ Level 4 in management. The manager has shown his capacity to organise the service on a day-to-day basis. This reassures people living at the home and their relatives that the service can continue to be provided in their best interests. A person who lives at the home said, “Tom (the manager) is someone who you can trust, he works hard and I will tell him if I have problems.” One of the staff team said, “He gives us good leadership.” People living at the home are empowered to give their views about all aspects of the support they get from staff. There are a number of meetings held at the home and also other informal occasions where the manager and deputy are able to check that people are satisfied with the service. The manager and his senior also carry out checks each month to see if the service is working at the standard that they expect. People who live at the home are asked their views and the views of friends, families or advocates are also considered as part of this; Improvement plans show what changes will be made to enhance the quality of life of the people living at the home with timescales over 12 months. One person who lives at the home said, “We have service user meetings for residents. I like this idea.” Staff at the home help people who live there to manage their money. Detailed records are kept of peoples’ day-to-day finances and where staff have supported them to make purchases. Five of these were checked which showed that the manager and staff keep accurate records. There were no noticeable hazards at the home throughout the inspection and arrangements are in place to minimise risks for people living there and the staff who support them. The home has been subject to inspections by the Fire Prevention Authority and local authority environmental health officers to make sure that the home is safe. There were records available to show that fire prevention training had been carried out for existing and new staff. The Grange DS0000007510.V377021.R01.S.doc Version 5.2 Page 26 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 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 3 2 3 3 X 4 X 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 3 25 X 26 X 27 3 28 X 29 3 30 3 STAFFING Standard No Score 31 X 32 3 33 3 34 3 35 3 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 X 3 X LIFESTYLES Standard No Score 11 3 12 3 13 3 14 X 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 3 3 3 X 3 3 X Version 5.2 Page 27 The Grange DS0000007510.V377021.R01.S.doc NO Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations The Grange DS0000007510.V377021.R01.S.doc Version 5.2 Page 28 Care Quality Commission North East Region Citygate Gallowgate Newcastle Upon Tyne NE1 4PA National Enquiry Line: Telephone: 03000 616161 Email: enquiries.northeastern@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. 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