Care Home: The Grange

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What the care home does well The manager at The Grange promotes positive relationships between people involved with the home. There is a high level of customer satisfaction with the care and people feel confident about approaching staff if they have any concerns. Staff are pleasant and treat people with dignity and respect, and staff approach is flexible. The routines of the home are flexible and accommodate different cultures and lifestyle choices. Routine health care and treatment is provided appropriately and there is liaison with health care personnel What has improved since the last inspection? The manager has ensured that people`s needs are assessed prior to or very soon after they are admitted to the home. Since the last inspection the entrance hall to The Grange and other areas in the home have been redecorated, re-carpeted and some new furniture has also been purchased. Since the previous inspection people have been consulted about activities and outings have been arranged and regular entertainment provided. There is now an improvement in the record kept of the meals people have consumed. Protection of vulnerable adult and medication training has been provided to staff and they have been supported in enrolling onto the National Vocational Qualification (NVQ) in health and social care level 2. Since the last inspection the adult protection policy has been updated and made known to staff. The recording of complaints has also improved and indicates that people are listened to. What the care home could do better: The manager should ensure that assessments include the personal history and individual interests of people living in the home. The manager should develop the care plans further so that they provide staff with a clearer description of the actions they must take to meet individually assessed needs. The manager needs to demonstrate that people are provided with opportunities to participate in a variety of meaningful activities on a daily basis. The manager should ensure that staff receive specialist training relating to the needs of people living in the home, for example, dementia care, developing activities for people living in residential homes, pressure area care and in different aspects of health and safety. CARE HOMES FOR OLDER PEOPLE The Grange 154 Reddish Road Reddish Stockport Cheshire SK5 7HZ Lead Inspector Michelle Haller Key Inspection 5th November 2007 09:10 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address The Grange DS0000008556.V344005.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. The Grange DS0000008556.V344005.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service The Grange Address 154 Reddish Road Reddish Stockport Cheshire SK5 7HZ 0161 476 0702 0161 476 0702 zyasin@tiscali.co.uk 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) Mr. Zahid Yasin Mrs Bobbie Baljit Walia Mrs Bobbie Baljit Walia Care Home 18 Category(ies) of Old age, not falling within any other category registration, with number (18) of places The Grange DS0000008556.V344005.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. Service users to include up to 18 OP. Date of last inspection 10th May 2006 Brief Description of the Service: The Grange is a detached care home situated in the Reddish area of Stockport, close to local amenities. The Granges current owners, Mr Yasin and Mrs Walia, purchased the property in February 2001. The home is registered to provide care for 18 elderly service users. Accommodation is available on two floors, with the majority of bedrooms being on the first floor. Access to the bedrooms on the upper floor is by means of stairs, passenger lift or chairlift. A number of bedrooms on the upper floor cannot be accessed by the lift. There are gardens with a fence around the perimeter. Off road parking is available at the front of the house. The Grange DS0000008556.V344005.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was a key inspection included an unannounced site visit to the home. The manager was not informed beforehand that we were coming to inspect. The inspection process involved interviews with four people individually and one relative. Two members of staff were interviewed and in depth discussions with the manager and registered person were also conducted. Six care files and other records and reports pertaining to these people were inspected. Other documents concerning the running of the home were also examined. The Commission for Social Care Inspection (CSCI) ‘Annual Quality Assurance Assessment’ which was completed by the manager also provided information that influenced the outcome of the inspection. Seven service users and five relative CSCI surveys were returned and these were used as part of the evidence when completing the inspection. A tour of the communal areas of the home was also undertaken and during the course of the inspection the interactions between people in the home was observed. Depending on type of placement and assessed needs the home charges from £325 to £400 each week. What the service does well: What has improved since the last inspection? The Grange DS0000008556.V344005.R01.S.doc Version 5.2 Page 6 The manager has ensured that people’s needs are assessed prior to or very soon after they are admitted to the home. Since the last inspection the entrance hall to The Grange and other areas in the home have been redecorated, re-carpeted and some new furniture has also been purchased. Since the previous inspection people have been consulted about activities and outings have been arranged and regular entertainment provided. There is now an improvement in the record kept of the meals people have consumed. Protection of vulnerable adult and medication training has been provided to staff and they have been supported in enrolling onto the National Vocational Qualification (NVQ) in health and social care level 2. Since the last inspection the adult protection policy has been updated and made known to staff. The recording of complaints has also improved and indicates that people are listened to. What they could do better: The manager should ensure that assessments include the personal history and individual interests of people living in the home. The manager should develop the care plans further so that they provide staff with a clearer description of the actions they must take to meet individually assessed needs. The manager needs to demonstrate that people are provided with opportunities to participate in a variety of meaningful activities on a daily basis. The manager should ensure that staff receive specialist training relating to the needs of people living in the home, for example, dementia care, developing activities for people living in residential homes, pressure area care and in different aspects of health and safety. The Grange DS0000008556.V344005.R01.S.doc Version 5.2 Page 7 Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. The Grange DS0000008556.V344005.R01.S.doc Version 5.2 Page 8 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection The Grange DS0000008556.V344005.R01.S.doc Version 5.2 Page 9 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 3 (Standard 6 is not applicable) Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Assessments are undertaken and provided to the service, thereby ensuring that the needs of anyone coming into the home can be met. EVIDENCE: The care records for six people were examined and in each case the manager or the deputy had completed needs led assessments. These assessments outlined the reason for admission, medical history, and mobility needs, level of support required in relation to personal care, communication, and medication. There was also information about the person’s family contact. Some assessments also identified personal preferences in respect to getting up and going to bed, preferred meal times, and other choices in respect of daily routines. The Grange DS0000008556.V344005.R01.S.doc Version 5.2 Page 10 The assessments also provided opportunity for the assessor to identify the individual’s cultural, religious and ethnic needs, however this was not always fully completed. Files also contained social service assessments that had been provided by the referring agency at the time of referral. The assessments could be improved if there was clear evidence of the involvement of the person or their representative in the process. Furthermore the assessments should include a profile of the person’s social history, wishes and aspirations. When questioned about the admission process one person said ‘Yes- I’m only here for a couple of weeks, my daughter sorted it out, but they asked me all about myself-what I could do. Yes, and checked with the doctor about my medicine.’ The Grange DS0000008556.V344005.R01.S.doc Version 5.2 Page 11 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,9 and 10 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. In the main people receive health care based on their individual needs and support is, mostly, provided in a manner that preserves privacy and dignity. EVIDENCE: The care plans for six people were fully examined. These documents did relate to the basic needs identified at assessment. However the instructions to staff laid out in the care plans were general and did not always provide staff with sufficiently detailed instructions about what people required in order to maintain independence, communicate, reduce risks and have a meaningful and fulfilling experience of living in the home. Neither did the care plans fully demonstrate that the support provided would fully addressed and managed all the needs identified in the assessment. This was because the actions requested of staff was a repeat of the expected outcomes relating to the need. The Grange DS0000008556.V344005.R01.S.doc Version 5.2 Page 12 Although moving and handling risk assessments had been completed the supporting care plans lacked some detail and potentially do not provide sufficient information for staff to follow and therefore provide support consistently and safely. The effects on individuals of diagnoses such as diabetes, stroke or dementia were not given sufficient prominence in the care plans. The importance of developing care plans that reflect individual needs was discussed with manager. Care plans were reviewed and updated each month and notes were available from social service reviews that involved the person, their relatives and the manager. Daily records, letters and other correspondence, discussions with staff, the manager, relatives, people living in the home and the information received thorough surveys, provided ample evidence that people received the health care they required. This included routine health checks such as the optician, podiatrist, general practitioner visits, dental checks, as well as access to specialist care and assessments through hospital consultations and the district nurse service. Charts and other records confirmed that staff responded to requests for additional intervention such a fluid intake monitoring, bed-rest and through the progress of an acute illness such as a chest infection. Daily records were written respectfully and at times provided detailed information concerning peoples’ progress. Staff were observed relating to people individually. They had an understanding of peoples preferences, were patient and kind to people, treating them with warmth and understanding. People were listened to and reassurance given and support was provided with dignity and in a respectful and discreet manner. All who returned CSCI surveys felt that their health care needs were always met and that they were treated with dignity and respect. Comments included ‘They provide excellent care’ ; ‘yes the staff listen and are very good’ and ‘My …is being very well looked after.’ The medication policy has been updated to address the use of homely remedies. The administration of medication was observed and all the medication administration record sheets (MARs) looked at. Medication was administered safely. A photograph of each person needs to be placed on individual MARs. The manager must also be able to demonstrate that hand written medication doses and prescriptions are double checked to confirm that the instructions are accurate. No unaccounted for omissions were noted. The Grange DS0000008556.V344005.R01.S.doc Version 5.2 Page 13 The systems for the monitoring and administration of controlled medication was examined and assessed as robust and safe. The system also includes a weekly audit that is competed by the registered manager. Certificates confirmed that staff that held responsibility for dealing with medication had received accredited medication training since the previous inspection. The Grange DS0000008556.V344005.R01.S.doc Version 5.2 Page 14 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,14 and 15 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People are provided with opportunities to experience a lifestyle that matches their expectations and mealtimes are relaxed and pleasant. EVIDENCE: Discussion with the manager, notes from meetings and comments made by people living at The Grange, indicates that opportunities for activities have increased. The manager has registered all people with the ‘Ring and Ride’ bus service and people have gone to a local Bingo Hall. People said that they go out for walks or to the local shops with staff, and to a local pub. A music group provides entertainment approximately monthly. People also stated that staff sit and talk to them whenever they can. People also described buffets and parties that had taken place to celebrate birthdays and other important occasions. Notes from a residents meeting confirmed that people had made suggestions about future activities that included visits to a garden centre, swimming trips, gardening, knitting and sewing. The Grange DS0000008556.V344005.R01.S.doc Version 5.2 Page 15 A calendar and record of activities was not available for examination. The manager is aware that this is required and understands that this will be beneficial to people as activities in keep people motivated and prevent boredom. The manager stated that they plan to introduce games sessions including quizzes and bingo. An important aspect of planning activities is to have an understanding of the social history and current interests of people living in the home. This aspect of care was discussed with the manager who agreed to begin a process of documenting this information and using it in planning individual and group activity sessions. During the day visitors came to home freely and commented that there were no restrictions. Comments included ‘I come every day, someone comes twice a day to see her.’ Documents and comments from people demonstrated that the routines in the home are flexible and preferences concerned with getting up and going to bed, meal times or other events are respected. Events during the inspection confirmed that people are able to visit the home freely and, comments confirmed that additional action is taken to support residents contacting friends and relatives for example, people requested a mobile landline telephone and this was purchased. People are supported in religious observance and a Communion service is led once a month. The majority of people who commented felt that activities were available either ‘usually’ or ‘sometimes’. People who were interviewed described a recent outing to bingo and stated that they enjoyed speaking to one another and watching television. One person wished that there was more going on in the home but was aware that the manager was trying to arrange more activities. Mealtime was observed. The main meal on the day of the inspection was corned beef hash and home made rice pudding. People where heard commenting that they had enjoyed the meal-‘Oh this is lovely, lovely and hot.’ Staff were observed supporting people who required assistance with eating, patiently and with dignity. The Grange DS0000008556.V344005.R01.S.doc Version 5.2 Page 16 The menu and food records were examined and suggested that meals tended to be repetitive. This was discussed with the manager who stated that when changes were introduced initially people would enjoy the change and then request a return to a more familiar menu. The weight records were examined this showed that the majority of people had increased their weight or remained stable since moving into the home. It was also clear that if a person lost weight action was taken to prevent further loss this included referral to the general practitioner, provision of food supplements and increased monitoring. People who returned the surveys in the main stated that they ‘usually’ enjoyed the food and comments included: ‘ Sometimes I like the food sometimes not because there are some things you like better than others.’ People who were interviewed said ‘ The food is very good.’ And ‘The food is alright. Although it is sometimes different from the menu.’ The Grange DS0000008556.V344005.R01.S.doc Version 5.2 Page 17 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People living at The Grange benefit from being able to express their concerns, have access to an effective complaints policy and are protected from abuse. EVIDENCE: The complaints procedure was examined and this provided people with clear information about how to complain and the manner in which they will be dealt with. The complaints recorded were read through and the comments and outcomes demonstrated that people were dealt with promptly and with fairness. A copy of the complaints procedure is in the home Statement of Purpose and each person is provided with one of these. People who returned the CSCI surveys were clear about how to complain and were confident that concerns would be dealt with impartially. The homes adult protection policy was examined and this has been updated to correspond with the procedure developed by Stockport Social Services. Certificates confirmed that within the past year, senior staff at The Grange have attended protection for vulnerable adults training for managers, and all staff have completed POVA training targeted at support staff. This training was The Grange DS0000008556.V344005.R01.S.doc Version 5.2 Page 18 provided by Stockport Metropolitan Borough Council (SMBC) training partnership. Staff who were interviewed clear about the incidents that could be considered to be abuse and were ware of the actions that should be taken, including alerting the social services duty team and CSCI, as well as making a record of the events and ensuring the safety of all concerned. The managers are aware of the complexities that are possible in relation to adult protection and will seek advice from different sources to ensure that people’s rights are protected. Discussion and observations also demonstrated that the managers were aware of the possible tensions that can occur between people living in care homes, and it was evident that action was taken to maintain positive relationships and to illustrate that all people had equal rights in respect of opportunities for selfexpression and choice. The Grange DS0000008556.V344005.R01.S.doc Version 5.2 Page 19 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 19 and 26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People at The Grange have access to a safe environment that is undergoing a programme of refurbishment. EVIDENCE: A tour of the private and communal areas confirmed the information in the AQAA that: ‘Most bedrooms have been redecorated with new floorcoverings. Bedroom furniture has been replaced in many rooms.’ And ‘Bathrooms and communal areas have been modernised.’ A number of the bedrooms had been personalised and all appeared clean and The Grange DS0000008556.V344005.R01.S.doc Version 5.2 Page 20 free from unpleasant odours. Some people mentioned that if they were in their room they wanted to leave the doors during the day. This was agreed provided this was clearly a personal choice and these are not fire doors. The refurbishment process must continue so that people will live in a wellmaintained and pleasant environment. The manager asserted that it was their intention to complete the refurbishment programme. People were content with the living accommodation and said: ‘My room is lovely and clean.’ Hand washing instructions were strategically placed and personal protection equipment including gloves and aprons was available and staff were observed making use of these. The laundry area was clean and dry. The manager stated that, food hygiene is now monitored through the ‘Better Food Better Business’ initiative that has been introduce by the Food Standard Agency. SMBC Food Safety Team monitors compliance. The Grange DS0000008556.V344005.R01.S.doc Version 5.2 Page 21 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 27,28,29 and 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Staff are employed in sufficient numbers to meet peoples needs and recruitment and selection procedures promote wellbeing and protect people from harm. EVIDENCE: Six staff files were examined and each contained a copy of the persons application form, references from two sources and additional proof of identity. Letters were on file that demonstrated the managers’ diligence in following up and authenticating references. On the day of inspection there were 18 people living at The Grange who were being supported by the deputy manager, two care assistants, domestic staff and one cook. The duty roster indicated that this was the usual staff compliment during the morning. The registered manager was working a later shift on the day of inspection. The deputy also stated that the joint owner also worked in the home most days. The Grange DS0000008556.V344005.R01.S.doc Version 5.2 Page 22 Two care staff are on duty during the evening and one wake and watch and one sleep in staff cover the night shift. It was observed that staff work hard and are diligent. Care staff stated that they believed people received good care and that the best part of the job was ‘Having a nice time with people.’ She said ‘The people (residence) are nice- I really like them.’ Staff training has increased and in the past year staff have received the following training: National Vocational Qualification (NVQ) level 2 in health and social care, falls prevention, first aid, food hygiene, Introductory and advanced levels in the safe handling of medication, the protection of vulnerable adults, and Essential skills for Health Care. The manager has attained the moving and handling facilitators qualification and provides training to staff. Additional training is needed to fully demonstrate that staff are given opportunities to become skilled and competent in the varied aspects of working in a care home. This training could include dementia care, an introduction to Parkinson’s disease, life-story and activities for people in residential care, food and nutrition for older people, communication, fire safety, infection control, person centre planning and developing care plans and diabetes awareness. People who returned CSCI surveys, however, were positive about the availability and competence of staff. People said: ‘Staff come and sit with me for a chat.’ Observations made by relatives included: ‘There is skilled health and all-round care and concern for the clients welfare.’ ‘I feel they look after my ….very well. They are kind and do what they can for her’ and ‘They provide excellent care for my ……and support for myself.’ The Grange DS0000008556.V344005.R01.S.doc Version 5.2 Page 23 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35 and 38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People benefit from a management system that is based on openness and respect, and people can make their views known as quality-monitoring systems are in place. EVIDENCE: Discussion with the management team of The Grange indicated that they were keen to work with statutory services to improve the quality of life experienced by people receiving a service. Information provided in the AQAA was candid and identified areas for improvements and ideas about how this could be achieved. The Grange DS0000008556.V344005.R01.S.doc Version 5.2 Page 24 Notes from quality assurance meetings that involved residents, their relatives and representatives from SMBC also demonstrated their openness to suggestions, and willingness to respond to suggestions. This has brought about positive changes that need to continue. The manager has also introduced a quality monitoring questionnaire and survey for people to complete. The information received has been used to influence the development of the menus, activities and purchase of a mobile landline phone. Information provided in the AQAA confirmed that all equipment checks were up-to-date in accordance with manufacturers or other regulatory bodies instructions. The fire records were checked, signed entries indicated that the manager completed fire drills and safety checks on a regular basis. Furthermore the local Fire Safety office has also completed an inspection since the last CSCI inspection. Health and safety policies are in place and have been reviewed, staff were also observed following these in relation to infection control and food hygiene. Health and safety training, however, is required as identified in an earlier section of this report. The Grange DS0000008556.V344005.R01.S.doc Version 5.2 Page 25 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 x x 3 x x N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 4 17 X 18 3 3 x x X X X X 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X X 3 The Grange DS0000008556.V344005.R01.S.doc Version 5.2 Page 26 Are there any outstanding requirements from the last inspection? Yes STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 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. 1. 2. Refer to Standard OP4 OP30 Good Practice Recommendations The registered person should provide staff with wider training opportunities. The registered person should produce a central record of all staff training to assist in the collation of this information and to assist in the planning for future training events. The registered person should consult with people further about their social interests and make arrangements to enable them to engage in social activities both inside and outside of the home. This will prevent boredom and promote emotional and psychological wellbeing. 3. OP12 The Grange DS0000008556.V344005.R01.S.doc Version 5.2 Page 27 Commission for Social Care Inspection Manchester Local Office 11th Floor West Point 501 Chester Road Manchester M16 9HU National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Text phone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI The Grange DS0000008556.V344005.R01.S.doc Version 5.2 Page 28 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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