Latest Inspection
This is the latest available inspection report for this service, carried out on 4th February 2010. CQC found this care home to be providing an Adequate service.
The inspector found no outstanding requirements from the previous inspection report,
but made 1 statutory requirements (actions the home must comply with) as a result of this inspection.
For extracts, read the latest CQC inspection for The Grange Residential Care Home.
What the care home does well The registered manager is able to demonstrate that progress and improvements have been made in meeting the requirements made at the last inspection.People who use the service told us, "I have everything that I need here. The staff are very good." "I would like to do more". "I have been here for a long time now. I have no complaints. My family comes to visit. That does make all the difference. It keeps me in touch". "The manager is very good. She listens to what we say". What the care home could do better: Care plans are not being updated to reflect the changes in peoples needs. The manager discussed the issue that the present care planning format is not very flexible and is restrictive if staff want to update and change things. She has decided to review the format of the care plans and develop a new system that will be easier to change, review and update. This means that people`s health care needs will be easier to identify and staff will be able to see quickly and easily what they have to do to look after a person in the way that suits them best. There are some risk assessments with regards how people are kept safe but these need to be further developed and more individualised. We can see that since the last inspection some progress has been made but there still needs to be further improvements made in these areas. We feel confident that the manager will continue to address and improve these issues. We were told that there is still no guidance or direction for staff on when to give medication on a `when required` basis. This means that people cannot be sure they will receive their medication when they need it. The manager said she would address this. The home has its own induction programme and all new staff complete this. The programme is not linked to `skills for care`. The registered manager is in the process of reviewing and accessing the information. This means that new staff will have a more in depth induction which will give them the basic knowledge on how to care for people safely and within a recognisd frame work. Random inspection report
Care homes for older people
Name: Address: The Grange Residential Care Home 2 The Street Kennington Ashford Kent TN24 9EX one star adequate service 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: Mary Cochrane Date: 0 4 0 2 2 0 1 0 Information about the care home
Name of care home: Address: The Grange Residential Care Home 2 The Street Kennington Ashford Kent TN24 9EX 01233621824 01233663028 thegrange1989@aol.com Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Conditions of registration: Category(ies) : Mr Malcolm Brown Friend,Mrs Diane Kathleen Friend care home 29 Number of places (if applicable): Under 65 Over 65 29 old age, not falling within any other category Conditions of registration: 0 The maximum number of service users to be accommodated is 29 The registered person may provide the following category of service only: Care home only (PC) to service users of the following gender: Either whose primary care needs on admission to the home are within the following category ; Old age, not falling within any other category (OP) Date of last inspection Brief description of the care home The Grange is a large detached property on the outskirts of Ashford. It is registered to provide accommodation, personal care and support for up to twenty-nine older persons. Care Homes for Older People Page 2 of 9 Brief description of the care home Mrs Karen Whiting is the Registered Manager and is responsible for the day-to-day running of the home. Accommodation is arranged on the ground and first floors: the third floor provides office and storage space. There are two passenger lifts. The home has twenty-one single rooms and four double bedrooms, seven of which have en-suite facilities. Bedrooms are fitted with TV and telephone points as well as individual call alarms. The ground floor consists of a dining room, two separate lounges (one of which also has a dining area), a conservatory, kitchen and laundry. There is a large well maintained and enclosed garden, including a safely fenced fish pond, and parking for several vehicles at the front/side of the home. Facilities such as health centres, a hospital, shops and churches are within a ten minute drive. The fees are currently in the range of £326.63 to £385.10 per week. Information about the home, including the inspection reports from the Care Quality Commission are available on request. Care Homes for Older People Page 3 of 9 What we found:
The reason for this inspection was to check compliance with the statutory requirements made at the previous inspection on 15th October 2009. Nine requirements were made with various timescales for the home to take action. This report details the information as to how the home has improved and met those requirements. We also looked at some other areas that were identified as needing improvement but where a requirement was not made. This report needs to be read in conjunction with the previous key unannounced inspection report. This unannounced random inspection was carried out on 4th February 2010 between 10.00am and 1.30p.m. The Registered Manager assisted throughout the inspection. We looked at three care plans and three staff files, together with training records, and other documentation. We spoke to residents and staff. The homes Statement of Purpose has been developed into a stand alone document. The information is now kept together in one file. It is accessible to people who wish to look at it. This means that people know about the philosophy and objectives of the service and what facilities and staff are available. Each person living at The Grange now has an indvidual contract which tells them how much they are paying for the service they receive. Care plans and risk assessments have improved. The care plans for personal care are more individualised and tell how people like to receive their personal care. They also explain what people can do for themselves and where they need support. There was more information about peoples health care needs. We saw that there was guidance in place to tell staff what action to take for a person with diabetes if their blood sugars became too high or too low. There was information available on how to support a person with an inhaler. There was also information about why and when to apply creams to peoples skin. The home is keeping a record of when people have appointments with doctors and nurses and what the outcomes of the visits are. We looked at the medication people are receiving. We were told that the service had recently had an inspection from the local pharmacy. An accurate record is kept of medication that people have been given. Creams that are applied by staff are now signed for in the persons own room and record is also kept for when people apply their own creams. The registered manager is in the process of further improving the activities that people are offered to support them to live a more fulfilling life. The service are employing extra staff to make sure that they have the resources available so residents can to do what they want to. The staff are keeping records about what choices people are offered and whether they prefer to join in an activity or not. They are also recording if people are enjoying the things that they do.
Care Homes for Older People Page 4 of 9 The home have improved their infection control procedures. Laundry is now transported more safely. The service have purchased new trolleys and bags for transporting dirty and soiled laundry. They have also purchased new trolleys for the house keepers so they can transport their cleaning materials more safely. Safeguarding training has been booked for staff. The first batch of training starts in March 2010 and the second in October 2010. We did discuss with the manager that it will be some time before all staff have the necessary training to make sure staff have the knowledge and information they need to keep people safe. The manager is going to try and bring the training forward. We looked at three staff files. Two were of the most recent staff to start work at the home. All staff recruited by the home now have the necessary safety checks in place to make sure they are safe to work with vulnerable people. The three members of staff had two references and the necessary police checks. We found that a full employment history had been obtained. There was still no up to date photographs of the staff on their files. The registered manager is addressing this. Procedures for recruiting staff are now robust. Mandatory and specialist training has been accessed and booked. Mental Capacity Act training and Deprivation of Liberties training has been booked for April 2010. Some staff have received the training they need and some are in the process of receiving it. The home now have a rolling training programme and a training matrix. This means the manager can quickly and easily keep an eye on what training staff need and when they need it. It means staff will have the skills and knowledge that they need to give the people the care they need in a way that suits them best while keeping them as safe as possible. Since the last inspection the manager has started her NVQ 3. She is also in the process of updating her mandatory and specialist training. At the moment she wants to carry on being the registered manager of the service. The registered manager is now also looking at how she makes sure the home is identifying its weaknesses and strengths and looking at ways of improving the service that is on offer. They have joined the Kent Care Homes Association and have sought advice on how to develop their quality monitoring systems. Service users meetings are now being held at regular intervals and people are being asked about how they feel about the home and the care and support they receive. Any issues that do arise are being acted on by the manager. She is also in the process of developing questionnaires for residents their families and other people who visit the home who have a professional interest. The registered manager will also be looking at how she audits the systems and procedures used in the home to make sure they are being adhered to and working effectively. What the care home does well:
The registered manager is able to demonstrate that progress and improvements have been made in meeting the requirements made at the last inspection. Care Homes for Older People Page 5 of 9 People who use the service told us, I have everything that I need here. The staff are very good. I would like to do more. I have been here for a long time now. I have no complaints. My family comes to visit. That does make all the difference. It keeps me in touch. The manager is very good. She listens to what we say. 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 6 of 9 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 7 of 9 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 7 15 Care plans of the residents 30/04/2010 need to be kept under review and up dated when peoples needs change. So that every person has their health and social care needs fully documented to enable the staff to meet these needs. Regulation 15 of the Care Homes Regulations 2001 requires you keep an up to date written plan as to how the residents needs in respect of their health and welfare are to be met. Failure to comply with this regulation is an offence. 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 8 of 9 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. © Care Quality Commission 2010 This publication may be reproduced in whole or in part in any format or medium for noncommercial purposes, provided that it is reproduced accurately and not used in a derogatory manner or in a misleading context. The source should be acknowledged, by showing the publication title and © Care Quality Commission 2010. Care Homes for Older People Page 9 of 9 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!
