Care Home: The Grove

Similar services:

• Chirnside House
• Keer Sands Residential Home
• Ruskin Lodge
• Bushell House
• Langrigg House
• Parkside
• Dystlegh Grange
• Thornton Lodge

What the care home does well Detailed assessments of people`s needs were always completed prior to admission to determine whether their needs could be met. Prospective residents and their relatives were encouraged to visit The Grove where they could meet residents and staff before making any decisions to live there. The medication policies and procedures provided staff with clear and safe guidance in all aspects of management of medicines and records showed that medicines had been managed safely. Residents and staff said the routines were flexible and one resident said he could do as he wished. The menus were varied and nutritious and choices and alternatives to the menu were available at each mealtime. Residents said they enjoyed the food and confirmed they were given choices. Residents had access to an effective complaints procedure and knew how to complainRotas showed the home was staffed with sufficient numbers of staff to meet the needs of the residents. Residents said there were enough staff to give them the support they needed and staff confirmed this. More than half of the care staff had achieved a recognised qualification in care and others were working towards it; this showed that the organisation was committed to improving the skills and knowledge of the staff. What has improved since the last inspection? People were given clear and useful information about services offered at The Grove to help them to decide whether it was suitable place for them and to determine whether their needs would be met. People were also given information about their rights and obligations and what to expect whilst residing at The Grove. Each resident had a care plan that recorded their health, personal and social needs and how they would like to be cared for. The care plans had been reviewed and updated to reflect current care needs and residents and their relatives had been involved in decisions about the care they received. An activities co-ordinator had recently been employed. Records showed that a range of suitable activities and entertainments were available; one resident said he was `over the moon` about the provision of leisure activities another said `the activities are great fun and anyone can join in`. Staff were pleased that residents were able to participate in the various activities and said `it has made such a big difference to the residents` and commented that the residents have a `good laugh`. The safeguarding procedures had been reviewed and staff had been provided with training to ensure residents were protected from abuse and neglect. There was a programme of refurbishment that was being completed in stages to ensure minimal disruption to residents, staff and visitors; this would ensure residents would be provided with a safer, more pleasant place to live in. Residents, visitors and staff were very positive about the improvements. Records showed that the recruitment policies and procedures had been reviewed and updated to ensure the process was clear and safe and would protect residents from being cared for by unsuitable people. From discussions with staff and review of records it was clear that the provision of training had improved and staff had received appropriate training to help them understand the needs of residents in their care. Policies and procedures had been reviewed to support staff with safe practiceStaff meetings had taken place and staff said they were able to air their views. Records showed they were regularly supervised; this helped to identify if they needed any extra support or training. A new manager has been employed. Mrs Julie Johnson is the manager for the service and she has been registered with the Commission for Social Care Inspection. Staff and residents spoke highly of Mrs Johnson and appreciated her positive contribution to improving the home. Improvements had been made to the ways in which people were consulted; people were kept up to date and were able to air their views and opinions about whether the home was meeting their needs and expectations. Checks had been introduced to monitor whether staff were following safe procedures and whether residents needs were being met. The outstanding concerns had been or were being addressed to improve outcomes for people who lived at The Grove. The registered provider (owner) regularly visited the home and records showed that he monitored the day-to-day management of the home. Records showed that systems and equipment were safe and well maintained and all staff had received training that would raise their awareness of safety matters and keep them and others safe. Recommendations made following the environmental health department visit had been carried out; the recommendations had been made to ensure that the kitchen was safe and the risk of contamination was reduced. CARE HOME MIXED CATEGORY MAJORITY OLDER PEOPLE The Grove Owen Street Rosegrove Burnley Lancashire BB12 6HW Lead Inspector Mrs Marie Matthews Unannounced Inspection 27th August 2008 09:30 X10029.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 Grove DS0000071609.V370485.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 and Care Homes for Adults 18 – 65*. 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 Grove DS0000071609.V370485.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service The Grove Address Owen Street Rosegrove Burnley Lancashire BB12 6HW 01282 437788 01282 430381 thegrove@waltoncare.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) Walton Care Limited Julie Johnson Care Home 38 Category(ies) of Old age, not falling within any other category registration, with number (38), Physical disability (6) of places The Grove DS0000071609.V370485.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The registered person may provide the following categories of service only. Care home with Nursing code N, to people of the following gender:Either. Whose primary care needs on admission to the home are within the following categories: Old age not falling within any other category - Code OP, Physical disability - Code PD (maximum number of places: 6) The maximum number of people who can be accommodated is: 38 Date of last inspection New service Brief Description of the Service: The Grove is a newly registered service owned by Walton Care Limited. An extensive refurbishment and improvement programme is currently underway; this is due to be completed by October 2008. The Grove is a purpose built single storey home with surrounding garden areas, an internal patio area and car parking to the front. Shops, pubs, churches and other amenities are within walking distance. The home can accommodate up to thirty eight people, either men or women who require nursing or personal care; within the available places six are suitable for younger persons who are physically disabled and thirty-two places for older people. All of the thirty-eight rooms in the home are utilised as single rooms, six of which provided en-suite facilities. The home has four lounges, one conservatory and a large dining room. Information about the services available at The Grove is provided in the form of a service user guide and is available, with a summary of the most recent inspection report, to existing and prospective residents and their relatives. The fees on the day of the key inspection visit range from £346.00 to £635.00 per week. Additional charges are made for newspapers and personal toiletries. The Grove DS0000071609.V370485.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 2 star. This means the people who use this service experience good quality outcomes. The key unannounced inspection, including a visit to the home, took place on 27th August 2008. The inspection process included looking at records, a tour of the home, and discussions with the registered owner, registered manager, two care staff and three residents who lived in the home. Information was also included from survey forms filled in by three care staff. The inspection also looked at things that should have been done since the last visit and a number of areas that affect people’s lives. The Grove had been registered as a ‘new’ service earlier this year; it was clear that the new owner was investing time and finances to ensure residents lived in a safe and well-maintained environment. There were twenty-three residents living in the home on the day of the inspection. What the service does well: Detailed assessments of people’s needs were always completed prior to admission to determine whether their needs could be met. Prospective residents and their relatives were encouraged to visit The Grove where they could meet residents and staff before making any decisions to live there. The medication policies and procedures provided staff with clear and safe guidance in all aspects of management of medicines and records showed that medicines had been managed safely. Residents and staff said the routines were flexible and one resident said he could do as he wished. The menus were varied and nutritious and choices and alternatives to the menu were available at each mealtime. Residents said they enjoyed the food and confirmed they were given choices. Residents had access to an effective complaints procedure and knew how to complain. The Grove DS0000071609.V370485.R01.S.doc Version 5.2 Page 6 Rotas showed the home was staffed with sufficient numbers of staff to meet the needs of the residents. Residents said there were enough staff to give them the support they needed and staff confirmed this. More than half of the care staff had achieved a recognised qualification in care and others were working towards it; this showed that the organisation was committed to improving the skills and knowledge of the staff. What has improved since the last inspection? People were given clear and useful information about services offered at The Grove to help them to decide whether it was suitable place for them and to determine whether their needs would be met. People were also given information about their rights and obligations and what to expect whilst residing at The Grove. Each resident had a care plan that recorded their health, personal and social needs and how they would like to be cared for. The care plans had been reviewed and updated to reflect current care needs and residents and their relatives had been involved in decisions about the care they received. An activities co-ordinator had recently been employed. Records showed that a range of suitable activities and entertainments were available; one resident said he was ‘over the moon’ about the provision of leisure activities another said ‘the activities are great fun and anyone can join in’. Staff were pleased that residents were able to participate in the various activities and said ‘it has made such a big difference to the residents’ and commented that the residents have a ‘good laugh’. The safeguarding procedures had been reviewed and staff had been provided with training to ensure residents were protected from abuse and neglect. There was a programme of refurbishment that was being completed in stages to ensure minimal disruption to residents, staff and visitors; this would ensure residents would be provided with a safer, more pleasant place to live in. Residents, visitors and staff were very positive about the improvements. Records showed that the recruitment policies and procedures had been reviewed and updated to ensure the process was clear and safe and would protect residents from being cared for by unsuitable people. From discussions with staff and review of records it was clear that the provision of training had improved and staff had received appropriate training to help them understand the needs of residents in their care. Policies and procedures had been reviewed to support staff with safe practice. The Grove DS0000071609.V370485.R01.S.doc Version 5.2 Page 7 Staff meetings had taken place and staff said they were able to air their views. Records showed they were regularly supervised; this helped to identify if they needed any extra support or training. A new manager has been employed. Mrs Julie Johnson is the manager for the service and she has been registered with the Commission for Social Care Inspection. Staff and residents spoke highly of Mrs Johnson and appreciated her positive contribution to improving the home. Improvements had been made to the ways in which people were consulted; people were kept up to date and were able to air their views and opinions about whether the home was meeting their needs and expectations. Checks had been introduced to monitor whether staff were following safe procedures and whether residents needs were being met. The outstanding concerns had been or were being addressed to improve outcomes for people who lived at The Grove. The registered provider (owner) regularly visited the home and records showed that he monitored the day-to-day management of the home. Records showed that systems and equipment were safe and well maintained and all staff had received training that would raise their awareness of safety matters and keep them and others safe. Recommendations made following the environmental health department visit had been carried out; the recommendations had been made to ensure that the kitchen was safe and the risk of contamination was reduced. What they could do better: 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 Grove DS0000071609.V370485.R01.S.doc Version 5.2 Page 8 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home Health and Personal Care Daily Life and Social Activities Complaints and Protection Environment Staffing Management and Administration Scoring of Outcomes Statutory Requirements Identified During the Inspection Older People (Standards 1–6) (Standards 7-11) (Standards 12-15) (Standards 16-18) (Standards 19-26) (Standards 27-30) (Standards 31-38) Adults 18 – 65 (Standards 1–5) (Standards 6, 9, 16 and 18–21) (Standards 7, 15 and 17) (Standards 22–23) (Standards 24–30) (Standards 31–35) (Standards 8, 10 and 37–43) The Grove DS0000071609.V370485.R01.S.doc Version 5.2 Page 9 Choice of Home The intended outcomes for Standards 1 – 6 (Older People) and Standards 1 – 5 (Adults 18 – 65) are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. (YA NMS 1) Each service user has a written contract/ statement of terms and conditions with the home. Each Service User has an individual contract or statement of terms and conditions with the home. (YA NMS 5) No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Prospective Service Users’ individual aspirations and needs are assessed. (YA NMS 2) Service users and their representatives know that the home they enter will meet their needs. Prospective Service Users know that the home they choose will meet their needs and aspirations. (YA NMS 3) Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Prospective service users have an opportunity to “test drive” the home. (YA NMS 4) Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. 6. The Commission considers Standards 3 and 6 (Older People) and Standard 2 (Adults 18-65) the key standards. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 2, 3 and 4. 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. People were given clear information about services offered to help them to decide whether the home was suitable and whether their needs would be met. EVIDENCE: Information about the services available at The Grove had improved so that people could make informed decisions about whether the home was suitable for them. The Grove DS0000071609.V370485.R01.S.doc Version 5.2 Page 10 The files of two recent admissions were looked at. Detailed needs assessments had been completed prior to admission to determine whether their needs could be met. Consideration should be given to reviewing the pre-assessment document to meet the diverse and complex needs of both younger adults and older people. Written confirmation that the resident’s needs could be met had been sent. Prospective residents and their relatives were encouraged to visit The Grove where they could meet residents and staff before making any decisions to live there. Residents had been issued with a contract; this would ensure they were aware of their rights and obligations and what to expect whilst residing at The Grove. The provision of training had improved. Records showed that staff had the skills, ability and qualifications to meet the residents in their care. The Grove DS0000071609.V370485.R01.S.doc Version 5.2 Page 11 Health and Personal Care The intended outcomes for Standards 7 – 11 (Older People) and Standards 6, 9, 16, 18 –21 (Adults 18-65) are: 7. The service user’s health, personal and social care needs are set out in an individual plan of care. Service Users know their assessed and changing needs and personal goals are reflected in their individual plan. (YA NMS 6) Also Service Users are supported to take risks as part of an independent lifestyle. (YA NMS 9) Service users’ health care needs are fully met. Service Users physical and emotional health needs are met. (YA NMS 19) 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, retain, administer and control their own medication where appropriate and are protected by the home’s policies and procedures for dealing with medicine. (YA NMS 20) Service users feel they are treated with respect and their right to privacy is upheld. Service Users rights are respected and responsibilities recognised in their daily lives. (YA NMS 16) Also Service Users receive personal support in the way they prefer and require. (YA NMS 18) Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The ageing, illness and death of a Service User are handled with respect and as the individual would wish. (YA NMS 21) 8. 9. 10. 11. The Commission considers standards 7, 8, 9 and 10 (Older People) and Standards 6, 9, 16, 18, 19 and 20 (Adults 18-65) are the key standards. 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. The care plans were clear, developed from information obtained prior to admission and generally included details about how resident’s health and personal care needs would be met. The principles of privacy, dignity and respect were put into practice. Medication policies and procedures provided safe guidance for staff but some practices need to be improved to ensure resident’s medicines were managed according to procedure. The Grove DS0000071609.V370485.R01.S.doc Version 5.2 Page 12 EVIDENCE: Three care plans were looked at in detail. The care plans had improved and included useful information regarding residents’ choices and preferences and likes and dislikes; this information would help staff to look after them properly. Information about residents’ personal and healthcare needs, as recorded in the initial assessment, had not always been included and this could result in residents not having all their needs met. For example two residents had behavioural problems and another had a minor skin tear and whilst it was clear that these residents were receiving the care they needed there was little information in the care plan to support staff. The care plans had been reviewed and updated to reflect current care needs and residents and their relatives had been involved in decisions about the care they received. Residents had access to specialist health care services to ensure their health was maintained. Residents said they received medical support when needed and had been visited by their own GP when it was necessary. Staff had been trained in health care matters and worked with the nurses as part of the team. Residents said they were looked after and were able to take responsibility for their own personal care with support from staff as needed. Areas of risk had been identified for each resident and the action to be taken to reduce or eliminate any identified risks had been recorded. The general risk assessment form still needs to be revised, as there was no information to advise staff how to reduce or eliminate the identified risk. The registered manager advised this form would be removed as a new more detailed form had been introduced. Audit systems were in place to ensure the records were accurate and that resident’s needs were being met. Residents were provided with a range of specialised aids and adaptations to maintain their comfort and safety and to help them to maintain their independence wherever possible. Information in residents’ care plans referred to maintaining privacy and dignity and this was included as part of the staff induction and ongoing training. Staff were observed talking to residents in a friendly and respectful manner. The Grove DS0000071609.V370485.R01.S.doc Version 5.2 Page 13 The medication policies and procedures provided staff with clear and safe guidance in all aspects of management of medicines; the medication disposal procedure needed minor changes to reflect the different methods of disposal. Records showed that medicines had been managed safely although staff must ensure that the appropriate coding was used if medicines were refused or not needed and that protocols to support staff with ‘PRN’ or ‘as needed’ medicines were in place. Residents’ permission should be obtained to permit staff to manage their medicines. Treatment rooms were secure and appropriate for medication storage. There were no residents who were managing their own medicines although facilities were available if they wished to do so. Regular management checks were completed to ensure staff were following policies and procedures. The Grove DS0000071609.V370485.R01.S.doc Version 5.2 Page 14 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 (Older People) and Standards 7, 11– 15 and 17 (Adults 18-65) are: 12. 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 have opportunities for personal development. (YA NMS 11) Also Service Users are able to take part in age, peer and culturally appropriate activities. (YA NMS 12). Also Service users engage in appropriate leisure activities. (YA NMS 14) Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service Users are part of the local community. (YA NMS 13) Also Service Users have appropriate personal, family and sexual relationships. (YA NMS 15) Service users are helped to exercise choice and control over their lives. Service Users make decisions about their lives with assistance as needed. (YA NMS 7) Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. Service Users are offered a healthy diet and enjoy their meals and mealtimes. (YA NMS 17) 13. 14. 15. The Commission considers standards 12, 13, 14 and 15 (Older People) and Standards 12, 13, 15 and 17 (Adults 18-65) the 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. Social and recreational activities had improved and met resident’s diverse needs and expectations. Residents received a healthy, varied diet that was suited to their individual preferences and requirements. EVIDENCE: An activities co-ordinator had recently been employed. Records showed that a range of suitable activities and entertainments were available that would meet The Grove DS0000071609.V370485.R01.S.doc Version 5.2 Page 15 resident’s diverse needs, preferences and expectations; the views of residents had been sought to ensure their varied interests and abilities would be considered when activities and excursions were being planned. Residents and staff made positive comments regarding the recent provision of activities and entertainments; one resident said he was ‘over the moon’ about the provision of leisure activities another said ‘the activities are great fun and anyone can join in’. Staff were pleased that residents were able to participate in the various activities and said ‘it has made such a big difference to the residents’ and commented that the residents have a ‘good laugh’. One resident said he enjoyed going out with family and friends. Residents also said they were able to spend time in their rooms if they preferred not to join in. Residents and staff said the routines were flexible and one resident said he could do as he wished. Care staff said residents were able to make choices about their day and could stay in bed if they wished. Residents had been encouraged to bring personal items into their rooms to make them more homely. There were no residents in employment or attending college and although resident’s involvement in the local community was limited at present this was improving and relationships were being developed. Information about advocacy support was displayed on the notice board for those residents who needed support and advice from a person outside the home. Residents said visitors would be welcome at any time and could visit in the privacy of the bedrooms or in any of the communal areas. The menus were varied and nutritious and offered two choices at each mealtime. Records showed residents were also given alternatives to the menu. Residents said they enjoyed the food and confirmed they were given choices. The cooks were aware of residents’ preferences and special dietary needs were catered for. Residents were given sensitive support with their meals when needed and were given time to finish their meals comfortably. The dining areas were bright and clean and appropriate utensils provided; the dining areas were due to be completely re furbished as part of the improvement programme. Birthdays and special occasions were celebrated and enjoyed and visitors were able to dine with their relatives for a small charge. Any recommendations made by the Environmental Health Officer had been completed and further improvements, including the introduction of the Food Standards Agency ‘Safer Food Better Business’ records, were underway to ensure the kitchen remained safe and fit for purpose. The Grove DS0000071609.V370485.R01.S.doc Version 5.2 Page 16 Complaints and Protection The intended outcomes for Standards 16 – 18 (Older People) and Standards 22 – 23 (Adults 18-65) 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 feel their views are listened to and acted on. (YA NMS 22) Service users’ legal rights are protected. Service Users are protected from abuse, neglect and self-harm. (YA NMS 23) Service users are protected from abuse. Service Users are protected from abuse, neglect and self-harm. (YA NMS 23) The Commission considers standards 16 and 18 (Older People) and Standards 22 and 23 (Adults 18-65) the key standards to be inspected. 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. Residents had access to a robust and effective complaints procedure and were protected from abuse by staff awareness and policies and procedures. EVIDENCE: The complaints procedure was clear and accessible. From discussion with residents it was clear they knew how to and whom to complain to. There had been no complaints and residents said they were happy with the service provided. There were clear procedures for safeguarding adults and staff had received training to help them to recognise and respond appropriately to any abuse or neglect. There had been no referrals under safeguarding. There was a ‘whistle blowing’ procedure that supported staff to report concerns about bad practice. There were procedures to support staff with dealing with verbal and physical aggression and managing residents finances. The Grove DS0000071609.V370485.R01.S.doc Version 5.2 Page 17 People were involved in the decisions to use any form of restraint such as bed rails and wheelchair belts. Risk assessments showed bed rails were used only when necessary and residents and significant others were involved in any restrictions on choices and freedom. The Grove DS0000071609.V370485.R01.S.doc Version 5.2 Page 18 Environment The intended outcomes for Standards 19 – 26 (Older People) and Standards 24 – 30 (Adults 18-65) are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service Users live in a homely, comfortable and safe environment. (YA NMS 24) Service users have access to safe and comfortable indoor and outdoor communal facilities. Shared spaces complement and supplement service users’ individual rooms. (YA NMS 28) Service users have sufficient and suitable lavatories and washing facilities. Service Users toilets and bathrooms provide sufficient privacy and meet their individual needs. (YA NMS 27) Service users have the specialist equipment they require to maximise their independence. (YA NMS 29) Service users’ own rooms suit their needs. Service Users’ own rooms suit their needs and lifestyles. (YA NMS 25) Service users live in safe, comfortable bedrooms with their own possessions around them. Service users’ bedrooms promote their independence. (YA NMS 26) Service users live in safe, comfortable surroundings. Service Users live in a homely, comfortable and safe environment. (YA NMS 24) The home is clean, pleasant and hygienic. The home is clean and hygienic. (YA NMS 30) The Commission considers standards 19 and 26 (Older People) and Standards 24 and 30 (Adults 18-65) the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 20, 21, 22, 24, 25 and 26. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The standard of the environment was improving with clear timescales for completion; this would ensure residents would be provided with a safer, more pleasant place to live. The Grove DS0000071609.V370485.R01.S.doc Version 5.2 Page 19 EVIDENCE: At previous visits there had been serious concerns about the standard of the environment and the previous owners lack of progress to improve this. A tour of all areas was undertaken. The current owner had made a commitment to improving all areas of the home. There was a programme of refurbishment that was being completed in stages to ensure limited disruption to residents, staff and visitors; clear timescales for completion in 2008 had been recorded. The work both inside and outside the home was ongoing as per plan. Half of the bedrooms had been fully re-furbished and the registered manager advised that the next stage would include the corridors. Residents were given a choice to move rooms as a temporary or permanent measure whilst work was underway. The gardens had been landscaped and trees had been cut back to ensure natural lighting to some of the rooms was improved. Plans were in place to provide a secure sensory garden area for residents and visitors to enjoy. Residents, visitors and staff were very positive about the improvements, which would ensure that The Grove would be a safer, more pleasant place to live. All bedrooms were single occupancy and some had en suite facilities; some had been completely re-furbished others were due. Rooms without en suite facilities had washbasins; toilets and bathrooms were located nearby. All residents had been offered a key to their room and had a secure lockable cabinet for storage of private and personal items. Resident’s rooms were clean and bright and most had been personalised with their treasured possessions. Specialist equipment and adaptations were available to meet the individual needs of people using the service. There was a selection of communal areas that allowed a choice of sitting quietly or being involved with others. The home was clean and odour free. The Grove DS0000071609.V370485.R01.S.doc Version 5.2 Page 20 Staffing The intended outcomes for Standards 27 – 30 (Older People) and Standards 31 – 35 (Adults 18-65) are: 27. 28. 29. Service users needs are met by the numbers and skill mix of staff. Service users are supported by an effective staff team. (YA NMS 33) Service users are in safe hands at all times. Service Users are supported by an effective staff team. (YA NMS 32) Service users are supported and protected by the home’s recruitment policy and practices. Service Users benefit from clarity of staff roles and responsibilities. (YA NMS 31) Also Service Users are supported and protected by the home’s recruitment policy and practices. (YA NMS 34) Staff are trained and competent to do their jobs. Service Users individual and joint needs are met by appropriately trained staff. (YA NMS 35) 30. The Commission considers standards 27, 28, 29 and 30 (Older People) and Standards 32, 34 and 35 (Adults 18-65) the 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. The staff team were experienced, well supported, competent and provided in sufficient numbers to meet resident’s needs. The recruitment procedure was clear and safe practice ensured residents were protected from harm. EVIDENCE: Rotas showed the home was staffed with sufficient numbers of staff to meet the needs of the residents. Residents said there were enough staff to give them the support they needed; staff confirmed this. The duty rota needed to include hours for the registered manager, catering staff, domestic staff, handyman and activities person; this would support that the home was adequately staffed and be used as reference in the event of any incidents occurring. Recent rotas show that the reliance on agency staff had decreased; The Grove DS0000071609.V370485.R01.S.doc Version 5.2 Page 21 residents were cared for by staff who were familiar with their routines and preferences. There was a recruitment procedure in place. Records showed that the recruitment policies and procedures had been reviewed and updated to ensure the process was clear and safe. The records of two recently employed staff were looked at in detail. The information regarding employment histories needed to be clearer to ensure there were no gaps in employment, otherwise a safe and fair process had been followed. Residents had not been actively supported and involved in the interview and selection of new staff but one resident confirmed he had sometimes been introduced to prospective staff. Staff roles and responsibilities were clearly defined and understood; this would ensure the home was efficient in meeting people’s needs. From discussions with staff and review of records it was clear that the provision of training had improved and staff had received appropriate training to help them understand the needs of residents in their care. More than half of the care staff had achieved a recognised qualification in care and others were working towards it; this showed that the organisation was committed to improving the skills and knowledge of the staff. All new staff had completed an introduction or ‘induction’ to ensure they were safe although the record needs to be dated and signed by the employee on the day of the induction. There was a training matrix that showed training that had either been booked or had taken place but this was not up to date. Care staff confirmed they had commenced internal training to ensure they up dated their skills and knowledge. Staff meetings had taken place and staff said they were able to air their views. Records showed they were regularly supervised; this helped to identify if they needed any extra support or training. The Grove DS0000071609.V370485.R01.S.doc Version 5.2 Page 22 Management and Administration The intended outcomes for Standards 31 – 38 (Older People) and Standards 8, 10, 23, 37 – 43 (Adults 18-65) are: 31. 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 a well run home. (YA NMS 37) Service users benefit from the ethos, leadership and management approach of the home. (YA NMS 38) The home is run in the best interests of service users. Service Users are consulted on and participate in, all aspects of life in the home. (YA NMS 8) Also Service Users are confident their views underpin all selfmonitoring, review and development by the home. (YA NMS 39) Service users are safeguarded by the accounting and financial procedures of the home. Service Users benefit from competent and accountable management of the service. (YA NMS 43) Service users’ financial interests are safeguarded. Service Users are protected from abuse, neglect and self-harm. (YA NMS 23) Staff are appropriately supervised. Service Users benefit from well supported and supervised staff. (YA NMS 36) Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. Service Users know that information about them is handled appropriately, and that their confidences are kept. (YA NMS 10) Also Service Users rights and best interests are safeguarded by the home’s policies and procedures. (YA NMS 40) and (YA NMS 41) The health, safety and welfare of service users and staff are promoted and protected. The health, safety and welfare of service users and staff are promoted and protected. (YA NMS 42) 32. 33. 34. 35. 36. 37. 38. The Commission considers standards 31, 33, 35 and 38 (Older People) and Standards 37, 39 and 42 (Adults 18-65) the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): The Grove DS0000071609.V370485.R01.S.doc Version 5.2 Page 23 31, 33, 35, 36 and 38. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents benefited from a well managed home and their health, safety and welfare was promoted and protected. Quality assurance systems that monitored whether the home met people’s needs and expectations had improved. EVIDENCE: The Grove had been registered as a ‘new’ service earlier this year; it was clear that the new owner was investing time and finances to ensure residents lived in a safe and well-maintained environment. A new manager has been employed. Mrs Julie Johnson is the manager for the service and she has been registered with the Commission for Social Care Inspection. Mrs Johnson is a qualified nurse with care and management experience and she has obtained the registered manager award, which will support her with her role. Staff and residents spoke highly of Mrs Johnson and appreciated her positive contribution to improving the home. One resident said ‘the new manager seems very nice and you can discuss things with her’ and a member of staff said ‘ she (Mrs Johnson) has worked hard to improve the home’. There had been a number of concerns raised at previous key inspections although most of these had been addressed to ensure positive outcomes for residents. Improvements had been made to the ways in which people were consulted; people were kept up to date and were able to air their views and opinions about whether the home was meeting their needs and expectations. Residents and staff had been kept up to date about the improvements to the service. Policies and procedures had been reviewed and reflected safe practice for staff. Monitoring checks were in place to monitor whether staff were following safe procedures and whether residents needs were being met. The AQAA, which was sent to us prior to this visit, contained useful information about the current situation in the home. Records showed that resident’s finances were safe guarded by the systems and record keeping. The procedure to support staff with managing residents The Grove DS0000071609.V370485.R01.S.doc Version 5.2 Page 24 finances and valuables needed minor amendment to include provision of receipts. Systems were in place to check that records were accurate. Records showed that systems and equipment were safe and well maintained. All staff had received training that would raise their awareness of safety matters and keep them and others safe. Risk assessments were in place for safe working practice although it was noted that disclaimers were in place permitting fire doors to be wedged open; the practice of keeping fire doors open should be included in the risk assessment and discussed with the fire safety officer. Consideration should be given to the safety of others in case of fire and to the purchase of automatic door closures when the alarm sounds. The Grove DS0000071609.V370485.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 3 2 3 3 2 4 3 5 X 6 N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 2 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 3 17 X 18 3 ENVIRONMENT Standard No Score 19 3 20 3 21 3 22 3 23 X 24 3 25 3 26 3 STAFFING Standard No Score 27 2 28 4 29 2 30 2 MANAGEMENT AND ADMINISTRATION Standard No Score 31 3 32 X 33 3 34 X 35 2 36 3 37 X 38 2 The Grove DS0000071609.V370485.R01.S.doc Version 5.2 Page 26 Are there any outstanding requirements from the last inspection? N/A 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. 1. Standard OP7 Regulation 14 Requirement The resident’s care plan must be generated from the initial assessment and include all aspects of their health and personal care needs. The practice of ‘wedging’ fire doors open should be included in the risk assessment and discussed with the fire safety officer. Consideration should be given to the safety of others in case of fire and to the purchase of automatic door closures when the alarm sounds. Timescale for action 20/10/08 2. OP38 13 20/10/08 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. Refer to Standard OP3 Good Practice Recommendations Consideration should be given to reviewing the preassessment document to meet the diverse and complex needs of both younger adults and older people. DS0000071609.V370485.R01.S.doc Version 5.2 Page 27 The Grove 2. OP9 The disposal of medicines procedure should be reviewed to reflect how medicines are recorded when removed by the community pharmacist or by the waste contractor. Medications to be given ‘as needed’ or ‘PRN’ should be supported by clear protocols. Appropriate codes should be used to support the reasons for non-administration of medicines. Residents’ permission should be obtained to permit staff to manage their medicines. The staffing rotas should include the names, roles and hours worked of all staff employed at The Grove. The information regarding employment histories needs to be clearer to ensure there are no gaps in employment. Consideration should be given to actively supporting residents in the recruitment and selection of new staff. The training matrix should clearly reflect the training that is planned and has taken place for all staff. The induction record should be signed by the employee and dated. The procedure for dealing with resident’s money and valuables should advise staff to provide receipts. 3. 4. OP27 OP29 5. OP30 6. OP35 The Grove DS0000071609.V370485.R01.S.doc Version 5.2 Page 28 Commission for Social Care Inspection Lancashire Area Office 3rd Floor Unit 1 Tustin Court Portway Preston PR2 2YQ National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © 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. 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