Care Home: The Grove Residential Care Home

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What the care home does well Residents live in a comfortable environment. They are satisfied with the services provided by the home. All new residents receive a full detailed assessment to ensure that their needs can be met by the resources of the care home before they are admitted. The home holds resident`s meetings to obtain their views on the service being provided by the home.The Grove Residential Care HomeDS0000072854.V375461.R01.S.docVersion 5.2 What has improved since the last inspection? We are not able to say what has improved as this is the first key inspection of this service. What the care home could do better: Staff must follow the infection control procedure of the home so that residents are protected from cross infection. Care plans must be reviewed and updated to ensure residents needs continue to be met. They must contain more detailed information about resident`s needs and guide staff as to how these individual needs are to be met safely. Care plans must be more personalised and include more detail of the resident`s background, wishes, choices and lifestyle. The range of activities offered by the home must be increased after consultation with residents. Formal supervision must be consistently provided to all staff to monitor staff development and identify training needs. The managers must ensure that new staff are not employed until the home`s recruitment procedure has been completed. Key inspection report CARE HOMES FOR OLDER PEOPLE The Grove Residential Care Home 4 Grove Road Sutton On Sea Lincs LN12 2LP Lead Inspector Ken Hague Key Unannounced Inspection 23rd April 2009 08:30 DS0000072854.V375461.R01.S.do c Version 5.2 Page 1 This report is a review of the quality of outcomes that people experience in this care home. We believe high quality care should: • • • • • Be safe Have the right outcomes, including clinical outcomes Be a good experience for the people that use it Help prevent illness, and promote healthy, independent living Be available to those who need it when they need it. We review the quality of the service against outcomes from the National Minimum Standards (NMS). Those standards are written by the Department of Health for each type of care service. Copies of the National Minimum Standards – Care homes for older people can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop. The mission of the Care Quality Commission is to make care better for people by: • Regulating health and adult social care services to ensure quality and safety standards, drive improvement and stamp out bad practice • Protecting the rights of people who use services, particularly the most vulnerable and those detained under the Mental Health Act 1983 • Providing accessible, trustworthy information on the quality of care and services so people can make better decisions about their care and so that commissioners and providers of services can improve services. • Providing independent public accountability on how commissioners and providers of services are improving the quality of care and providing value for money. The Grove Residential Care Home DS0000072854.V375461.R01.S.doc Version 5.2 Page 2 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report Care Quality Commission General Public 0870 240 7535 (telephone order line) Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address The Grove Residential Care Home DS0000072854.V375461.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service The Grove Residential Care Home Address 4 Grove Road Sutton On Sea Lincs LN12 2LP 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) 01507 441 266 01507 441 266 Paramount Residential Care Ltd Christina Battle Care Home 11 Category(ies) of Old age, not falling within any other category registration, with number (11) of places The Grove Residential Care Home DS0000072854.V375461.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 only - Code PC to service users of the following gender: Either whose primary care needs on admission to the home are within the following categories: Old age, not falling within any other category - Code OP The maximum number of service users who can be accommodated is 11 New Service 2. Date of last inspection Brief Description of the Service: The Grove Care home is a privately owned and managed home situated in the coastal resort of Sutton on Sea. The 2-storey detached house has been adapted and extended to provide accommodation for 11 service users. The home caters for older people needing permanent or respite care. Bedroom accommodation is in single rooms and all but one has an ensuite. Residents are actively encouraged to personalise their rooms. The home offers a choice of sitting rooms and a separate dining area. A stair lift is installed for access to the first floor. The home has good access to the local community and sea front amenities. Paved areas to the front and the back of the property provide external seating. There is unrestricted parking available for visitors on the wide roadway around The Grove and some parking on the driveway at the side of the house. The weekly fees range from £348 - £450 depending on the residents assessed needs. Additional charges are made for services such as chiropody, hairdressing and toiletries. Information about these costs as well as the day-to-day operation of the home, The Grove Residential Care Home DS0000072854.V375461.R01.S.doc Version 5.2 Page 5 including a copy of the last inspection report, can be found in the home statement of purpose and service user guide. These documents are made available to all new potential residents and explain the resources and services offered, by the care home. A dedicated intermediate care service is not provided by the home. The Grove Residential Care Home DS0000072854.V375461.R01.S.doc Version 5.2 Page 6 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this home is one star. This means that residents received adequate quality outcomes. This key visit was unannounced and any previous information held by the Care Quality Commission about the home was taken into account. Throughout this report the terms we and us therefore refer to the Care Quality Commission. Before the visit the provider had returned an Annual Quality Assurance Assessment (AQAA). This gave us information about how; they think they are meeting resident’s needs. The method of inspection used is called case tracking. This involves selecting a proportion of the residents and tracking the care they received through the checking of records, discussions with them and the staff who care for them, and observations of care practice. The views of residents were obtained by discussions carried out during the visit. Peoples views and comments are reflected within this report. What the service does well: Residents live in a comfortable environment. They are satisfied with the services provided by the home. All new residents receive a full detailed assessment to ensure that their needs can be met by the resources of the care home before they are admitted. The home holds residents meetings to obtain their views on the service being provided by the home. The Grove Residential Care Home DS0000072854.V375461.R01.S.doc Version 5.2 Page 7 What has improved since the last inspection? 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 on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line – 0870 240 7535. The Grove Residential Care Home DS0000072854.V375461.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 Grove Residential Care Home DS0000072854.V375461.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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People receive a comprehensive assessment before being admitted to the care home. EVIDENCE: The assessments of resident’s needs were found to be up-to-date and important pointers to peoples wishes and choices were recorded. Risk assessments had been carried out. If a risk was identified staff were instructed how to reduce or remove the risk. The risk assessments would be improved if the number of staff The Grove Residential Care Home DS0000072854.V375461.R01.S.doc Version 5.2 Page 10 required to provide safe care and the equipment required was included in assessments. Residents confirmed that they have been involved in their own initial assessment and had signed and dated the documents. The assessments contained details of current medication and medical history. They also show the support provided by the community healthcare services, known allergies, and details of peoples extended family. The information gathered at the assessments is then used to write initial care plans. The Grove Residential Care Home DS0000072854.V375461.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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): People using the service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Care plans inform staff of residents needs and how these can be met by the resources of the home. However risk assessments do not provide sufficient detail to ensure residents are cared for in a safe way. EVIDENCE: The care plans for seven residents were studied. They all contained the identified social and care needs of each resident. Care files were found to vary in quality and detail. Care records did not contain detailed risk assessments for all residents. One resident needed supervision at mealtimes as they had difficulty swallowing. The residents risk assessment did not guide staff as to what action The Grove Residential Care Home DS0000072854.V375461.R01.S.doc Version 5.2 Page 12 should be taken if the resident began to choke. The range of the risks considered when carrying out a full risk assessment were not detailed or recorded on care records. The care records for one resident who is registered blind did not contain a full risk assessment showing what possible risk areas had been considered to make sure their social activities and personal care needs could be met safely. Residents choices in respect of activities, food and diet were not recorded on every care plan. Information in relation to extended family, past employments, hobbies and choice of social activity were missing on some files. The residents spoken to during the site visit stated that their dignity and privacy and respected by staff. A resident stated “ staff are kind and courteous they always ask permission to enter my room and provide care in a very courteous and sensitive manner.” Care plans which had been reviewed in 2009 were of a higher quality and contained more detailed information. Care plans which have not been reviewed this year lacked detail. Care records contain information obtained from the community health care services and local social services teams. Care records were signed and dated by the assessor and the individual resident or a member of their family. Staff training records and discussions with members of staff provided evidence that staff, are trained in the administration and storage of medication. A member of staff was seen to administer medication and to be following the homes up-to-date medication procedure. The Grove Residential Care Home DS0000072854.V375461.R01.S.doc Version 5.2 Page 13 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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): Standards 12 13, 14 &15 People using the service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The range of activities available in the home does not fully reflect the needs and wishes of the residents. However residents benefit from being able to maintain links with the local community. EVIDENCE: The care home has a written visiting procedure which the deputy manager said this information is given to residents on admission and displayed in the care home. Residents confirmed this statement to be correct. Staff stated that visiting is encouraged and residents are supported to maintain contacts with the local community. Residents were seen to visit local shops and cafes during a site visit. The home is only a short distance from the seafront and shops. The Grove Residential Care Home DS0000072854.V375461.R01.S.doc Version 5.2 Page 14 Not all care plans include detail of individual residents wishes in respect of their social lifestyle. The care records for a resident with limited vision contained no details of how social stimulation was to be provided. This resident, said activities for me are limited. Social activities with other residents are also limited. No organised activity was observed to take place during the site visit. A second resident stated we do have entertainers who visit now and again but it is limited. Residents spoke about their satisfaction with the menu of the care home. A resident stated we are offered a choice of food. The food itself is of good quality and theres plenty of it. A second resident, stated staff know the food I like and dont like. There is always good food to eat here. Staff confirmed that choice of food is always offered and in their opinion the food is of good quality. Residents were observed taking lunch, no negative comments were passed about the food. The Grove Residential Care Home DS0000072854.V375461.R01.S.doc Version 5.2 Page 15 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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): Standards 16 &18 People using the service experience Good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People know how to complain. EVIDENCE: The complaints procedure was seen to be displayed in the reception area of the home. Residents confirmed that they are aware of the complaints procedure and feel confident they can raise any concerns with the management. The deputy manager stated that she monitors the accident reports. We have not received any notifications have been received by the Care Quality Commission which have raised concerns about the care practice of the home. Staff training records produced evidence that training has been provided to staff to ensure they can protect residents from any potential abuse. Staff confirmed this training had taken place. Staff stated that they would use the whistle blowing procedure of The Grove Residential Care Home DS0000072854.V375461.R01.S.doc Version 5.2 Page 16 the care home if they have any concerns about care practice. Staff could not identify any health and safety issues which would affect the safety of residents. Residents stated that they feel safe living in the care home. A resident stated staff look after you here I can always talk to them if I have a problem. A second resident stated the management and staff listen to us and if we have concerns or problems they help us. There have been no concerns expressed by the community healthcare services or social services about the standard of care provided to residents at this home. Residents said We feel safe living in this care home. A resident stated I like this home very much its comfortable and so close to the shops. I can go out for a daily walk and enjoy the nice weather. The Grove Residential Care Home DS0000072854.V375461.R01.S.doc Version 5.2 Page 17 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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): People using the service experience Good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents benefit from a well maintained environment. EVIDENCE: The deputy manager stated ongoing maintenance is being carried out and the new owners are making improvements to the home. The garden and patio area of the home is being improved and extended. The proprietors are also planning an extension to the home which will improve the quality of bedrooms offered to residents. The amount of social space available to residents has The Grove Residential Care Home DS0000072854.V375461.R01.S.doc Version 5.2 Page 18 been increased as areas of the home which were used by the previous owners are now used by residents. The home was found to be clean tidy and free of any odours. A sample of residents rooms were seen these had all been personalised by the resident. A resident stated I am very happy with this room staff helped me to keep it clean and tidy. Personal possessions were observed in all rooms seen during the site visit. The gardens of the care home are well maintained and there is a patio area where residents can sit outside. The home itself is only a short distance from the shops and seafront and most of the residents go out into the community on a daily basis. The dining room is well furnished and there is an area on the second floor where residents can sit and talk quietly to their relatives or just read. The home’s yellow bin which holds infected material was seen to be unlocked in the driveway of the care home. Maintenance records provided evidence that fire equipment and hoists are being serviced. Water temperatures are being monitored to ensure residents are not at risk of being scolded. The Grove Residential Care Home DS0000072854.V375461.R01.S.doc Version 5.2 Page 19 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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): People using the service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Staff, are trained but are not recruited safely which puts residents at risk. EVIDENCE: The staff training plan provided evidence that core and specialised training is provided. A number of staff have been provided with training in how to manage dementia. The registered manager produced evidence that 70 of staff hold an NVQ level 2 in care a national recognised care qualification or its equivalent. The deputy manager stated that supervision and appraisals do take place. Staff confirmed that staff meetings do take place. Staff said that formal staff supervisions have not taken place. One member of staff stated she had only received one supervision session in 2009. The Grove Residential Care Home DS0000072854.V375461.R01.S.doc Version 5.2 Page 20 The personal files for two staff member were seen. New staff have not been recruited in accordance with the homes recruitment procedure. One written reference was missing from the file of a new member of staff. Staff, were able to discuss in detail the needs of the individual residents being case tracked. They described how they helped each individual resident while maintaining their dignity and privacy. Residents were seen to be spoken to in a sensitive manner. Staff stated that the staffing rota is given to them in plenty of time to allow them to maintain their own personal lifestyle. There is no pressure to work additional hours except by choice. This is a small home with only 10 care staff. A resident stated we know the care staff very well they are kind and very helpful. A second resident stated We could not wish for better staff, we have a good laugh and they will help us in any way they can. The Grove Residential Care Home DS0000072854.V375461.R01.S.doc Version 5.2 Page 21 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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): People using the service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Management arrangements are not sufficiently well planned to ensure the effective running of the home. EVIDENCE: The registered manager was on the premises during the visit however the deputy manager assisted with the inspection. Staff, The Grove Residential Care Home DS0000072854.V375461.R01.S.doc Version 5.2 Page 22 were seen to be carrying out their tasks effectively and calmly. Residents were not disturbed or unhappy. The whole home was calm tidy and under control. The registered manager was leaving her post on the day of the site visit. The deputy manager assisted the Inspector during his time in the care home. The registered manager had been on leave for a period prior to the site visit. Staff stated that they were unsure who was in charge during this period. The deputy manager was unclear who was in charge of the home after the day of the site visit. Staff stated this made it difficult for them to carry out their work effectively. The proprietor wrote to the Care Quality Commission after the site visit and explained the management arrangements for the care home. A member of staff has confirmed that they have a contract to work as the acting manager of the care home. Staff stated that they felt the homes managers are supportive. Staff training records provided evidence that essential skill training and specialised training is being provided. Staff have not followed the infection control procedure of the care home and therefore placed residents at risk see evidence under standard 19 to 26. Residents are very satisfied with the care being provided to them by the home. They state that they can communicate well with staff members and management. The care home has appointed a deputy manager as acting manager since the site visit. The Grove Residential Care Home DS0000072854.V375461.R01.S.doc Version 5.2 Page 23 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 x HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 3 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 x 18 3 3 x x x x x x 3 STAFFING Standard No Score 27 3 28 3 29 2 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 x x x 3 x 2 The Grove Residential Care Home DS0000072854.V375461.R01.S.doc Version 5.2 Page 24 Are there any outstanding requirements from the last inspection? no 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 15 Requirement A care plan must be written for each resident to guide staff as to how identified needs can be met by the resources of the care home. This is to ensure that staff have access to up-to-date information and to enable them to meet peoples needs. 2 OP7 15 Care plans must include all areas of need and be in sufficient detail to enable care staff to provide comprehensive care, including peoples choices and preferences. This is to ensure that staff have access to up-to-date information and to enable them to meet peoples needs. 3 OP7 15 A risk assessment must be completed which identifies any potential risk to the resident. Where a risk is identified, a detailed management plan to reduce or remove the risk must DS0000072854.V375461.R01.S.doc Timescale for action 31/07/09 31/07/09 31/07/09 The Grove Residential Care Home Version 5.2 Page 25 be included in the care plan. This is to protect the resident from any injury. 4 OP7 15 Care Plans must be reviewed and updated regularly. This is to ensure that staff have access to up-to-date information and to enable them to meet peoples needs. 5 OP26 13 The infection control procedure in the home must be known to staff, who must then follow this procedure. This is to ensure that residents are protected from any possible source of infection. The staff recruitment procedure must be robust. This includes obtaining the documentation set out in the Care Home Regulations 2000 before a member of staff is offered employment. This is to ensure that staff are recruited safely and residents not placed at risk. A range of activities must be provided to residents, which meets their choices and wishes. This should include residents going out into local community where possible. This is to enable residents to maintain links with the community and to provide them with enjoyable activities. 25/04/09 31/07/09 6 OP29 19 25/04/09 7 OP12 16 31/07/09 The Grove Residential Care Home DS0000072854.V375461.R01.S.doc Version 5.2 Page 26 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 OP30 Good Practice Recommendations Care staff should receive formal supervision. The Grove Residential Care Home DS0000072854.V375461.R01.S.doc Version 5.2 Page 27 Care Quality Commission East Midlands Region Citygate Gallowgate Newcastle upon Tyne NE1 4PA National Enquiry Line: 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. 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