Care Home: The New Grange Care Home

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What the care home does well The home is well run and people were complimentary about the manager Mr Griggs. There is a well trained motivated team of staff in the home who respect the choices, privacy and dignity of residents. We are told that staff encourage residents to achieve their optimum level of independence. The home is clean comfortable and homely and good home cooked food is served. Records related to the running of the home are up to date and well maintained. Comments we received from visitors to the home include; "Outstanding care and staff fantastic". "Staff well motivated". "Staff go that extra mile". "Would recommend the home to anyone". "Keith is always around and ensures everyone is ok". What has improved since the last inspection? This is a new registration, however the new owners are in the process of refurbishing the home to a good standard. What the care home could do better: The outcomes for residents would be improved by the employment of an activities coordinator. The manager of the home told us that they are in the process of recruiting to this post. Key inspection report Care homes for older people Name: Address: The New Grange Care Home 10-16 Homefield Road Worthing W Sussex BN11 2HZ     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home 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 full review a ‘key’ inspection. Lead inspector: Jo Hartley     Date: 1 4 1 0 2 0 0 9 This is a review of 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. The first part of the review gives the overall quality rating for the care home: • • • • 3 2 1 0 stars - excellent stars - good star - adequate star - poor There is also a bar chart that gives a quick way of seeing the quality of care that the home provides under key areas that matter to people. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Care Homes for Older People Page 2 of 21 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. 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 Care Homes for Older People Page 3 of 21 Information about the care home Name of care home: Address: The New Grange Care Home 10-16 Homefield Road Worthing W Sussex BN11 2HZ 00000 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Cornelia Grange Care Homes LTD Name of registered manager (if applicable) Mr Keith William Griggs Type of registration: Number of places registered: care home 58 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia mental disorder, excluding learning disability or dementia Additional conditions: The maximum number of service users to be accommodated is 58 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: Mental disorder, excluding learning disability or dementia (MD) Dementia (DE) Date of last inspection Brief description of the care home The New Grange is a care home for people with dementia, or a mental disorder. The home is located within a residential area just under a mile from Worthing town centre, opposite the general hospital. Accommodation, of thirty seven single and eight double bedrooms, is provided within four properties, which have been linked to form one Care Homes for Older People Page 4 of 21 Over 65 0 0 58 58 Brief description of the care home establishment. The property has three floors, which are serviced by a passenger lift. There is a well-maintained, secure garden to the rear of the property. Parking is available to the front of the property. Care Homes for Older People Page 5 of 21 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: The quality rating for this service is 2 star. This means the people that use this service experience good quality outcomes. The purpose of the inspection was to assess how well the home is doing in meeting the key National Minimum Standards and Regulations. The findings of this report are based on several different sources of evidence. These include: the Annual Quality Assurance Assessment (AQAA) completed by the home, surveys received from residents and staff, and an unannounced visit to the home, which was carried out on the 14th October 2009. During the visit we looked at policies and procedures, staff records and residents records. All regulatory activity since the home was registered was reviewed and taken into account including notifications sent to the Care Quality Commission. This was the first inspection since the home changed ownership in April 2009. Care Homes for Older People Page 6 of 21 What the care home does well: 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. Care Homes for Older People Page 7 of 21 Details of our 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) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 8 of 21 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Prospective residents have the information they need to make an informed choice about whether to live in the home. Full assessments are carried out to ensure the home will be able to meet identified needs and trial visits are encouraged. Evidence: All prospective residents are admitted after being assessed at home or hospital by a suitably qualified person. We looked at a number of residents care records and could see that their assessments include a full needs assessment together with a person centred daily living assessment. Complex risk assessments are compiled to give staff the information they need to keep residents safe. Trial visits are offered. Surveys completed by residents told us that they had all received enough information about the home to make a decision. Care Homes for Older People Page 9 of 21 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. All residents have an up to date care plan which is generated from the assessment process and staff give good quality care to residents according to their wishes. Safe medication systems are in place and residents get their medication as prescribed. Staff respect the residents privacy and dignity. Evidence: All residents have an up to date care plan which details areas and topics relevant to that particular resident, such as abilities, needs, aims of care, methods and evaluation. Some of the care plans have been signed by residents or their advocates to say they agree with the plan. Records of health care monitoring are kept such as weights, mental condition, skin integrity. Risk assessments are in place. We saw personal information records about the particular habits and wishes of residents that staff need to know to meet their needs. We were told by residents and relatives that staff do follow these plans and do give the personal touches to residents that make them feel better. We also observed staff respecting the privacy and dignity of residents. Four surveys from residents told us that staff always listen to and act on what they say, two said usually. Six surveys told us that staff were always available. Care Homes for Older People Page 10 of 21 Evidence: Some examples of respecting residents wishes included: Mrs X likes to have a sandwich before settling for the night, Mrs Y likes to have a nap after lunch and Mrs Z likes going for a walk around the garden. One person who completed a survey told us that their relative who has severe dementia had been admitted from hospital very poorly, not eating and staying in their room but that since being in the home they had improved greatly. They told us staff had encouraged them and now this resident was eating and going out of their room. We were told that staff went that extra mile. Specialist equipment is provided if a need is identified and Deprivation of Liberties assessments are completed for residents who stay in their rooms. We could see from records that residents have access to other health professionals when needed and any visits from GPs, nurses, chiropodists etc are recorded. Policies for the safe administration of medicine are in place as are the sample signatures of staff who administer medication. We saw that any changes on the medication administration records are signed by a GP as a safeguard for residents. We did a check on medication records and stocks and these were in order. Care Homes for Older People Page 11 of 21 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. A programme of activities is available although an activity co-ordinator is not in post. Residents are encouraged to maintain contact with family and friends and staff encourage residents to make decisions and choices about their daily lives. Good home cooked food is served with special diets catered for. Evidence: We could see from care plans and assessments that residents likes and dislikes are recorded also times of going to bed and getting up. We were told that staff respect these wishes. Three surveys told that residents thought there was always enough activities provided two said usually, one said there was never enough activities and one did not know. The home does not have an activities co-ordinator at present but is trying to recruit a full time one. Outside entertainers do visit the home. One relative told us that their mother found it difficult to settle but staff were very good, they were patient and encouraged her to make a friend. They told us that she was also allowed to wander around the home which was good for her. We were told that residents are encouraged to maintain contact with relatives and friends and that visiting is encouraged. Care Homes for Older People Page 12 of 21 Evidence: The home has a pleasant dining room which has recently been redecorated, the menu for the day is displayed on a board. While we were there the main meal of the day was liver and bacon casserole, alternatives were available as was a choice of puddings. Two surveys told us that the meals were always good and four said usually. Care Homes for Older People Page 13 of 21 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this 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 and their relatives know their complaints will be listened to and acted on. Residents legal rights are protected in the home and residents are safeguarded from abuse by staff checks and training. Evidence: There is a complaint procedure in place and a copy is also displayed in the home. We saw records of complaints and could see that they are acted on in a timely fashion, records kept and outcomes recorded. Completed surveys told us that people knew how to complain and would feel able to. Records show that residents legal rights are protected, all residents who stay in their rooms have a Deprivation of Liberties assessment carried out as a right. The providers carry out security and safety checks on prospective staff to ensure they are fit to work with vulnerable people and training in safeguarding is provided. Care Homes for Older People Page 14 of 21 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this 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 live in a safe, well maintained and clean environment they have sufficient and suitable toilet and washing facilities and specialist equipment is provided. Residents own rooms meet their needs and they have personal possessions around them to make them feel at home. Evidence: The home is clean, comfortable and furnished in a homely fashion. Parts of the home have been redecorated and refurbished, half of the bedrooms have been redecorated and new furnishings and furniture purchased and there are plans now to finish the other half. Bathrooms are being refurbished with one bathroom being changed into a shower room. Specialist equipment is available: e.g. bath hoists and a stair lift. Residents bedrooms can be personalised to make them more homely. Records were seen to evidence that safety checks are undertaken for maintenance, electrical, fire detection, emergency call system and specialist equipment. Care Homes for Older People Page 15 of 21 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this 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 needs are met by the numbers and skill mix of staff and residents are in safe hands at all times. The home operates a safe recruitment procedure and there is a staff training programme in place. Evidence: Surveys told us that people thought there was enough staff on duty to meet residents needs. We were told that new staff have recently been recruited including: three new carers, a new deputy manager, an administrator, two new housekeepers and a painter and decorator. The home told us that they are in the process of recruiting an activities co-ordinator. We saw records that rolling staff training programme is in place and that a number of staff have completed training in dementia. The home operates a safe recruitment procedure with all staff being checked to show they are safe to work with vulnerable people and all legal records obtained before staff work alone with residents. Staff told us in their surveys that they are supported to carry out their roles and given enough information to be able to meet residents needs. Care Homes for Older People Page 16 of 21 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home is well run and managed for the benefit of residents and the management approach is open. Staff are well trained and supervised and the record keeping in the home is good. The health and safety of residents and staff is promoted and protected. Evidence: The manager Mr Griggs is qualified, competent and experienced to run the home. Surveys told us that people think the home is well run and that it is run for the benefit of the residents. Staff told us they are well supported to carry out their roles and that training is provided. We were told that the management approach in the home is open. To ensure communication is good in the home there are regular meetings between the providers and the manager and also the manager and the rest of the staff. There is a staff supervision system in place and training records are maintained. The home has a quality assurance system in place with new surveys for self monitoring. The home does not look after any of the residents finances. Care Homes for Older People Page 17 of 21 Evidence: Records relating to the running of the home were seen and were in good order and the health and safety of resident and staff promoted and protected by staff training and maintenance of equipment and safety systems. Care Homes for Older People Page 18 of 21 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, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 19 of 21 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, Care Homes 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 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 20 of 21 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. 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. Care Homes for Older People Page 21 of 21 - 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!