Care Home: The Range Rest Home

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What the care home does well Care workers had achieved National Vocational Qualifications Level 2 with a small number also having completed a Level 3. The owners had also provided other training, such as adult protection, safe handling of medicines, food hygiene, moving and handling, fire training and care of the dying. The residents who were spoken with either individually or in a group in the conservatory said that they were happy with the care provided, had good food and the staff looked after them well. Residents were encouraged to keep their independence by taking part in the day-to-day routines of the home, such as helping with washing up and laying tables if they wished to do so. A `shop night` when the care workers opened up the `shop` selling toiletries, cards and sweets was very popular. The owners were very much a part of the staff team enjoying good relationships with residents, relatives and care workers. During the visit the inspector observed care staff with residents who were relaxed and happy in their company. Activities took place most evenings and a list was displayed in the entrance hall. Residents were able to spend time and have meals in their rooms if that is what they wanted. Residents were encouraged to continue with their previous lifestyle as far as their capabilities would allow. The majority of the care plans began with a `pen picture` of the resident, which made the care plan very personal. All the residents had been given a named carer. The care worker was responsible for making sure that the overall care needs of the individual resident were being met and that the care plan was reviewed on a monthly basis. What has improved since the last inspection? Criminal Record Bureau disclosures were now obtained according to guidelines, which ensured that only suitable people were employed. All the policies and procedures had been reviewed and updated as necessary. A copy was kept in the dining room and was available to all. The Commission was now informed on any significant events as required under the Care Home Regulations.Two of the bedrooms had been fitted with an en-suite facility, which comprised of a toilet and washbasin; this has given the occupants of these rooms a greater degree of privacy. What the care home could do better: There were a few areas, which needed attention, however the trainee manager was aware of these and plans were in place to address them. CARE HOMES FOR OLDER PEOPLE The Range Rest Home 10/12 Hooley Range Heaton Moor Stockport Cheshire SK4 4HU Lead Inspector Jackie Kelly Unannounced Inspection 17th June 2008 02:00 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address The Range Rest Home DS0000008580.V365531.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. The Range Rest Home DS0000008580.V365531.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service The Range Rest Home Address 10/12 Hooley Range Heaton Moor Stockport Cheshire SK4 4HU 0161 431 9408 0161 432 4805 evclay@yahoo.co.uk Telephone number Fax number Email address Provider Web address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Mr John Francis Williams Mrs. Anita Williams Mrs. Anita Williams Care Home 13 Category(ies) of Mental Disorder, excluding learning disability or registration, with number dementia - over 65 years of age (3), Old age, of places not falling within any other category (10) The Range Rest Home DS0000008580.V365531.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. Service users to include up to 10 OP and up to 3 MD (E). Date of last inspection 25th July 2007 Brief Description of the Service: The Range is a care home providing personal care and accommodation for 12 older people. The registration also allows for the accommodation of people who may have a mental health problem. The home is owned and managed by Mr and Mrs Williams. The Range comprises of two semi-detached houses, which have been converted into one large house. The accommodation is spread over two floors, with each floor having bathroom and toilet facilities. Five rooms have an en-suite facility, which comprises of toilet and washbasin. The laundry, office, kitchen and staff room are situated in the basement. There is no passenger lift but a stair lift is available to take those service users who cannot manage the stairs to the first floor bedrooms. There is a well-stocked and mature garden for residents to use. The home is located in the Heaton Moor area of Stockport and is close to local shops and other amenities, such as cafés, restaurants, public houses, banks, post office and a cinema. There are churches of most denominations, a library and a selection of health centres, doctors’ surgeries, dentists and opticians. Stockport town centre, motorway network and public transport are easily accessible. There was a service user guide and statement of purpose available for all the residents. The fees range from £340.00 to £430.00, depending on requirements and personal circumstances. The inspection report was available on request. The Range Rest Home DS0000008580.V365531.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. This was a key inspection, which included an unannounced visit to the service, which took place over one day. Time was spent talking with one of the providers, the trainee manager and a senior care worker. Records were looked at which included the care plans of three residents and staff files. Before the inspection, we asked the manager of the home to complete a form called an Annual Quality Assurance Assessment (AQAA) to tell us what they felt they did well and what they needed to do better. This helped us to determine if the management of the agency saw the service they provided the same way that we saw it. The form was completed well with concise and adequate information that enabled us to make this assessment. At the time the AQAA was completed, the home employed enough care workers to provide a 24-hour, seven day a week service. On the day of the inspection there were 12 residents living at the home. One of the senior care workers also did the cooking. Three care workers had terminated their employment over the past 12 months. However, the majority of the care workers had been employed for a number of years. A tour of the ground and first floor took place, which included bathrooms, dining room, lounge and bedrooms. The home was clean and homely with bedrooms reflecting the residents’ personalities. Neither of the owners had a relevant qualification; although they had many years of experience. Therefore, they had appointed a trainee manager who had completed a National Vocational Qualification Level 4. The trainee manager had started to complete the Registered Manager’s Award and an Assessors Award, which will enable her to assess staff that are taking National Vocational Qualifications (NVQ). The trainee manager is to apply to the Commission for registration within the next few weeks. Once the trainee manager is registered, the providers must complete a monthly report under the Care Homes Regulations, which must be available for inspection purposes. The report should contain information of interviews with residents and a general overview of the home to ensure that people are being cared for. The Range Rest Home DS0000008580.V365531.R01.S.doc Version 5.2 Page 6 Ten completed resident and six completed relative survey forms were returned to the Commission. Of the ten resident forms completed, five had received support from a member of staff. The majority of the questions were answered positively, such as: all but two said that they received enough information about the home before they moved in. With regard to care and support all said always that they received the care and support needed, that the staff were always available when they needed them and that they always received the medical support needed; all said always that they liked the meals at the home; all said staff listened and acted on what they said. Written comments from relatives were as follows: ‘The home gives a homely atmosphere, you don’t feel that you are in anyway institutionalised when you come through the door. The staff treat the residents with respect. I enjoy their company when I see my mother. Finally one word which covers the care my mother receives is Fantastic’. ‘The home provides my mum with a range of practical daily activities, which keep her focused and busy. She has dementia so keeping her brain active is very important. The lounge is a very special place its size makes it intimate and homely. The staff are dedicated, knowledgeable and kind. Efficient staff; good care; good food; the staff and management do try their best’. ‘Staff very caring. Home from Home’. The four staff surveys returned were also positive: ‘We give care on an individual person based basis. All staff knows the residents and visitors very well’; ‘All residents get individual one to one care’; ‘We look after all our residents well and on an individual basis. Each resident is individually cared for, encouraged and supported’. All said that they were being given training which was relevant to their role; helped them understand and meet the individual needs of service users; and kept them up to date with new ways of working. The care files, which included care plans, risk assessments, GP and District Nurse visits were looked at along with the daily records for each resident and medication administration sheets. Staff personnel files and supervision files were also seen, all of which were satisfactory. There had been no complaints or safeguarding referrals made, either to the manager of the home or to the Commission. Information from the survey forms returned indicated that the majority knew who to speak to if they were not happy with any aspect of the care they received and how to make a complaint. The Range Rest Home DS0000008580.V365531.R01.S.doc Version 5.2 Page 7 What the service does well: What has improved since the last inspection? Criminal Record Bureau disclosures were now obtained according to guidelines, which ensured that only suitable people were employed. All the policies and procedures had been reviewed and updated as necessary. A copy was kept in the dining room and was available to all. The Commission was now informed on any significant events as required under the Care Home Regulations. The Range Rest Home DS0000008580.V365531.R01.S.doc Version 5.2 Page 8 Two of the bedrooms had been fitted with an en-suite facility, which comprised of a toilet and washbasin; this has given the occupants of these rooms a greater degree of privacy. 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 Range Rest Home DS0000008580.V365531.R01.S.doc Version 5.2 Page 9 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 Range Rest Home DS0000008580.V365531.R01.S.doc Version 5.2 Page 10 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 3, 6 Quality in this outcome area is good. This judgement has been made using available evidence, including a visit to this service. The assessment procedure enabled prospective residents to make a choice and ensured that the home could meet their needs. EVIDENCE: The assessment process, which included a social work assessment, a visit to the prospective resident and completion of a pre-admission assessment form, had not changed from the previous visit to the home in 2007. The managers of the home had, since the last inspection, decided to use the Department of Health’s assessment document. However, after using the document and assessing its usefulness, they had decided to look at the content and tailor it to meet the needs of the home. The Range Rest Home DS0000008580.V365531.R01.S.doc Version 5.2 Page 11 Prospective residents were still invited to spend some time at the home whenever possible. The information obtained from the written assessment forms and visits was used to complete the care plan in order that the needs of the residents were met and care workers were aware of each person’s likes and dislikes. Standard 6 was not applicable, as the home did not have any intermediate care beds. The Range Rest Home DS0000008580.V365531.R01.S.doc Version 5.2 Page 12 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 7, 8, 9, 10 Quality in this outcome area is good. This judgement has been made using available evidence, including a visit to this service. The health and personal care needs of the residents were met by the owners and care workers, and their privacy and dignity respected. EVIDENCE: The care plans were completed using the pre-admission assessments and visits to the home. The plans included the resident’s likes, dislikes and health and personal care needs. They were also updated with information as the care workers gradually got to know the person better. Each resident was allocated a care worker, known as a ‘key worker’, with whom the resident could talk to on a personal and private level. The key worker was responsible for a monthly review of the care plan with the trainee manager reviewing them on a three monthly basis. The Range Rest Home DS0000008580.V365531.R01.S.doc Version 5.2 Page 13 The medication records were pre-printed by the chemist who also provided a monitored dosage system. A new type of container, which was disposable, was now being used. The records had been completed satisfactorily. All the residents had a single room, which enabled them to receive visitors in private and a portable phone was available. The owners and care workers respected the residents’ privacy and dignity. The Range Rest Home DS0000008580.V365531.R01.S.doc Version 5.2 Page 14 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 12, 13, 14, 15 Quality in this outcome area is good. This judgement has been made using available evidence, including a visit to this service. Residents were given choices so that they could maintain control over their daily life, as far as their capabilities would allow. EVIDENCE: Activities were organised which included bingo, music, craft sessions and memory games. Large dominoes and cards had been purchased for those people who may have difficulties in handling and seeing small objects. A ‘shop’, which sold items such as toiletries, sweets, tissues, cards, and was ‘open’ on a Tuesday evening, was proving very popular. Friends and relatives were welcomed at the home at all reasonable times of the day and evening. Relatives were often involved in the admission process of residents. The Range Rest Home DS0000008580.V365531.R01.S.doc Version 5.2 Page 15 The residents who were spoken with on the day of the inspection said that the food was good. Each resident was asked what he or she would like for lunch, which was a snack type meal with the main meal being served in the evening. On the day of inspection the evening meal was roast chicken, which was well presented and everyone appeared to enjoy it. The Range Rest Home DS0000008580.V365531.R01.S.doc Version 5.2 Page 16 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 16,18 Quality in this outcome area is good. This judgement has been made using available evidence, including a visit to this service. The residents were protected through the complaints procedure, training and Criminal Record Bureau Disclosures. EVIDENCE: A complaints procedure was available to all residents or their relatives through the service user guide. Training on the protection of vulnerable adults had been given to the majority of the care workers by a professional trainer who visited the home. Neither the home nor the Commission for Social Care Inspection had received any complaints and there had been no safeguarding referrals. All care workers had received a Criminal Record Bureau Disclosure, which followed the process as stated in the Care Homes Regulations. The Range Rest Home DS0000008580.V365531.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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 19, 26 Quality in this outcome area is good. This judgement has been made using available evidence, including a visit to this service. The home was clean, satisfactorily maintained and decorated to meet the needs of the residents. EVIDENCE: The downstairs shower and toilet had been refurbished which made it more accessible and usable for the residents. Since the last inspection two of the bedrooms had been fitted with an en-suite facility, which consisted of a toilet and washbasin. The rooms had also been decorated in modern colours and new carpet laid. The alterations had worked well and given residents more privacy. Each resident now had a single room; five of which were en suite. The Range Rest Home DS0000008580.V365531.R01.S.doc Version 5.2 Page 18 A further bedroom was to have a door repositioned which would provide this bedroom with an en-suite facility. There was no passenger lift but there was a stair lift for access to the first floor. The home was clean, satisfactorily maintained and decorated. The majority of furnishings and fittings were in good condition and suitable for the needs of the residents. However, a small number of carpets need to be replaced. The trainee manager was aware of this and plans were in place to seek the views of residents as to colours, etc. The Range Rest Home DS0000008580.V365531.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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 27, 28, 29, 30 Quality in this outcome area is good. This judgement has been made using available evidence, including a visit to this service. Experienced care workers, who were sufficient in numbers and had received appropriate training, looked after the residents. EVIDENCE: The providers employed sufficient staff that were experienced and trained to care for the residents; many having worked at the home for a number of years. The providers never used agency staff, as the existing staff team covered holidays and sickness. National Vocational Qualification (NVQ) training was ongoing with five staff having completed either a level 2 or a level 3. Three other care workers were currently doing the NVQ training. Other training had taken place, such as moving and handling, safe handling of medicines and basic food hygiene. All the staff team had a training assessment. The AQAA stated that a new staff recruitment policy had been implemented and that a pre-employment pack had been devised and introduced. New staff were required to complete the Skills for Care induction standards. The Range Rest Home DS0000008580.V365531.R01.S.doc Version 5.2 Page 20 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 31, 33, 35, 36, 38. Quality in this outcome area is good. This judgement has been made using available evidence, including a visit to this service. The providers and trainee manager ensured that the home was run in the best interests of the residents. EVIDENCE: The owners had many years of experience but no relevant qualification. Therefore, a trainee manager had been employed who had now completed a National Vocational Qualification (NVQ) Level 4 and was currently doing the Registered Manager’s Award and Assessors award. The Range Rest Home DS0000008580.V365531.R01.S.doc Version 5.2 Page 21 The provider and trainee manager said that the application to register would be completed and sent to the Commission within the next two weeks from the date of this inspection. The providers must ensure that this is done. Once the manager is registered the providers must produce a written report as required under Regulation 26 of the Care Homes Regulations. This was discussed with both the provider and trainee manager. A quality assurance report had been written and sent to the Commission for Social Care Inspection. The report provided an overview of the most recent surveys; the responses received were positive. The policies and procedures had been reviewed and updated as necessary; a copy of each was available in the dining room. The providers do not have any responsibility for residents’ finances. Small amounts of cash for individual residents were kept for day-to-day expenses; receipts and records were kept. Staff received regular supervision from the trainee manager where their work and training needs were discussed. The owners and trainee manager followed safe working practices and had in place risk assessments, moving and handling training, food hygiene training and complied with all the relevant legislation. A representative from the health and safety department had visited on the morning of the inspection. He had made one recommendation; ‘to fit a stair rail the outside steps leading to the cellar’. The gas certificate was in need of renewal, which the trainee manager said would be dealt with, immediately. The Range Rest Home DS0000008580.V365531.R01.S.doc Version 5.2 Page 22 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 x x 3 x x N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 x 18 3 3 x x x x x x 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 x 3 x 3 x x 3 The Range Rest Home DS0000008580.V365531.R01.S.doc Version 5.2 Page 23 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. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations The Range Rest Home DS0000008580.V365531.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Manchester Local Office Unit 1, 3rd Floor Tustin Court Port Way 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 The Range Rest Home DS0000008580.V365531.R01.S.doc Version 5.2 Page 25 - 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. 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