Jenny Gray Home Care Home Service Adults Melville Street Lochgelly KY5 9JD Telephone:

Jenny Gray Home Care Home Service Adults Melville Street Lochgelly KY5 9JD Telephone: 01592 583325 Inspected by: Carole Kennedy Aileen Scobie Type of inspection: Unannounced Inspection completed on: 15 August 2012

Contents Page No Summary 3 1 About the service we inspected 5 2 How we inspected this service 7 3 The inspection 11 4 Other information 20 5 Summary of grades 21 6 Inspection and grading history 21 Service provided by: Fife Council Service provider number: SP2004005267 Care service number: CS2003006830 Contact details for the inspector who inspected this service: Carole Kennedy Telephone 01383 841100 Email enquiries@careinspectorate.com Jenny Gray Home, page 2 of 23

Summary This report and grades represent our assessment of the quality of the areas of performance which were examined during this inspection. Grades for this care service may change after this inspection following other regulatory activity. For example, if we have to take enforcement action to make the service improve, or if we investigate and agree with a complaint someone makes about the service. We gave the service these grades Quality of Care and Support 5 Very Good Quality of Environment 5 Very Good Quality of Staffing 5 Very Good Quality of Management and Leadership 5 Very Good What the service does well We found that people who use this service continue to be well supported by a committed staff team. People continue to be consulted about all aspects of the service they experience. There is a warm and friendly atmosphere and relatives are made to feel welcome when they visit. What the service could do better This was a very positive inspection with no requirements or recommendations identified. The manager and staff team should continue implementing and reviewing their participation strategy to increase and improve upon their already very good practice in this area. The management should continue to progress the areas for improvement noted in their self assessment and in this report. What the service has done since the last inspection The care home has demonstrated improvements to various aspects of the service. There has been several improvements to the physical environment including refurbishment of bathrooms and decoration of some bedrooms. The format and content of personal plans continues to improve. The plans are written from the perspective of the resident and provides staff with fuller information to help them know what help and support residents require. Jenny Gray Home, page 3 of 23

Conclusion Inspection report continued The care home continues to provide clean and comfortable accommodation. There was a pleasant, homely atmosphere and residents, relatives and staff were observed to interact well together. Residents and their relatives told us that they enjoy good quality care and support from a friendly and caring staff team. Who did this inspection Carole Kennedy Aileen Scobie Lay assessor: Not Applicable. Jenny Gray Home, page 4 of 23

1 About the service we inspected The Care Inspectorate regulates care services in Scotland. Prior to 1 April 2011, this function was carried out by the Care Commission. Information in relation to all care services is available on our website at www.careinspectorate.com. The Care Inspectorate will award grades for services based on findings of inspections. Grades for this service may change after this inspection if we have to take enforcement action to make the service improve, or if we uphold or partially uphold a complaint that we investigate. The history of grades which services have been awarded is available on our website. You can find the most up-to-date grades for this service by visiting our website, by calling us on 0845 600 9527 or visiting one of our offices. Requirements and recommendations If we are concerned about some aspect of a service, or think it could do more to improve its service, we may make a recommendation or requirement. - A recommendation is a statement that sets out actions the care service provider should take to improve or develop the quality of the service but where failure to do so will not directly result in enforcement. - A requirement is a statement which sets out what is required of a care service to comply with the Public Services Reforms (Scotland) Act 2010 and Regulations or Orders made under the Act, or a condition of registration. Where there are breaches of the Regulations, Orders or conditions, a requirement must be made. Requirements are legally enforceable at the discretion of the Inspectorate. Jenny Gray House is registered to provide 24-hour permanent and respite care for a maximum of 32 older people. There are 26 permanent places and six respite beds. The 2 storey care home is situated in its own spacious grounds, in a residential area near Lochgelly town centre. There are level access gardens with pleasant areas to sit in and around the house and grounds, good access into the house and onsite parking for visitors. There were 29 people resident in the home on the day of inspection. The people who live in Jenny Gray House prefer to be known as residents therefore this term has been used throughout this report. Based on the findings of this inspection this service has been awarded the following grades: Quality of Care and Support - Grade 5 - Very Good Quality of Environment - Grade 5 - Very Good Jenny Gray Home, page 5 of 23

Quality of Staffing - Grade 5 - Very Good Quality of Management and Leadership - Grade 5 - Very Good Inspection report continued This report and grades represent our assessment of the quality of the areas of performance which were examined during this inspection. Grades for this care service may change following other regulatory activity. You can find the most up-to-date grades for this service by visiting our website www.careinspectorate.com or by calling us on 0845 600 9527 or visiting one of our offices. Jenny Gray Home, page 6 of 23

2 How we inspected this service The level of inspection we carried out In this service we carried out a low intensity inspection. We carry out these inspections when we are satisfied that services are working hard to provide consistently high standards of care. What we did during the inspection The inspection of Jenny Gray Home was carried out during an unannounced visit on 15 August 2012. The inspector also took part in a relatives meeting between 6pm - 7.30pm on 13 August 2012. The service submitted a completed Annual Return and a self-assessment form as requested by the Care Inspectorate and this information was used in preparation and during the visit. The inspection was carried out by Inspectors Carole Kennedy and Aileen Scobie. During the inspection, evidence was gathered from a number of sources including: Talking to residents and visitors. Discussion with the manager and staff. Examination of a sample of the policies, procedures, health & safety records which the service is required to maintain: personal plans and care plan reviews medication system and records accident records for staff and for the people using the service records of incidents staff rota staff records including training records records of complaints insurance certificates repairs log and maintenance records minutes of staff meetings and people who use services meetings quality assurance systems, records and reports. Review of questionnaires completed by residents and relatives. Observation of practice. Grading the service against quality themes and statements We inspect and grade elements of care that we call 'quality themes'. For example, one of the quality themes we might look at is 'Quality of care and support'. Under Jenny Gray Home, page 7 of 23

each quality theme are 'quality statements' which describe what a service should be doing well for that theme. We grade how the service performs against the quality themes and statements. Details of what we found are in Section 3: The inspection Inspection report continued Inspection Focus Areas (IFAs) In any year we may decide on specific aspects of care to focus on during our inspections. These are extra checks we make on top of all the normal ones we make during inspection. We do this to gather information about the quality of these aspects of care on a national basis. Where we have examined an inspection focus area we will clearly identify it under the relevant quality statement. Fire safety issues We do not regulate fire safety. Local fire and rescue services are responsible for checking services. However, where significant fire safety issues become apparent, we will alert the relevant fire and rescue services so they may consider what action to take. You can find out more about care services' responsibilities for fire safety at www.firelawscotland.org Jenny Gray Home, page 8 of 23

The annual return Every year all care services must complete an 'annual return' form to make sure the information we hold is up to date. We also use annual returns to decide how we will inspect the service. Annual Return Received: Yes - Electronic Comments on Self Assessment Every year all care services must complete a 'self assessment' form telling us how their service is performing. We check to make sure this assessment is accurate. We received a completed self assessment document from the service provider. This was completed to a satisfactory standard and gave relevant information for each of the quality Themes and Statements. The service provider identified what they thought they did well, some areas for future development and how they planned to implement changes and further develop the service. The service should take care to identify how residents have participated in the self assessment process and give examples of how this has improved service provision. Taking the views of people using the care service into account We received 3 questionnaires which had been completed by residents and spoke with 9 residents during the inspection. All expressed themselves very happy with the quality of care and support. Comments included; "Very good home" "Very nice place to stay" "The staff are kind and friendly and the care is of a high standard". "Very satisfied with the level of care and help provided". "Fine in here". "It's grand". "Thoroughly enjoyed going for a pub lunch" "Getting out more would be nice". Taking carers' views into account We received 6 questionnaires which had been completed by relatives/carers, all were very positive. 5 strongly agreed and 1 agreed with the statement 'Overall, I am happy with the quality of care my relative/friend receives at this home'. We also chatted with 8 relatives in the course of the inspection. Jenny Gray Home, page 9 of 23

All expressed themselves highly satisfied with all aspects of the service provide by the staff of Jenny Gray Home. Some comments are noted below and others have been included in the body of the report. "It's their home, they all like it here" "Never so glad when told mum was being discharged from hospital back to Jenny Gray, a relief" "The staff know me by my first name and I know them, it's brilliant. I'm at peace knowing dad's well cared for. They really care for him". "My mum has been in the home 4 years now, she regards it as her home". "We as a family are very happy with the care our mother gets in the care home. The staff are always pleasant and helpful anytime we visit". Jenny Gray Home, page 10 of 23

3 The inspection We looked at how the service performs against the following quality themes and statements. Here are the details of what we found. Quality Theme 1: Quality of Care and Support Grade awarded for this theme: 5 - Very Good Statement 1 We ensure that service users and carers participate in assessing and improving the quality of the care and support provided by the service. Service strengths We found that people who use this service are encouraged to become involved in the day to day decisions about the home. The service uses a variety of methods to encourage and support residents and relatives participation in assessing and improving the quality of care and support provided. Examples include: review meetings, residents meetings, informal discussions, satisfaction surveys and the service complaints procedure. Details of independent advocacy are publicly displayed in the home and the in-house newsletter and notice boards provide residents and relatives further opportunities to express their views. Following discussion at the most recent relatives meeting a suggestion's box is being placed in the entrance area. Examination of a sample of personal plans identified residents or their relative sign to confirm they have discussed and agree with the content of the personal care plans and care review. Photo albums had been produced to record resident's participation in the variety of activities and outings which take place. The albums help raise awareness of relatives and visitors and are proving a popular talking point with everyone who uses the service. The residents group also discussed the benefits of the informative newsletter and agreed to come up with suggestions for items to be included in the next edition. Feedback from residents and relatives confirmed they are asked for their views on the service and the service acts on any comments and suggestions received. Discussion with residents, relatives and staff and observation of practice verified staff's commitment to encouraging people to make choices and confirm their satisfaction with day to day activities. Comments from residents and relatives regarding care and support included; "Very nice place to stay" Jenny Gray Home, page 11 of 23

"Very happy here" "Nice people, nice food. Give you choices" "The staff are quick to answer your buzzer" "Feel safe here" Areas for improvement The service is in the process of developing a Friends & Family Committee. Progress in this will be reviewed at the next inspection. Grade awarded for this statement: 5 - Very Good Number of requirements: 0 Number of recommendations: 0 Statement 3 We ensure that service users' health and wellbeing needs are met. Service strengths A range of appropriate health care policies and procedures was available in the service to guide and support staff practice. Each resident has an individualised personal plan based on an assessment of their health and social needs. We examined four personal plans. We saw that the personal plans are written from the perspective of the resident and subject to regular evaluation and updating. Information about medical history and health conditions is recorded including a range of risk assessments and care plans. The assessments help staff identify any changes which may require action. Care reviews take place 6 monthly, all residents had recently been reviewed, and a record of the meeting is kept in the personal plan. We evidenced the service has good contacts with local GP's, SALT, dietitian, district nurses and other health services. We found evidence that advice and guidance had been sought from health agencies and referrals made in response to concerns. Healthy eating is promoted and residents weights are monitored and recorded. During the inspection we observed the serving of lunch and the dining experience. The meals were attractively presented and people were offered choice in portion size and could have extra if wished. Drinks were regularly offered and topped up. Overall we felt the dining experience was a pleasant, unhurried affair and the residents told us they enjoyed the meal. Jenny Gray Home, page 12 of 23

We saw that some residents had been assessed as incapable of consenting to treatment and section 47 certificates (Adults with Incapacity (Scotland) Act 2000, part 5) and copies of Power of Attorney and Guardianship where these powers had been granted, were filed in the person's personal plan. This ensures the service is aware of who must be involved in making decisions involving the resident. The opportunity to participate in social activities and outings helps to provide stimulation and interest for residents. There was evidence that residents are supported to take part in organised activities and to maintain community links. Residents told us they liked the variety of social activities, enjoyed taking part and experienced good quality of life in the home. Relatives confirmed they are kept informed of any changes in their relatives health. They said, "No communication problems", "If X not well I get phone calls, kept well informed with whatever's going on". "The doctor's called straight away". Relatives are aware that if a resident is in hospital, staff in the care home phone the hospital every day to keep informed of the person's condition". The system for storage, handling and administration of medication was looked at and found to be satisfactory. Residents confirmed they receive their medications as prescribed. Areas for improvement The manager is aware that the AWI(S) Act 2000 requires that a supporting treatment plan should be retained in the resident's care record alongside the section 47 certificate. The manager advised this is being progressed with the resident's GP. DNACPR forms are also being progressed with residents doctors and once completed will be placed in individual personal plans. Progress in these matters will be monitored at the next inspection. The service shall continue to evaluate and further develop recording all aspects of health care needs in personal plans. Grade awarded for this statement: 5 - Very Good Number of requirements: 0 Number of recommendations: 0 Jenny Gray Home, page 13 of 23

Quality Theme 2: Quality of Environment Grade awarded for this theme: 5 - Very Good Statement 1 We ensure that service users and carers participate in assessing and improving the quality of the environment within the service. Service strengths The evidence for the grade awarded in this statement is included in Quality Theme 1, Statement 1, Service Strengths above. Areas for improvement The areas for development for this statement are included in Quality Theme 1, Statement 1, Areas for Improvement above. Grade awarded for this statement: 5 - Very Good Number of requirements: 0 Number of recommendations: 0 Statement 2 We make sure that the environment is safe and service users are protected. Service strengths We identified the service has a number of strengths in this area and performs well in relation to this quality statement. A comprehensive range of policy documents are in place to support staff practice. Staff confirmed they had awareness of the policies and had ready access to them. The care home has a secure entry system in place. A record of accidents and incidents is maintained. Each accident is reviewed by the manager to check the outcomes of the accident and any treatment given. We evidenced that routine maintenance and health & safety checks are undertaken and a record of these is maintained along with details of any remedial action taken. Maintenance and service contracts are in place for utilities and essential equipment. Residents have access to a call system in bedrooms and communal areas and many also wear neck pendants to summon assistance if necessary. Corridors and circulation areas were seen to be clear of hazards. All areas visited were found to be clean and no malodours noted. At the time of the visit there was sufficient staff on duty to meet residents needs. These measures help ensure people are safe and comfortable living in the care home. Residents told us they were very comfortable and felt safe in the home. Jenny Gray Home, page 14 of 23

Areas for improvement The service management gave commitment to continue to monitor and evaluate practice to ensure a safe environment is maintained. The adjoining property which was previously used as a day care unit has been unused for a number of years. The property has been repeatedly targeted by vandals and is in a state of neglect. Apart from being an eyesore the adjoining grounds are littered with broken glass and vandalised furniture and fittings. The management of Jenny Gray had reported their concerns but Fife Council had been slow to safeguard the property and clean up the debris. Remedial actions were introduced in response to the Care Inspectorates inspection. Grade awarded for this statement: 5 - Very Good Number of requirements: 0 Number of recommendations: 0 Inspection report continued Jenny Gray Home, page 15 of 23

Quality Theme 3: Quality of Staffing Grade awarded for this theme: 5 - Very Good Statement 1 We ensure that service users and carers participate in assessing and improving the quality of staffing in the service. Service Strengths The evidence for the grade awarded in this statement is included in Quality Theme 1, Statement 1, Service Strengths above. Areas for improvement The areas for development for this statement are included in Quality Theme 1, Statement 1, Areas for Improvement above. Grade awarded for this statement: 5 - Very Good Number of requirements: 0 Number of recommendations: 0 Statement 3 We have a professional, trained and motivated workforce which operates to National Care Standards, legislation and best practice. Service strengths Following discussion with the manager, residents, relatives and staff and observation of daily practice, we found the service performs to a very good standard in relation to this statement. All staff receive regular supervision and are supported in their role. Supervision provides opportunity to discuss professional development and identify any training needs. This helps to support staff and maintain the quality of the service. Staff had awareness of the National Care Standards and the Scottish Social Services Council (SSSC) Codes of Practice. They also confirmed they received induction and ongoing training opportunities which helped them to support and care for residents. Discussion with staff and review of records identified that regular staff meetings are held. Meetings have a set agenda but staff are also able to add items for discussion to the agenda. Staff told us they found the meetings useful forums to discuss and influence day to day practice. Decisions made, actions taken and outcomes are shared, recorded, and followed up at the next meeting. Jenny Gray Home, page 16 of 23

Provision of regular staff meetings and training provide opportunities to identify and introduce good practice and afford residents in Jenny Gray Home improved care and support. The manager demonstrated professionalism and was respected by all staff. Staff reported they felt listened to and had opportunity to comment on all aspects of the service. We observed staff to be supportive, professional and friendly in their interactions with residents, visitors and colleagues. Feedback from residents and their relatives regarding the staff group at Jenny Gray was extremely positive. A relative said, "Some carers have been here over 5 years. I think that's great, very few places can do this, says a lot about the carers and how they're treated" "They know X and I can speak to them. Been with X since day 1". Other comments from relatives included; "They are brilliant here" "If I ask a question and they don't know, the girls find out and get back to me quickly" A resident told us "The staff are kind and friendly and the care is of a high standard". Areas for improvement The service should continue to evidence staff are trained to carry out all aspects of their role. We saw that all staff had been scheduled to shortly receive training in Adult Support and Protection, progress in this will be reviewed at the next inspection. Grade awarded for this statement: 5 - Very Good Number of requirements: 0 Number of recommendations: 0 Jenny Gray Home, page 17 of 23

Quality Theme 4: Quality of Management and Leadership Grade awarded for this theme: 5 - Very Good Statement 1 We ensure that service users and carers participate in assessing and improving the quality of the management and leadership of the service. Service strengths The evidence for the grade awarded in this statement is included in Quality Theme 1, Statement 1, Service Strengths above. Areas for improvement The areas for development for this statement are included in Quality Theme 1, Statement 1, Areas for Improvement above. Grade awarded for this statement: 5 - Very Good Number of requirements: 0 Number of recommendations: 0 Statement 4 We use quality assurance systems and processes which involve service users, carers, staff and stakeholders to assess the quality of service we provide. Service strengths A range of evidence was sampled and the performance of the service was found to be very good in relation to this statement. The providers quality assurance processes ensure that residents and relatives are consulted about their views on the quality of the care and service provided and how it can improve. There are also systems in place for checking the quality of the services provided in the home, and evidence that any problems identified are properly addressed. These include; a variety of audits are undertaken to check on quality including, medication management, care plan records, health & safety, training and staff supervision. The service has a complaint procedure and details of this are provided to residents and their relatives. A record of accidents and incidents is maintained. Each accident is reviewed by the manager to check the outcomes of the accident and any treatment given. This helps identify any trends or patterns and enables the management to take any actions necessary to reduce further risk. The care home service has very good systems, policies and procedures. Resources are provided to ensure residents have a safe and comfortable environment. Jenny Gray Home, page 18 of 23

These actions support the maintenance of a good quality service. Areas for improvement The service provider should continue to build on the improvements which have been made and areas for improvement noted in their self assessment and ensure the service continues to develop good practice in relation to this quality statement. Grade awarded for this statement: 5 - Very Good Number of requirements: 0 Number of recommendations: 0 Jenny Gray Home, page 19 of 23

4 Other information Complaints No complaints have been upheld, or partially upheld, since the last inspection. Enforcements We have taken no enforcement action against this care service since the last inspection. Additional Information None noted. Action Plan Failure to submit an appropriate action plan within the required timescale, including any agreed extension, where requirements and recommendations have been made, will result in SCSWIS re-grading the Quality Statement within the Management and Leadership Theme as unsatisfactory (1). This will result in the Quality Theme for Management and Leadership being re-graded as Unsatisfactory (1). Jenny Gray Home, page 20 of 23

5 Summary of grades Quality of Care and Support - 5 - Very Good Statement 1 Statement 3 5 - Very Good 5 - Very Good Quality of Environment - 5 - Very Good Statement 1 Statement 2 5 - Very Good 5 - Very Good Quality of Staffing - 5 - Very Good Statement 1 Statement 3 5 - Very Good 5 - Very Good Quality of Management and Leadership - 5 - Very Good Statement 1 Statement 4 5 - Very Good 5 - Very Good 6 Inspection and grading history Date Type Gradings 15 Nov 2011 Unannounced Care and support 4 - Good Environment Not Assessed Staffing 4 - Good Management and Leadership 4 - Good 16 May 2011 Unannounced Care and support 4 - Good Environment Not Assessed Staffing 4 - Good Management and Leadership 2 - Weak 15 Mar 2011 Re-grade Care and support 4 - Good Environment Not Assessed Staffing Not Assessed Management and Leadership 4 - Good Jenny Gray Home, page 21 of 23

23 Nov 2010 Unannounced Care and support 5 - Very Good Environment Not Assessed Staffing Not Assessed Management and Leadership Not Assessed 30 Sep 2010 Announced Care and support 5 - Very Good Environment Not Assessed Staffing Not Assessed Management and Leadership Not Assessed 27 Jan 2010 Unannounced Care and support 5 - Very Good Environment 4 - Good Staffing 4 - Good Management and Leadership Not Assessed 11 Nov 2009 Announced Care and support 5 - Very Good Environment Not Assessed Staffing 4 - Good Management and Leadership Not Assessed 5 Feb 2009 Unannounced Care and support Not Assessed Environment Not Assessed Staffing Not Assessed Management and Leadership 5 - Very Good 28 Aug 2008 Announced Care and support 5 - Very Good Environment 5 - Very Good Staffing 5 - Very Good Management and Leadership 5 - Very Good All inspections and grades before 1 April 2011 are those reported by the former regulator of care services, the Care Commission. Jenny Gray Home, page 22 of 23

To find out more about our inspections and inspection reports Read our leaflet 'How we inspect'. You can download it from our website or ask us to send you a copy by telephoning us on 0845 600 9527. This inspection report is published by the Care Inspectorate. You can get more copies of this report and others by downloading it from our website: www.careinspectorate.com or by telephoning 0845 600 9527. Translations and alternative formats This inspection report is available in other languages and formats on request. Telephone: 0845 600 9527 Email: enquiries@careinspectorate.com Web: www.careinspectorate.com Jenny Gray Home, page 23 of 23