Inspection on 16/03/10 for The Old Rectory

This is the latest available inspection report for this service, carried out on 16th March 2010.

CQC found this care home to be providing an Good service.

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

The Old Rectory 30/04/09

The Old Rectory 03/05/07

The Old Rectory 26/04/06

The Old Rectory 10/11/05

The Old Rectory 27/06/05

The Old Rectory 23/11/04

The Old Rectory 26/06/04

Extracts from inspection reports are licensed from CQC, this page was updated on 03/06/2010.

Key inspection report Care homes for older people Name: Address: The Old Rectory Church Street Tenbury Wells Worcestershire WR15 8BP     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: Michael Moloney     Date: 1 6 0 3 2 0 1 0 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 24 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) © Care Quality Commission 2010 This publication may be reproduced in whole or in part in any format or medium for non-commercial purposes, provided that it is reproduced accurately and not used in a derogatory manner or in a misleading context. The source should be acknowledged, by showing the publication title and © Care Quality Commission 2010. www.cqc.org.uk Internet address Care Homes for Older People Page 3 of 24 Information about the care home Name of care home: Address: The Old Rectory Church Street Tenbury Wells Worcestershire WR15 8BP 01584810249 01584810249 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Chantry Retirement Homes Ltd care home 28 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia old age, not falling within any other category physical disability Additional conditions: The home may accommodate one neamed service user under the age of 65 who has both a learning disability and physical disability. The maximum number of service users to be accommodated is 28. The registered person may provide personal care and accommodation for service users of both sexes whose primary care needs on admission to the home are within the following categories: Dementia over 65 years (DE)(E) 28 Physical Disability over 65 years (PD)(E) 28 Old age not falling within any other category (OP) 28 Date of last inspection Brief description of the care home The Old Rectory is registered to provide residential care for up to twentyeight older people who are frail, who may have a physical disability or dementia. Respite care can be provided when a bed is available and in addition two day care places can be provided to people from the local community. The house is an imposing listed building Care Homes for Older People Page 4 of 24 Over 65 28 28 28 0 0 0 2 3 0 7 2 0 0 9 Brief description of the care home dating back to 1830. Previously a rectory, it is situated within 100 yards of St Marys Parish Church and it is also in close proximity to the centre of Tenbury Wells. The home was purchased by Chantry Retirement Homes Limited, in March 2004. The fees for this home range from £425 per week to £550 per week. Care Homes for Older People Page 5 of 24 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: We, the Commission, used a range of evidence to make judgements about this service. This includes: information from the provider which included a self assessment document that they are required by law to complete and notifications that have been received by the Care Quality Commission from the home about incidents, bereavements and other incidents that affect the welfare of the people who live in the home. The visit was unannounced with the purpose of carrying out a Key Inspection which is where the homes performance is measured against a set of standards identified by the Department of Health. One visit had been made by Care Quality Commission staff since the last Key Inspection to check that the requirement made at the last key inspection had been complied with. This inspection was undertaken by one inspector, Mike Moloney and lasted five hours. Care Homes for Older People Page 6 of 24 During that time we Case Tracked a number of the people who live in this home. This means that we talked to them and/or their relatives, where this was practical, to find out their views of the care that was being provided to them. This also enabled us to see if the records that identified peoples needs such as the care plans that are provided for the staff to follow were accurate and covered each individuals personal issues. We also talked to members of the staff team and the manager to check that they were aware of the identified needs of the people who live in this home were and whether or not they had the approach and training required to meet them. The standards set out by the Department of Health are in seven different groups. Each group can be judged as being either poor, adequate, good or excellent. The inspectors reach their judgement by following the guidelines laid down in the document known as the Key Lines Of Regulatory Assessment (KLORA) which is available on the Care Quality Commission web-site: www.cqc.org.uk Care Homes for Older People Page 7 of 24 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 8 of 24 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 9 of 24 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. People looking to live in the home and their representatives have the information needed to choose a home which will meet their needs They have their needs assessed and a contract which clearly tells them about the service they will receive. Evidence: We looked at the records of a number of people who had been admitted to the home since the last inspection and these showed that peoples needs are assessed on admission so that a plan for their care can be produced. If someone comes into the home with little or no notice these assessments are carried out as soon as possible after they are admitted. We also saw documents that are available to people who are considering living in the home and these contained that information that they would need when making their decision. This information contained the details of the fees charged by the home. Care Homes for Older People Page 10 of 24 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. The health and personal care that a person living in this home receives is based on their individual needs. The principles of respect, dignity and privacy are put into practice. Evidence: We looked at the records of a number of the people who live in this home and, where possible, talked to them about the care that they receive. We also spoke to a number of other people and their relatives who were able to give their views about the home. We saw that the records that were kept described the needs of each person when they wanted to move around. Comments on those records had been signed and dated indicating that the need for this level of assistance had been reviewed monthly. We also saw assessments about people and their eating. These included comments about peoples appetites, their ability to chew and swallow as well as their ability to use utensils and cups. We saw that people who have difficulty coping with solid food could have their food liquidised to help them and when this was necessary it was Care Homes for Older People Page 11 of 24 Evidence: noted in their records. We talked to some of the staff preparing and service the meals and they were fully aware of these instructions. We saw written assessments of each persons skin care needs. We saw that these were also reviewed regularly. We saw that the records included information about such things as continence, peoples ability to maintain their own personal hygiene and individuals weights. Other records included information about visits by healthcare professionals, why these visits took place and what action was necessary as a result. We saw that the storage of medication was appropriate and secure and records were being kept appropriately so that it could be seen that the right person was being given the right medication at the right time. Care Homes for Older People Page 12 of 24 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. People who live in this home are able to choose their life style, social activity and keep in contact with family and friends. Social, cultural and recreational activities meet their expectations. They receive a healthy, varied diet according to their assessed requirement and choice. Evidence: We talked with a number of the people who live in this home about what they do to pass the time. One told us that she likes to spend time in her room watching television as she liked the privacy. She told us that staff visited her regularly to make sure that she was alright and while we were walking around the building we noticed the staff going to and from her room. We talked to other people who were sitting in the communal areas. They told us that the staff arrange group activities for them such as pancake tossing. They also told us that outings on the homes minibus are often arranged for people to go out on during the afternoons. We saw a member of staff playing dominoes against one lady. That lady told us that this happened regularly. We talked to a number of people who were visiting their relatives and they said that Care Homes for Older People Page 13 of 24 Evidence: the people who live in the home have plenty of activities to keep them occupied. More detailed records of what activities had taken place, who had been involved and when would enable those who monitor the homes performance to evaluate its effectiveness in providing social experiences more easily. Throughout the inspection we saw staff sitting and chatting with people and would excuse themselves when they were needed to assist in the care of other people. All of the people that we spoke to told us that they found the staff to be very caring and friendly. On the day of the inspection there were four care staff, including a senior carer and an activity organiser on duty. We saw that for most of the time there was at least one person in the main lounge talking with or providing support to the people who were relaxing in there. The people that we spoke to also told us that they liked the meals that are cooked in the home. They told us that they have a choice of main meals and the written menus that we saw showed that the diet was varied but balanced. We talked to the cook and she told us that if someone should need a special diet for religious, cultural or medical reasons they would be able to provide this. She told us that at the time of the inspection the only diet that was required for medical reasons was a low sugar one. She also talked about how various religious and cultural diets were accommodated. Care Homes for Older People Page 14 of 24 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. The people who live in this home have access to a robust and effective complaints procedure, are protected from abuse and have their legal rights protected. Evidence: We looked at the homes complaints policy and this was seen to contain information on how and with whom issues of concern could be raised. We spoke to a number of the people who live in this home and their relatives who all said that they knew how to raise any issue and that they were confident that they would be dealt with. No referrals had been made into the local procedures that deal with allegations of abuse of vulnerable people. We looked at the training records and saw that staff had received training in the identification of abuse and the procedures that they must follow if they see such an instance. We also spoke to a number of the staff who confirmed that those records were accurate. Care Homes for Older People Page 15 of 24 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. The physical design and layout of the home gives anyone living there a safe, wellmaintained and comfortable environment which encourages independence. Evidence: We visited the home and we saw that it is close to the centre of the Worcestershire town of Tenbury Wells. There is a small car park to the side of the building. The home is an older building that has been modernised and extended for its current use. We saw that there is a well maintained garden to the front of the building that the people who live there can use during the warmer weather. We looked at the residential accommodation and saw that it is on three levels with both stairs, a stair lift and a shaft lift available to get between them. We saw that the bedrooms are a mixture of single and shared rooms although most are singles. A number of the bedrooms have en suite facilities. We saw that a number of the rooms contained personal ornaments and pictures belonging to the people staying in them. Care Homes for Older People Page 16 of 24 Evidence: We also saw that there were three seating areas that people could use during the day including a dining room. We spoke with a number of people about the building. One told us So friendly; like home. We looked at the condition of the decor and we saw that it was generally clean, tidy and in a good state of repair. We saw that the laundry was equipped with equipment that would keep the clothing and bedding of the people who live in the home both clean and hygienic. Care Homes for Older People Page 17 of 24 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. Staff in the home are trained, skilled and in sufficient numbers to fill the aims of the home and meet the changing needs of people who live in this home. Evidence: We looked at the employment records of three of the staff and saw that background checks had been carried out before those people had access to people living in this home as part of the procedure that ensures that they are fit do so. The records for each stage in the recruitment process were seen to be clear and easily accessed by those people who need to look at them. Looking at the staff rota as well as talking with the people living in the home, their relatives, the manager and staff showed that there were enough staff on duty to make sure that the care needs of the people living there are met. During the inspection a lot of conversations between people who live in the home and staff were seen and heard. The staff were always professional, clear and polite when they spoke. When we spoke to those living in the home as well as their relatives they were very complimentary about the staff saying such things as, So friendly; like home and Staff do their absolute level best. We talked with a number of the staff who confirmed that they have received or were Care Homes for Older People Page 18 of 24 Evidence: about to go on the training that would ensure that they are able to meet the needs of the people living at the home. This included such things as manual handling training to make sure that when they are helping people to move that they do so in a safe manner and basic first aid so that they can provide support to people who are ill or hurt until more skilled assistance arrives. Infection control training was also in place. The kitchen staff and the care staff who serve out the food confirmed that they had undertaken food hygiene training meals so that they would know how to do so safely. The manager explained the system that the home uses to identify what training each member of staff has had or needs. They showed this to be a systematic process that would put the staffs skills in place so that they could meet the needs of the people who live in this home. Talking with staff and looking at the training records showed that the training for care staff included National Vocational Qualification training to level 2 in care to help more experienced staff to develop their skills and knowledge and Common Induction Training which gives an immediate and basic training for those who are new to this type of work. The senior care staff who are able to lead shifts and give out medication are all trained to National Vocational Qualification training to level 3. Care Homes for Older People Page 19 of 24 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 management and administration of the home is based on openness and respect, has effective quality assurance systems developed by a qualified, competent manager. Evidence: We talked to the manager and she confirmed that she had completed the Registered Managers Award which is a qualification that is considered to be appropriate for someone who runs an organisation such as this. We found that the proprietor carries out regular monthly quality assurance inspections and saw the records of the result of these. We saw the minutes of the residents and their relatives meetings. The manager told of how the home was aware of the local procedures that are designed to protect the human rights of people who lack the capacity to do so for themselves. She told us that nobody in the home had any restrictions placed upon Care Homes for Older People Page 20 of 24 Evidence: them as a result of these. We found that the home stores small amounts of cash on behalf of some of the people who live there. We saw that these sums are kept and recorded in a clear and easily checked way. We asked for and were shown the records of the regular testing of such things as hot water temperatures, fridge/freezer and fire alarm systems. We saw that these records were clearly and regularly maintained showing that the safety of the people who live in this home is monitored on a regular basis. We looked for records of staff training. We saw that records contained comprehensive records of what training staff had received. Care Homes for Older People Page 21 of 24 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 22 of 24 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 23 of 24 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 24 of 24 - 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!