This is the latest available inspection report for this service, carried out on 10th June 2010.
CQC found this care home to be providing an Good service.
The inspector found there to be outstanding requirements from the previous inspection
report. These are things the inspector asked to be changed, but found they had not done.
The inspector also made 1 statutory requirements (actions the home must comply with) as a result of this inspection.
Random inspection report
Care homes for older people
Name: Address: The Old Rectory Nursing Home 45 Old Tiverton Road Exeter Devon EX4 6NG two star good service 21/04/2009 The quality rating for this care home is: The rating was made on: A quality rating is our assessment of how well a care home, agency or scheme 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 review a ‘key’ inspection. This is a report of a random inspection of this care home. A random inspection is a short, focussed review of the service. Details of how to get other inspection reports for this care home, including the last key inspection report, can be found on the last page of this report. Lead inspector: Teresa Anderson Date: 1 0 0 6 2 0 1 0 Information about the care home
Name of care home: Address: The Old Rectory Nursing Home 45 Old Tiverton Road Exeter Devon EX4 6NG 01392431839 01392436216 enquiries@southernhealthcare.co.uk www.southernhealthcare.co.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Southern Healthcare (Wessex) Ltd Type of registration: Number of places registered: Conditions of registration: Category(ies) : care home 47 Number of places (if applicable): Under 65 Over 65 47 old age, not falling within any other category Conditions of registration: 0 The maximum number of service users who can be accommodated is 47 The registered person may provide the following category of service: Care home with nursing - code N to service users of either gender whose primary care needs on admission to the home are within the following category:- Old Age, not falling within any other category (code OP) Date of last inspection Brief description of the care home The Old Rectory Nursing Home is registered to provide care for up to 47 people over retirement age with general nursing needs. It is owned by Southern Healthcare (Wessex) Limited.
Care Homes for Older People Page 2 of 9 2 6 0 3 2 0 1 0 Brief description of the care home The home is on the eastern side of the city of Exeter, in a residential area approximately one mile from the centre. The former Rectory - which dates back to 1875 - has been converted and extended for its present use but retains some original features. A health centre, Anglican church, pub and local shops are relatively close, with a bus stop opposite the home. Accommodation is on three floors, with two shaft lifts and a platform lift providing level access within the home. There are two conservatory areas overlooking well-tended gardens to the rear, which include a pond and enclosed courtyard garden. There is a car parking area at the front of the home, with time-limited roadside parking available in the area. Mature trees screen the front of the building from the road below. Up to date information about fees are available direct from the home. Fees do not include the cost of items such as hairdressing, private chiropody, aromatherapy, newspapers and toiletries (which are charged at cost price). Care Homes for Older People Page 3 of 9 What we found:
We (the Commission) carried out this unannounced random inspection to check that the Requirements made at the random inspection carried out in March had been actioned. The site visit was carried out by two inspectors, Teresa Anderson and Viv Stephens, over one day. The requirements were made because in March we found that peoples plans of care did not always provide instructions for staff about how to meet needs and the plans in place were not always being reviewed. In addition, some people were at risk because risks to their health and welfare were not being satisfactorily addressed and, although the GP was contacted in a timely fashion, referrals were not always being made to specialist health care professionals when they should have been. We also found that the Commission were not being kept up to date with accidents and incidents in the home. Prior to the visit to the service the owner of this home had sent to us an improvement plan detailing how the shortcomings identified were to be addressed. He told us that alternative management arrangements had been put in place, that care plans were being reviewed and rewritten and that referrals had been made to healthcare specialists. During our visit to the home we looked at care plans, spoke with the owner and management team, with staff and with some people living here and their visitors. Care plans we looked at were of varying quality and detail. The new manager explained that a decision had been made to ensure that priority was given to ensuring that peoples health and welfare needs are being met and that care plans were being updated as needs changed and at a pace that would help to ensure staff understand how written care planning works. We were also told that both internal and external training in care planning for staff is on going. We saw in the care plans which had been updated that people had been comprehensively assessed. Where a need or risk had been identified a care plan was in place telling staff how this need is to be met or how the risk is to be managed. Care planning records include a place where care plans can be reviewed. We saw one care plan that had been reviewed because the person had received specialist input from a Diabetic Nurse. The care plan included the instructions left for staff from the Diabetic Nurse, and records of all blood tests and medication given. We spoke with staff about this plan. Staff demonstrated a good understanding of this persons needs and of the plan of action being put in place to help meet this persons needs. We also spoke with staff about the plan of care for another person. This persons care plan was not as specific or easy to understand. However, care staff demonstrated a good understanding of this persons needs and of their personality and preferences. They told us what actions they take to meet this persons needs and how they reduce risk to this person. This person is at risk of developing pressure sores, so they have put in place pressure relieving equipment and staff were able to describe how they assess this person to ensure that early signs of pressure damage are noted so that actions can be taken.
Care Homes for Older People Page 4 of 9 We saw in care records that referrals had been made to specialist health professionals including the dietitian, tissue viability nurse, speech and language therapist and community psychiatric nurse. The manager had also made arrangements for one person with mental health problems to be admitted to hospital for a mental health assessment, in recognition that the home were not able to meet this persons needs. We also saw that some care plans referred to peoples end of life wishes. However, some records that we saw relating to this were written in a type of short hand without identifying how decisions were made or who was involved in the decision making, as they should do. We spoke with a relative about the care of one person living here. They told us that they have always been happy with the care but that they could see that improvements had taken place. This visitor has been encouraged to help the person they visit to eat and drink and had been shown how to record this so that staff can assess if this person has had enough to eat and drink. We also noted that additional calories had been introduced in the home in the form of small chocolate snacks. People told us they really enjoy this type of dietary supplement. What the care home does well: 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 set out on page 2. Care Homes for Older People Page 5 of 9 Are there any outstanding requirements from the last inspection? Yes R No £ 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, Regulations 2001 and the National Minimum Standards.
No. Standard Regulation Requirement Timescale for action 1 7 15 Each person living here must 28/05/2010 have a plan of care which details their care needs and gives instructions to staff on how these needs are to be met. Care plans must be reviewed at least monthly, and when needed. Reviews must account for how care decisions have been made and evidence the information used in the review and in making the decision about care. People can be assured that their health and welfare needs will be planned and delivered and that decisions made can be accounted for. 2 7 15 The work started to improve care planning and reviews should continue. This will help to ensure that people get the care they need and that reviews of the care delivered are based on feedback from those delivering the care. This Will help to ensure that reviews are based on factual information and that changes to care are made accordingly. 31/07/2009 Care Homes for Older People Page 6 of 9 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, 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 1 7 15 Each person living here must 27/08/2010 have a plan of care which details their care needs and gives instructions to staff on how these needs are to be met. Care plans must be reviewed when needed. Reviews must be written according to good practice guidance. They must account for how care decisions have been made and evidence the information used in the review and in making the decision about care. In this way people can be assured that their health and welfare needs will be planned and delivered and that decisions made can be accounted for. Care Homes for Older People Page 7 of 9 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 1 7 Care plans records relating to end of life instructions should be reviewed to ensure that they comply with the Mental Capacity Act guidance and show how decisions were made and who was involved. Care Homes for Older People Page 8 of 9 Reader Information
Document Purpose: Author: Audience: Further copies from: Inspection Report Care Quality Commission General Public 0870 240 7535 (telephone order line) Our duty to regulate social care services is set out in the Care Standards Act 2000. Copies of the National Minimum Standards –Care Homes for Older People can be found at www.dh.gov.uk or got 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 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. © Care Quality Commission 2010 This publication may be reproduced in whole or in part in any format or medium for noncommercial 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. Care Homes for Older People Page 9 of 9 - 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!
