Inspection on 17/04/09 for The Old Vicarage

This is the latest available inspection report for this service, carried out on 17th April 2009.

CQC found this care home to be providing an Adequate 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.

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Extracts from inspection reports are licensed from CQC, this page was updated on 21/07/2009.

Key inspection report Care homes for adults (18-65 years) Name: Address: The Old Vicarage Old Vicarage Church Road Bradmore Wolverhampton W Midlands WV3 7EN     The quality rating for this care home is:   one star adequate 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 7 0 4 2 0 0 9 This is a review of quality of outcomes that people experience in this care home. We believe high quality care should • • • • • Be safe Have the right outcomes, including clinical outcomes Be a good experience for the people that use it Help prevent illness, and promote healthy, independent living Be available to those who need it when they need it. The first part of the review gives the overall quality rating for the care home: • • • • 3 2 1 0 stars - excellent stars - good star - adequate star - poor There is also a bar chart that gives a quick way of seeing the quality of care that the home provides under key areas that matter to people. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Care Homes for Adults (18-65 years) Page 2 of 26 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 Adults (18-65 years) can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The mission of the Care Quality Commission is to make care better for people by: • Regulating health and adult social care services to ensure quality and safety standards, drive improvement and stamp out bad practice • Protecting the rights of people who use services, particularly the most vulnerable and those detained under the Mental Health Act 1983 • Providing accessible, trustworthy information on the quality of care and services so people can make better decisions about their care and so that commissioners and providers of services can improve services. • Providing independent public accountability on how commissioners and providers of services are improving the quality of care and providing value for money. Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report Care Quality Commission General public 0870 240 7535 (telephone order line) Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 26 Information about the care home Name of care home: Address: The Old Vicarage Old Vicarage Church Road Bradmore Wolverhampton W Midlands WV3 7EN 01902620030 01902621314 info@ldcg.org Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Claremont Care Limited Name of registered manager (if applicable) Type of registration: Number of places registered: care home 5 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 learning disability Additional conditions: Date of last inspection Brief description of the care home The Old Vicarage is a home that has been recently modified to its current purpose in a sympathetic manner.It is, as the name suggests, an old vicarage set in large gardens next to a church in a residential area of Wolverhampton. It is registered as the home for up to 5 people with a learning disability and is owned and managed by Claremont Care Limited. At the time of this inspection the home had only been registered for a short time and had not long been admitting new occupants. The home is managed by Mr Paul Morgan who has been registered with the Care Homes for Adults (18-65 years) Page 4 of 26 Over 65 0 5 Brief description of the care home Commission for Social Care Inspection. At the time of the inspection there was no service user guide and so information such as the fees was not available. Care Homes for Adults (18-65 years) Page 5 of 26 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: one star adequate service Choice of home Individual needs and choices Lifestyle Personal and healthcare support Concerns, complaints and protection Environment Staffing Conduct and management of the home peterchart Poor Adequate Good Excellent How we did our inspection: A range of evidence was used to make judgements about this service. This includes: information from the provider, records kept in the home, medication records, discussions with the staff team, tour of the premises, previous inspection reports and talking with as well as observing the care experienced by people using the service. Direct conversation with those people was limited by the nature of their disability. Care Homes for Adults (18-65 years) Page 6 of 26 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 Adults (18-65 years) Page 7 of 26 Details of our findings Contents Choice of home (standards 1 - 5) Individual needs and choices (standards 6-10) Lifestyle (standards 11 - 17) Personal and healthcare support (standards 18 - 21) Concerns, complaints and protection (standards 22 - 23) Environment (standards 24 - 30) Staffing (standards 31 - 36) Conduct and management of the home (standards 37 - 43) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Adults (18-65 years) Page 8 of 26 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, what they hope for and want to achieve, and the support they need. People can decide whether the care home can meet their support and accommodation needs. This is because they, and people close to them, can visit the home and get full, clear, accurate and up to date information. 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 the person 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 who may want to live in this home and their representatives have most of the information needed to choose a home which will meet their needs. They have their needs assessed so that the home can judge whether or not they can meet them before they decide to offer them a place. Evidence: The homes statement of purpose was seen to be available on request but its service user guide was not meaning that, should anyone want to know about the range of services that would be available to them and what the cost would be, that information would not be accessible to them. The first person had moved into this home just over a month before this visit and the second one had moved in the previous week. Talking with staff and a family member who was visiting at the time of the inspection confirmed that the process of introducing people to the home had involved them being visited by the homes staff where they had been living and then visiting the home so that their reaction to it could be gauged. When talking with both of the people who lived there they were able to Care Homes for Adults (18-65 years) Page 9 of 26 Evidence: say that they liked the home, smile and nod. Looking at the records made by the home during the assessment process showed that the method used included looking at such as areas as the persons nutritional needs, cultural issues, personal care needs, mobility issues, sleeping likes and needs, aspirations and any behavioural issues. Conversations within the home on the day of the inspection confirmed that it was only after such information had been obtained that the decision to proceed with the placements had been made. Care Homes for Adults (18-65 years) Page 10 of 26 Individual needs and choices 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 needs and goals are met. The home has a plan of care that the person, or someone close to them, has been involved in making. People are able to make decisions about their life, including their finances, with support if they need it. This is because the staff promote their rights and choices. People are supported to take risks to enable them to stay independent. This is because the staff have appropriate information on which to base decisions. People are asked about, and are involved in, all aspects of life in the home. This is because the manager and staff offer them opportunities to participate in the day to day running of the home and enable them to influence key decisions. People are confident that the home handles information about them appropriately. This is because the home has clear policies and procedures that staff follow. 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 involved in decisions about their lives and play an active role in planning the care and support they receive. Evidence: During this visit the care plans for both of the people currently living in this home were looked at. These were seen to cover areas such as relationships that were important to them, their religious and spiritual needs, social and recreational wishes, what sort of room they would like, what type of facilities, such as a newsagent nearby, that they would like, any specific nutritional needs and wishes where, for example, one person said that they had a particular liking for crisps. Other information contained within the care plans related to such things as whether or not someone liked to lie in at the week-ends, whether or not they would like to learn work skills and whether or not they wanted a key to their room. Issues around challenging behaviour had also been identified and descriptions of how Care Homes for Adults (18-65 years) Page 11 of 26 Evidence: staff should manage these had been developed. Talking with the staff established that they had read these documents and were aware of their contents. Watching and listening to staff while they were with the people that they provided care for showed them responding to requests from them in a positive way. Various examples of this were seen such as one person asking for a different drink with their meal and staff getting one straight away or another person asking to go out to buy a newspaper. Staff were seen and heard to be respectful to the people living in the home throughout the inspection. Talking with the staff identified that dates had already been identified for the formal review of how the people were settling in to the home. Care Homes for Adults (18-65 years) Page 12 of 26 Lifestyle 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 can take part in activities that are appropriate to their age and culture and 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 and the home supports them to have appropriate personal, family and sexual relationships. People are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. Their dignity and rights are respected in their daily life. People have healthy, well-presented meals and snacks, at a time and place to suit them. People have opportunities to develop their social, emotional, communication and independent living skills. This is because the staff support their personal development. People choose and participate in suitable leisure activities. 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 make choices about their life style and are supported to develop their life skills. Social, educational, cultural and recreational activities meet individuals expectations. Evidence: Talking with the two people living in the home, one of their relatives and the staff as well as looking at their records confirmed that both attend day services provided by the local authorities. Both day services were closed for the Easter break at the time of the visit but looking at their daily records and talking to both them and the staff showed that they had gone out at different points. One of the outings was to bowling which had been identified as a favourite for one person and the records showed that the other person had also been able to go to buy a newspaper on a number of occasions. At the time of Care Homes for Adults (18-65 years) Page 13 of 26 Evidence: the visit the father of one of the people was visiting and offering his son the opportunity to go out with him but he did not want to. His daily records said that at various times during the previous week he had spent time exploring the building and gardens as it was all new to him. A number of risk assessments that give staff guidance on how to address any dangers that may arise whilst on these activities were seen to have been developed and talking to staff confirmed that they knew what they contained. Various documents identified a number of activities that both of the people liked to do. One liked recycling at the day centre and this was included in their timetable and the other said that he liked gardening. A wheel barrow and various garden tools were seen outside the building and the manager explained that these were the property of the person who enjoyed gardening and had been delivered the evening before. The extensive gardens to the rear of the home would give ample opportunity for him to use them. Each persons food preferences were seen to have been listed. Looking at the daily notes showed that those preferences and religious considerations had been taken into account when they had been offered meals. Talking to the staff confirmed that they were aware of these issues particularly when eating such things as sausage and chips from a chip shop after they had all been out bowling. Two vehicles are available to take people who live in the home out to social events or other appointments should they need them. Each person had their own room. The room belonging to the person who had moved in the previous month had been personalised with posters and the like. The other persons room had yet to be personalised other than with a few personal nick-nacks. One of the people had been given the key to his bedroom door. He said that he was happy to leave the key in the lock all of the time. Care Homes for Adults (18-65 years) Page 14 of 26 Personal and healthcare support 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 receive personal support from staff in the way they prefer and want. Their physical and emotional health needs are met because the home has procedures in place that staff follow. If people 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. If people are approaching the end of their life, the care home will respect their choices and help them to 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 people receive is based on their individual needs. The principles of respect, dignity and privacy are put into practice. Evidence: The records for each person living in the home were seen to contain the contact details for the health care professionals who were familiar with their situations. These included G.P.s, consultants and community nurses. Contacts with those people were seen to be recorded within the files. Each file contained a Healthcare checklist which contained information about that persons medications, continence, eating and drinking, epilepsy, mobility, skin issues, vision, hearing, oral hygiene and behaviour. The records also contained documents that explained the history of any behaviours that might be difficult for the staff to manage as well as suggestions about how they might be avoided or otherwise managed. Both files contained Hospital Passports that contain the information that would be Care Homes for Adults (18-65 years) Page 15 of 26 Evidence: needed if someone were to be hospitalised. Both were still only partially complete. Medication was seen to be stored in a secure cupboard and records of when and who they were given to were seen to be up to date and complete. Talking with the staff confirmed that only those who had received training in the safe management of medicines were allowed to give out medication. Personal care issues were seen to have been highlighted within the individual care plans. Issues of this nature that were addressed by staff during the inspection were seen to be handled in a way that protected the privacy and the dignity of the person concerned. Talking with the staff confirmed that issues around privacy and dignity were covered in their induction training as well as during any further training. Care Homes for Adults (18-65 years) Page 16 of 26 Concerns, 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. Their concern is looked into and action taken to put things right. The care home safeguards people from abuse, neglect and self-harm and takes action to follow up any allegations. 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 express their concerns and have access to a robust, effective complaints procedure, are protected from abuse and have their rights protected. Evidence: The home was seen to have a complaints policy that contained all of the information about how to raise an issue with the manager or the homes owners should the need arise. A complaints book was also seen to be in place that would show what any complaints were and what the homes management were doing to address them but this had, at the time of the inspection, no entries in it. Talking with both of the people living at the home confirmed that they would know how to complain, should the need arise, even though they would not be able to access the formal document. Talking with the staff confirmed that they were aware of their role in the reporting and investigation of any adult protection issues and they were seen to have access to a whistle blowing policy that is designed to give them guidance in such a situation. Care Homes for Adults (18-65 years) Page 17 of 26 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, comfortable, 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. People have enough privacy when using toilets and bathrooms. 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 enables people who use the service to live in a safe, well maintained and comfortable environment, which encourages independence. Evidence: As the name suggests this home was once the vicarage to a nearby church in a residential area of Wolverhampton. It has been recently converted to its current use and the registration inspection showed that it complied with the National Minimum Standards for Adults. The building is on two floors with most of the bedrooms being on the upper floor. Each bedroom is spacious, bright and has en suite facilities. The bedroom doors are all lockable and the occupants have a key available to them should they wish. Downstairs there is a further bedroom, a large lounge area, a large dining room, a kitchen and a laundry area that is equipped to meet the needs of the people who live in the home. Walking around the home showed that efforts were already being made to personalise peoples bedrooms. Garden tools had just been delivered so that they could be used Care Homes for Adults (18-65 years) Page 18 of 26 Evidence: by the people living there to work in the large and attractively laid out garden at the rear of the home. The garden to the front of the building had parking for a number of cars. Care Homes for Adults (18-65 years) Page 19 of 26 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, qualified 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. People’s needs are met and they are supported because staff get the right training, supervision and support they need from their managers. People are supported by an effective staff team who understand and do what is expected of them. 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 support the people who use the service. Evidence: Talking to the staff who were on duty at the time of the inspection and the manager as well as looking at the staff rotas and the daily activities records showed that there were always enough staff on duty to meet the needs of the people who live there. At the time of the inspection two new members of staff were also there and they confirmed that they were undergoing their induction training. The records of this were also seen. The staff explained what training they had received and what they had undertaken. As most had previous experience in the care industry they had already received training in such things as food hygiene, first aid and the safe handling of medication all of which are required to enhance the safety of the people that live in the home. The staff files were also looked at and these showed and some of the staff confirmed that most of them had already achieved National Vocational Qualification level 2 or above in care showing that they had been trained in the skills and knowledge Care Homes for Adults (18-65 years) Page 20 of 26 Evidence: necessary for those working in a service such as this. The manager confirmed that the home was continuing with its staff recruitment programme and that further admissions would only be started as the appropriate number of staff were available. Looking at the recruitment records of those staff who had already started to work at the home it could be seen that all of the checks necessary to make sure that those people who wanted to work at the home were fit to do so had been carried out. Throughout the inspection the staff were heard talking with the people who live in the home in a friendly and professional manner. If they were approached by someone they would respond to them immediately even if was just to give a friendly acknowledgement that the person was there and to include them in any group that may have been chatting together. Care Homes for Adults (18-65 years) Page 21 of 26 Conduct and management of the 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 have confidence in the care home because it is run and managed appropriately. People’s opinions are central to how the home develops and reviews their practice, as the home has appropriate ways of making sure they continue to get things right. The environment is safe for people and staff because 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. They are safeguarded because the home follows clear financial and accounting procedures, keeps records appropriately and makes sure staff understand the way things should be done. This is what people staying in this care home experience: Judgement: People using this service experience adequate 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, but the quality assurance systems had not identified that the checks of the systems designed to ensure the safety of the people living in the home had not been carried out. Evidence: The report written at the time of the registration of this home said that the manager had achieved the Registered Managers Award which is the qualification seen as appropriate for someone managing a service such as this. Talking to him during the inspection confirmed this to be the case. Talking to the manager and the staff confirmed that the first formal visit from a member of the organisations senior management had taken place the evening before. These are monthly visits that are required by law and are intended to ensure that the proprietor is aware of how well the home is meeting the needs of the people who live there. The draft copy of a questionnaire that is intended to be used in the future was seen. This is to be completed, with help if necessary, by people living in the home and Care Homes for Adults (18-65 years) Page 22 of 26 Evidence: is designed to show how well they think that their needs are being met. A range of records that would show that the safety of the people living in the home is being monitored were looked for. Although staff did say that they were checking the temperatures of the fridges and freezers on a daily basis they were not keeping a record that would show that food was being stored in a safe manner. Similarly no record was found of any checks being made on the temperature of the hot water that people living in the home have access to. Although on the day of the inspection the water temperature was found to be acceptable there was no record that showed that the temperature regulator was reliable. Records relating to the checking of fire protection systems were found to be incomplete and so it was not known whether or not those systems would function should the need arise. Hazardous materials such as some cleaning fluids were seen to be kept securely and instructions about how they should be used safely were also available. Care Homes for Adults (18-65 years) Page 23 of 26 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 Adults (18-65 years) Page 24 of 26 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 Adults (18-65 years) Page 25 of 26 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 Adults (18-65 years) Page 26 of 26 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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