Inspection on 25/07/06 for Old Vicarage, The

This inspection was carried out on 25th July 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Old Vicarage, The 23/09/09

Old Vicarage, The 24/09/08

Old Vicarage, The 03/09/07

Old Vicarage, The 04/01/06

Old Vicarage, The 04/05/05

Old Vicarage, The 11/01/05

Old Vicarage, The 02/07/04

Similar services:

22 Sandown Road

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Turret Villa Retirement Home

Dilston College Of Further Education

West View House

Moor House

Prince Bishop Court

Park View (15)

Extracts from inspection reports are licensed from CQC, this page was updated on 09/07/2008.

CARE HOMES FOR OLDER PEOPLE Old Vicarage, The 2 Waterville Road North Shields Tyne & Wear NE29 6SL Lead Inspector Aileen Beatty Key Unannounced Inspection 25th July 2006 09:30 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Old Vicarage, The DS0000000374.V295185.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Old Vicarage, The DS0000000374.V295185.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Old Vicarage, The Address 2 Waterville Road North Shields Tyne & Wear NE29 6SL Telephone number Fax number Email address Provider Web address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) 0191 2570937 Dr Sandeep Dewan Mrs Doris Nicholson Care Home 25 Category(ies) of Dementia - over 65 years of age (6), Learning registration, with number disability (2), Old age, not falling within any of places other category (17) Old Vicarage, The DS0000000374.V295185.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. Two learning disability beds are currently occupied by named residents. If any of these residents vacate the beds CSCI must be notified and action will be taken to revert those places to the category of OP. 4th January 2006 Date of last inspection Brief Description of the Service: The Old Vicarage is a privately owned residential home situated in a residential area of North shields, close to the town centre. The home provides personal care (no nursing care) for up to twenty-five elderly people of both sexes. The accommodation is provided over two floors. The original building was extended and en-suite facilities are provided in the new part of the home only. Residents living in the home include people who require care due to old age and physical frailty, people with memory loss including dementia type illnesses, and some with physical disabilities. Fees range from £356-£360. Old Vicarage, The DS0000000374.V295185.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection took place on the 25th July 2006. It involved a tour of the premises, discussions with residents, visitors, staff and the proprietor, and a review of records. The inspection found that the overall standard of care is good. What the service does well: What has improved since the last inspection? Security has improved. An intercom and a new garden fence have been provided. A number of rooms have been redecorated. Some new furniture and equipment has been provided. The medication room has been moved to a more suitable place. The general standard of care records has improved. Old Vicarage, The DS0000000374.V295185.R01.S.doc Version 5.2 Page 6 What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Old Vicarage, The DS0000000374.V295185.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Old Vicarage, The DS0000000374.V295185.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 3 and 6 Quality in this outcome area is good. This judgement has been made from evidence gathered both during and before the visit to this service. No service user moves into the home without having his or her needs assessed. Intermediate care is not provided. EVIDENCE: The manager carries out an assessment of all new residents, usually visiting them before they are admitted. Any important care plans can then be written in readiness for the person arriving in the home. A comprehensive assessment is provided by social services. Copies of these are held in the individual’s file. Old Vicarage, The DS0000000374.V295185.R01.S.doc Version 5.2 Page 9 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,9 and 10 Quality in this outcome area is good. This judgement has been made from evidence gathered both during and before the visit to this service. All care need are set out in an individual plan of care. Service user’s health needs are fully met. Service users are protected by the homes policies and procedures for the administration of medicines. Service users feel treated with respect and their right to privacy upheld. EVIDENCE: A number of care plans were read and have improved since the last inspection. Staff no longer use abbreviations or slang, and they are professionally written in non-judgemental language. Some care plans require more detail. For example, some refer to “psychological problems” but do not mention the specific diagnosis that causes Old Vicarage, The DS0000000374.V295185.R01.S.doc Version 5.2 Page 10 the problem, such as depression, or dementia. One care plan contained the abbreviation CVA (Cerebrovascular Accident) which means a stroke, but may not be understood by all people reading the plan. It is recommended that where technical terms are used, they are explained in brackets alongside. Care plans for Diabetic residents must contain more detail about how blood sugar levels and diet will be monitored. Assessments such as moving and handling, falls risk, nutritional, pressure area risk are completed. The weight record for one resident showed a steady weight loss. There is then a gap in the record of weights between March and July, during which time there has been a loss of 11 lbs. Care must be taken to ensure weights are recorded regularly and where significant loss noted, a care plan put in place to address this. When a moving and handling assessment finds that a hoist is required, it is recommended that the size of sling to be used with the hoist is recorded in the care plan. Some care plans are typed, and appear to be used for a number of residents. These care plans are of a good standard but care must be taken when using this generic style, to ensure they contain personal details relevant to the person. For example, care plans relating to personal care should say whether the resident prefers assistance from a male or female worker, prefers a bath to a shower and so forth. Care plans are written using “person centred” principles. This means that they contain information that is very relevant to that person as a unique individual. This is good practice and is being further developed as more staff complete training in person centred care. The health needs of residents are fully met. The home does not provide nursing care, which is provided by visiting District Nurses, where necessary. All residents are registered with a GP of their choice. Records of GP visits are kept. GP’s may refer residents to other professionals such as Community Psychiatric nurse, dietician, or speech therapist for example. A chiropodist visits the home 6 weekly, and an optician at least annually, and as required in between. Medication procedures are generally good. The medication is now stored in a bigger room, that is located nearer to the main living area. A fridge is required for the storage of some medication, such as antibiotics. Medication was given out while residents were eating lunch. It is recommended that this is given out after lunch to avoid interrupting their meal. Medication is provided by Boots, and is dispensed from blister packs. Records of medicines given to residents were examined and there were no unexplained gaps. Old Vicarage, The DS0000000374.V295185.R01.S.doc Version 5.2 Page 11 Residents said that they feel they are treated with respect, and their right to privacy upheld. Staff knock on doors and residents may receive visitors in private. Where people prefer to stay in their own room, this is respected by staff who make sure they have the necessary means of calling for help, such as a pull cord near by. Some resident have their own room key, and prefer to keep their rooms locked when they are not using them. One lady was in bed, near the laundry where a radio was playing quite loudly. The member of staff was unaware that anyone was still in bed, but it is recommended that staff take care not to accidentally disturb anyone in this way. Old Vicarage, The DS0000000374.V295185.R01.S.doc Version 5.2 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,14 and 15. Quality in this outcome area is good. This judgement has been made from evidence gathered both during and before the visit to this service. Service users find that the home meets their social, cultural, religious and recreational needs. Service users maintain contact with family and friends and the local community if they wish. Service users are helped to exercise choice and control over their lives. A wholesome appealing diet is provided in pleasant surroundings. EVIDENCE: Residents are offered a variety of activities. These include Bingo, church services, cards and dominoes, pie and pea suppers, arts and crafts and simple exercises. One visitor said that he is made to feel very welcome in the home, and is very pleased with the care provided and the attention of staff. Old Vicarage, The DS0000000374.V295185.R01.S.doc Version 5.2 Page 13 There appears to be a genuine attitude amongst staff that nothing is too much trouble to them. They respond very warmly and attentively to resident’s requests and are very helpful and polite. One resident explained that they are unable to be very independent due to their physical problems. They said that staff come quickly when called and are very accommodating. Visitors confirmed this. Residents are offered choices, including at meal times. As well as selecting their meal, residents were heard choosing their own portion size. A good choice of meals was offered at lunchtime. There were lamb chops, fish pie, salad, or sausage and chips. A choice of drinks was also available. Lemonade was not offered as one of the choices at lunchtime, but one resident asked for some and this was provided. The cook confirmed that they are happy to provide an alternative if residents do not like what is on the menu. Requirements from the environmental health inspection in June 2006 have been met. The cook on duty demonstrated an understanding of supplementing foods for people who are underweight, and of special diets such as diabetic. Most desserts are made with a sugar substitute, which means that even diabetic residents have a full choice most of the time. The freezer was well stocked with ice-lollies and ice cream for the recent hot weather. Cleaning schedules, fridge and food temperatures are all recorded. Old Vicarage, The DS0000000374.V295185.R01.S.doc Version 5.2 Page 14 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18 Quality in this outcome area is good. This judgement has been made from evidence gathered both during and before the visit to this service. Complaints are taken seriously and acted upon. Service users are protected from abuse. EVIDENCE: There has been one informal complaint received by the home since the last inspection. There have been no complaints received by CSCI. The complaint was taken seriously, and the outcome was recorded as though it were a formal complaint. The complaints procedure is displayed. Some of these need to be updated as they have the wrong manager name on them. Staff have received training in the Protection of Vulnerable Adults. (POVA) Further training is planned. Staff records contain the required checks such as two references and criminal records check. Where full CRB clearance has not been received, staff work under supervision. An interim check called a “POVA First” check is carried out to check that the prospective staff member does not appear on the Department of health POVA list. Old Vicarage, The DS0000000374.V295185.R01.S.doc Version 5.2 Page 15 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19 and 26 Quality in this outcome area is good. This judgement has been made from evidence gathered both during and before the visit to this service. Service users live in a generally safe and well-maintained environment. The home is clean, pleasant and hygienic. EVIDENCE: A number of rooms have been redecorated since the last inspection. This includes communal lounges. Old mismatching furniture has been removed and some new chairs have been purchased. New beds and bedroom furniture has also been purchased and improvements are ongoing as part of a rolling programme. New digital televisions have been provided in lounges. Bedrooms are nicely decorated and personalised. Old Vicarage, The DS0000000374.V295185.R01.S.doc Version 5.2 Page 16 Bedroom doors have names on, and are in plastic pockets to keep them tidy. It is recommended that name cards are laminated. Most names are written with letters in different colours. This may be difficult for some residents to read, and it is recommended that this be reviewed, especially for residents with dementia or visual problems. Bathrooms are clean and tidy and one toilet has been fully refurbished. The home is generally clean and tidy. There were no odour problems noticed on the day of the inspection. Some high ceiling cobwebs were noticed in the corners in some bedrooms. The laundry is small but functional. Clothing is clean and well laundered. A number of towels are stored in the bathroom. It is recommended that only towels to be used the same day are stored. This is current advice from infection control, as towels stored in bathrooms can become damp over time, and there is a tendency to use the top towels only. This will help to ensure that only clean, fresh laundered towels are used. Old Vicarage, The DS0000000374.V295185.R01.S.doc Version 5.2 Page 17 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27,28,29 and 30 Quality in this outcome area is adequate. This judgement has been made from evidence gathered both during and before the visit to this service. There are sufficient skilled staff on duty. Service users are in safe hands at all times. Service users are protected by the home’s recruitment policies and procedures. Staff are trained and competent to do their jobs. EVIDENCE: There were sufficient staff on duty on the day of the inspection. Agency staff are used to cover short staffing, and the same staff are used to help to provide continuity of care. New systems of staff supervision, and appraisal are now in place. The manager was not on duty during the inspection so this will be discussed in more depth at the next inspection. These new systems will help to identify training needs and will enable the manager to identify any skills that need to be developed. The current recruitment procedures ensure that residents are in safe hands at all times. It has recently come to the attention of the manager that one of the Old Vicarage, The DS0000000374.V295185.R01.S.doc Version 5.2 Page 18 domestic staff has not had a police (CRB) check, as she was told in the past she did not need one. The manager must take immediate steps to rectify this situation, and confirm that a POVA first check has been done, whilst awaiting full clearance. It must be confirmed that CRB clearances for all other staff have been seen in person by the manager and are held on file. Staff training takes place on a regular basis. In the past twelve months, staff have received training in decontamination, health and safety at work, including fire safety, safe handling of medication, POVA, dementia awareness, moving and handling, covert medication, NVQ’s level 2,3 and 4, Registered Managers Award, and are working towards “Investors in people” status. Further training is planned including refreshers in some of the above, person centred care planning (as part of dementia awareness), continence, and equality and diversity. Old Vicarage, The DS0000000374.V295185.R01.S.doc Version 5.2 Page 19 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31,33,35 and 38 Quality in this outcome area is adequate. This judgement has been made from evidence gathered both during and before the visit to this service. Service users live in a home managed by a person fit to be in charge. The home is run in the best interests of service users. Service users financial interests are safeguarded. The health, safety and welfare of service users are generally promoted and protected. Old Vicarage, The DS0000000374.V295185.R01.S.doc Version 5.2 Page 20 EVIDENCE: The manager was not present during the inspection. She has, however, been through the fit person process and has been found fit to be in charge by The Commission for Social Care Inspection. There continue to be improvements generally within the home. There is good support from deputising staff who appear knowledgeable about the running of the home in the managers absence. Requirements set at the last inspection have been met. The home is run in the best interests of residents. Residents spoken to say that they feel well cared for. Staff appear to respond promptly and courteously to residents who were seen to enjoy a joke with staff at various times during the inspection. Visitors spoken to said that staff are very helpful and could not think of anything they would like to be improved. There have been no changes to procedures for handling resident’s money since the last inspection. Personal allowances are held in the home for residents to spend as they wish. There are charges for some services such as hairdressing, chiropody, newspapers and items such as toiletries. Health and safety of residents is generally safeguarded. There are regular checks on water temperatures, and fire equipment. Outside contractors visit regularly to check gas, electrical items and Legionella (water) checks. There is no more staff smoking in the dining area, and this is noticeably much more pleasant for residents. A security intercom system has been installed. The garden fence has been made secure so that residents can use the garden safely, following concerns expressed by some relatives. Staff demonstrate a good understanding of maintaining a safe environment for residents. This inspection was unannounced. The staff member who answered the door, was carrying a razor and other potentially hazardous items in her hands, as she was aware they could not be left unattended in the bathroom. A risk assessment must be carried out when residents wish to have glass fronted china cabinet in their room. If there is a risk that someone may fall against it, it should be placed in a position that would reduce the risk of injury, and safety film applied. Following an accident with a lighter, procedures for residents who smoke have been tightened up, and there is not unsupervised access to lighters. Old Vicarage, The DS0000000374.V295185.R01.S.doc Version 5.2 Page 21 A number of window restrictors were damaged, or did not sufficiently restrict the opening of windows to the recommended distance. An immediate requirements notice was issued and the home confirmed that all windows, including those on the ground floor are now restricted. Some residents were unhappy about this. It was agreed that if individual residents wish to open their windows further, a risk assessment must be carried out, and the room inaccessible to other residents, for example those with dementia. Routine safety checks should be carried out by the manager, which would identify some of the issues raised above. A useful resource for planning such safety checks is the Health and Safety Executive publication that deals specifically with health and safety in care homes. Old Vicarage, The DS0000000374.V295185.R01.S.doc Version 5.2 Page 22 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 3 X X X X X HEALTH AND PERSONAL CARE Standard No Score 7 2 8 2 9 2 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 2 3 X X X X X X 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X X 2 Old Vicarage, The DS0000000374.V295185.R01.S.doc Version 5.2 Page 23 Are there any outstanding requirements from the last inspection? YES STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard OP7 Regulation 15 Requirement Care plans must be sufficiently detailed and contain instructions as to how needs will be met. Personal preferences and needs must be contained in standardised care plans. Where weight loss is observed over a consistent period, a care plan must be put in place and weight checked regularly. A fridge must be provided to store medication, in a locked treatment room. Confirm all staff have a current CRB check seen by the manager and held on file. Routine safety checks must be carried out by the manager and recorded. Risk assessments for glass fronted china cabinets must be carried out. Timescale for action 25/09/06 2. OP8 15 25/08/06 3. 4. 5. OP9 OP18 OP38 13 (2) 19 13 (4) (c) 25/08/06 25/08/06 25/08/06 Old Vicarage, The DS0000000374.V295185.R01.S.doc Version 5.2 Page 24 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. 2. 3. 4. 5. 6. Refer to Standard OP7 OP8 OP10 OP16 OP19 OP26 Good Practice Recommendations Where technical terms are used in care plans, these are explained in brackets alongside. Manual handling assessments should record the size of hoist sling to be used. The use of the radio in the laundry should be monitored to ensure privacy is not invaded. Check copies of complaints procedure are up to date. Names on room doors may be more easily read in plain writing. One day’s supply of towels should be stored in the bathroom. Old Vicarage, The DS0000000374.V295185.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Cramlington Area Office Northumbria House Manor Walks Cramlington Northumberland NE23 6UR National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Old Vicarage, The DS0000000374.V295185.R01.S.doc Version 5.2 Page 26 - 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. 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