Inspection on 25/10/06 for Old Vicarage, The

This inspection was carried out on 25th October 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. 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 13/11/07

Old Vicarage, The 14/12/05

Old Vicarage, The 07/07/05

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

CARE HOMES FOR OLDER PEOPLE Old Vicarage, The 26 Cottage Road Wooler Northumberland NE71 6AD Lead Inspector Anne Urwin Brown Key Unannounced Inspection 25th October 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 DS0000064203.V299777.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 DS0000064203.V299777.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Old Vicarage, The Address 26 Cottage Road Wooler Northumberland NE71 6AD 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) 01668 281662 01668 281662 oldvicwooler@btconnect.com A & P Ltd Mrs Janet Cresswell Care Home 17 Category(ies) of Old age, not falling within any other category registration, with number (17) of places Old Vicarage, The DS0000064203.V299777.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 14th December 2005 Brief Description of the Service: The old Vicarage is a stone built detached house on the outskirts of Wooler. This former vicarage has been extended and converted to provide residential accommodation for up to seventeen older people. Day care is also provided for up to five older people. The public rooms, which are comfortable and spacious are on the ground floor. There is a shaft lift fitted for access to the first floor. The home stands in its own grounds, which are accessible and well maintained. Car parking is available to the front and rear of the house. Public transport is available in the centre of Wooler a short walk from the home. The home has an estate care that is used to transport residents. Fees range from £379 to £420. Old Vicarage, The DS0000064203.V299777.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This key inspection was carried out over seven hours. Before the visit the Inspector used information from the pre-inspection questionnaire to assist in planning the inspection. The inspection involved talking to the Manager, ten residents and seven staff, a tour of the building and inspection of records. What the service does well: What has improved since the last inspection? What they could do better: Care plans need to be regularly monitored to ensure that they reflect the changing needs of individual residents. Old Vicarage, The DS0000064203.V299777.R01.S.doc Version 5.2 Page 6 Staff need abuse training. There should be an annual development plan for the home that is based on a cycle of planning, action and review. 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. The summary of this inspection report can be made available in other formats on request. Old Vicarage, The DS0000064203.V299777.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 DS0000064203.V299777.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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 2, 3 and 6 were assessed. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. All residents have a copy of a written contract that details the terms and conditions of residence. No resident moves into the home without having had his/her needs assessed and been assured that these will be met. Intermediate care is not provided at the Old Vicarage. EVIDENCE: All residents have now been supplied with a written contract that shows the terms and conditions of residence. This process has been completed since the last inspection. Residents’ records inspected contained a full assessment of need. The assessment covers the areas identified in this standard. Care management assessments were available. Residents said that their needs are met by staff. Old Vicarage, The DS0000064203.V299777.R01.S.doc Version 5.2 Page 9 Records showed that intermediate care is not provided. Admissions to the home are for long term or respite care. Old Vicarage, The DS0000064203.V299777.R01.S.doc Version 5.2 Page 10 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 7, 8, 9 and 10 were assessed. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Each resident has an individual plan of care detailing their health, personal and social care needs, but improvements could be made in recording of some plans. Residents’ health care needs are met. Residents are protected by the policies and procedures for dealing with medicines. Each person’s is treated with respect and their right to privacy is upheld. EVIDENCE: Individual care plans show residents’ needs and how these are met. Most plans contain clear and detailed information, but improvements could be made in recording of one plan seen. Care plans are regularly reviewed and changes are made to reflect changing needs. Risk assessments are in place. Residents said that staff know what they need help with and are well informed about their likes and dislikes. Old Vicarage, The DS0000064203.V299777.R01.S.doc Version 5.2 Page 11 Residents’ health care needs and any specific treatment are clearly recorded. Records are available of any contact with the doctor, district nurse and other health care professionals. Risks are regularly assessed for pressure areas, falls and pressure areas. Residents said that the staff are aware of their health needs and support is provided to attend appointments. They said that they were satisfied that they can access the health services that they need. Guidance is in place for handling medicines. Staff training has been provided in administering medicines. Records are kept in good order and these show the general practitioner initials any changes of prescribed medicines. Arrangements for the storage of medicines are satisfactory. Residents said that they felt that staff respect them and treat them well. Staff were seen knocking on residents’ doors before entering rooms by the inspector. There was a relaxed atmosphere evident in the home and staff spoke respectfully to residents during the inspection. Staff induction training includes reference to privacy and dignity and staff said that the importance of this is highlighted at staff meetings. Old Vicarage, The DS0000064203.V299777.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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 12, 13, 14, 15 were assessed. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents are satisfied that routines in the home suit their expectation and preferences. They said that they were satisfied that their social, cultural, religious and recreational interests and needs are met. Residents maintain contact with family, friends, representatives and the local community if they wish. Residents can exercise choice and control over their lives. Residents enjoy and wholesome, well-balanced and nutritious diet in comfortable surroundings suited to their needs. EVIDENCE: Residents said that they are able to make choices about their routines. They person gave examples like when they get up and go to bed, what they do, food and social activities. There is information about residents’ interests within individual care plans. A staff member liaises with residents about activities. A new car has been purchased and residents said that they are enjoying going out more often. Residents were satisfied with the arrangements for activities and outings. They said that they are able to make choices about whether or not they take part. One person said she preferred to stay in rather than go out. Old Vicarage, The DS0000064203.V299777.R01.S.doc Version 5.2 Page 13 Residents said that they have regular visitors and the inspector saw this during the inspection. Residents said that they can see visitors in their own rooms or in the public areas of the home. Information is available for relatives about visiting and this is made available before a resident is admitted. Residents are encouraged to continue to manage their finances for as long as they are able and records confirm this. Residents’ rooms are well furnished with their own possessions and they said that they were encouraged to bring items from their previous home. Residents said that they thought they could look at their records, but most were not sure that they wanted to. Menus show that there is a good selection of food provided. A choice is not provided at each mealtime, but residents said that they could ask for an alternative if they did not like the food. In the kitchen staff have a list of residents’ likes and dislikes on a board. The food served during the inspection was well cooked and presented. Residents said they enjoyed the food and that it is always good. Food hygiene training has been provided for staff. Meals are served in the dining rooms or in residents’ rooms if they prefer. Old Vicarage, The DS0000064203.V299777.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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 16 and 18 were assessed. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents and their relatives are satisfied that their complaints will be listened to, taken seriously and acted upon. Residents are protected from abuse, but further staff training is needed. EVIDENCE: Guidance is in place for dealing with complaints. Residents are clear that there is a complaints procedure and said that they could talk to any member of staff if they had a concern/complaint. They also said that they felt satisfied any complaint would be taken seriously. An appropriate recording system is in place for complaints. Staff were aware of the procedures. Appropriate guidance is in place for dealing with allegations of abuse. Staff were clear about the procedures to be followed if an allegation is made, however more staff training is needed. Old Vicarage, The DS0000064203.V299777.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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 19, 20, 21, 24, and 26 were assessed. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents live in a safe well-maintained environment. Residents have access to safe, comfortable indoor and outdoor communal facilities. There are sufficient suitable lavatories and bathrooms. Residents’ live in safe and comfortably furnished rooms with their own possessions around them. The home is clean, pleasant and hygienic. EVIDENCE: The home is well maintained and records confirm that repairs are carried out promptly. There is a large garden and apple orchard that is accessible to residents. Seating is available to the side and rear of the building. Residents use this area regularly. The building complies with the requirements of the local fire service and environmental health department. A new fire alarm system has been fitted since the last inspection. Records show appropriate Old Vicarage, The DS0000064203.V299777.R01.S.doc Version 5.2 Page 16 health and safety checks are carried out regularly. The residents said that they were very satisfied with the accommodation at the Old Vicarage; they said it was homely and comfortable. The main hallway and staircase has been redecorated since the last inspection. A shaft lift is fitted. There is spacious sitting and dining areas that are comfortably furnished to suit residents’ needs. New blinds have been fitted in the conservatory. One sitting area is available for smokers. Lighting is appropriate for reading and other activities. It is planned that the sitting rooms will be re-decorated in the next few months. Bathrooms are well equipped with aids fitted to suit residents’ needs. Paper towels and liquid soap are available. Eleven bedrooms have en-suite toilet and wash hand basin. Residents’ rooms are well furnished and decorated. Residents’ rooms show evidence of their interests and personal taste. Most residents have brought in furniture and other personal items for their own room. One resident said her room was her own space and she enjoyed spending her time there. She said “staff respect my privacy, but help me to keep the room nice”. She said her room was always clean and staff helped her keep her clothes tidy. The laundry is on the ground floor near the rear exit . The washing machine has appropriate cycles for cleaning soiled linen. Space is limited, but it is planned to move the central heating boiler, which will give more space for shelving and a sluice to be fitted. The home was clean and hygienic at the time of the inspection. The kitchen was clean and tidy. Records show that cleaning routines are in place. All foodstuffs are appropriately stored and dates where necessary. Staff working in the kitchen have completed Food Hygiene training. Records show that infection control training is provided. Old Vicarage, The DS0000064203.V299777.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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 27, 28, 29 and 30 were assessed. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents’ needs are met by an appropriate number of experienced care and other staff. Residents are in safe hands at all times. The home’s staff recruitment procedures support and protect the residents. Staff are trained and competent to do their jobs. EVIDENCE: The rota showed there are enough staff available throughout the day and night. Three care staff, the Manager and Deputy Manager were on duty at the time of this inspection. One member of staff is on duty throughout the night. Residents said that they felt there are enough staff on duty in the home and that staff respond promptly to their needs. No staff member is under eighteen years of age. Nine staff have completed qualifications in care. Staff have achieved a level of sixty per cent of qualified staff and are to be commended for their commitment to training. Records confirm that any new staff complete an appropriate induction programme. Recruitment procedures are in place and records show these are followed. Appropriate reference and Criminal Records Bureau checks are carried out Old Vicarage, The DS0000064203.V299777.R01.S.doc Version 5.2 Page 18 before staff start work at the Old Vicarage. Evidence of identity checks was available. Staff said that new staff receive appropriate induction training and records confirmed this. All staff have three days paid training in a year. Training provided in the past year included Promotion of Continence, Leadership and Management, Infection Control, Protection of Vulnerable Adults, Literacy Skills, Equality and Diversity and Care planning. Staff said that they have access to appropriate training opportunities. Old Vicarage, The DS0000064203.V299777.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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 31, 33, 35 and 38 were assessed. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents live in a home that is run and managed by a person who is of good character and is experienced in caring for older people. The home is run in the best interests of residents, but an appropriate development plan has not been prepared. Residents’ financial interests are safeguarded. Systems are in place to protect residents and staff from health and safety hazards. EVIDENCE: The manager has recently completed a training course for registered managers. She is experienced in caring for older people and has been the manager at the Old Vicarage for more than a year. An appropriate job description is available. At present she meets regularly with the Registered Old Vicarage, The DS0000064203.V299777.R01.S.doc Version 5.2 Page 20 Provider, but does not have professional supervision. She would benefit from regular opportunities to discuss her work and professional practice. Questionnaires are used to seek the views of residents about the service provided. Information from the questionnaires is used to plan changes for the service, but there is not a written annual development plan for the home. Audit and refurbishment plans are informal and the manager was able to describe what these are, but there was no evidence to confirm that residents are involved in contributing to this process. Policies are in place for handling residents’ money. Records are kept of all money held and each transaction is signed and receipts are kept. Samples of money held were checked and balanced with the records kept. Training in moving and handling, first aid, fire safety, food hygiene and infection control is provided at regular intervals. Records showed this and staff said that they receive this training. Regular checks are made of electrical equipment and the central heating system. The central heating boiler is to be replaced. Thermostatic controls are fitted on all hot water outlets. Risk assessments are in place for safe working practices. Staff said that they receive appropriate induction training and records are in place to confirm this. Records of fire alarm tests, servicing of fire equipment and the alarm, fire training and emergency lighting are kept in an appropriate manner. Full details of accidents are kept. Old Vicarage, The DS0000064203.V299777.R01.S.doc Version 5.2 Page 21 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 X 3 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 3 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 3 3 X X 3 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 2 X 3 X X 3 Old Vicarage, The DS0000064203.V299777.R01.S.doc Version 5.2 Page 22 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 Timescale for action 31/12/06 2 3 OP18 OP33 13 24 The content of care plans must be regularly monitored to ensure that they fully reflect the needs of individual residents. Staff must receive training in 31/01/07 dealing with allegations of abuse. An annual development plan 28/02/07 must be drawn up. 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 Refer to Standard OP31 Good Practice Recommendations Consideration should be given to providing the manager with appropriate professional supervision. 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