Inspection on 07/07/05 for Old Vicarage, The

This inspection was carried out on 7th July 2005.

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 25/10/06

Old Vicarage, The 14/12/05

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

CARE HOMES FOR OLDER PEOPLE The Old Vicarage 26 Cottage Road Wooler Northumberland NE71 6AD Lead Inspector Anne Urwin Brown Announced 7 July 2005 09:00 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 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. The Old Vicarage B53 B03 S64203 Old Vicarage V241019 070705 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service The Old Vicarage Address 25 Cottage Road Wooler Northumerland NE71 6AD 01668 281662 N/A N/A A & P Limited Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Mrs Janet Cresswell CRH 17 Category(ies) of OP Old Age - 17 registration, with number of places The Old Vicarage B53 B03 S64203 Old Vicarage V241019 070705 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: There are no conditions of registration. Date of last inspection 22.02.05 Brief Description of the Service: The Old Vicarage is a large stone built detached house on the edge of Wooler. This former vicarage has been extended and converted to suit its present use as a residential home for up to seventeen older people. Day care is also provided for up to five people. Residents accommodation is provided on two floors linked by a shaft lift. All bedrooms are used as single rooms at the time of this inspection and some have en-suite facilities. All accommodation is well furnished and well decorated. The gardens are well maintained and provide comfortable seating areas for those who want to enjoy the gardens. There is a conservatory at the side of the house and a gazebo was erected, so that residents can enjoy sitting out. The Old Vicarage B53 B03 S64203 Old Vicarage V241019 070705 Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This announced inspection lasted seven hours and involved discussion with the new Manager, ten residents, two relatives and staff. Four residents’ records were inspected together with other records relating to the running of the home. Three staff files were seen. A tour of the building was carried out. What the service does well: The Old Vicarage provides individual support to suit the needs of the residents within a homely setting. Staff know each residents’ needs well and residents confirmed this. Resident said that staff respond quickly to their needs and that they feel able to talk to staff about any concerns. Records contain information about residents’ needs and their likes and dislikes. Residents and relatives spoke positively about the staff and the quality of personal care offered. There was a relaxed atmosphere and it was evident that residents had a good relationship with staff. All residents apart from one said that they were happy with the food served. They said there was a good variety of food provided. Residents said they were able to choose whether or not they had meals in the dining room or their own rooms. Residents are encouraged and assisted to maintain interests and contacts within the community. Visitors are welcomed to the Home. Relatives spoke highly of the support offered to residents. Residents said they were satisfied that any concerns or complaints would be treated seriously. Most residents said that they felt very happy about the appointment of the new manager and that she was available to talk to them. The Home is well maintained and décor is attractive and homely. The Home is furnished and equipped to suit the needs of the residents. Residents’ rooms show evidence of their interests and taste. Most rooms have en-suite accommodation. Residents and staff spoke positively about the support the acting manager provided since the previous manager left. Staff said that they had felt well supported by the home’s management during this time. The staff welcomed the appointment of the new manager and said that they are satisfied that there are consistent and effective management arrangements in place now. They confirmed that they are able to put forward their views to the new manager and to the owner or his representative. Staff reported that morale is good. Evidence was available that there is clear direction and leadership from the management of the Home. Record keeping is good and evidence was available that this is improving. The Old Vicarage B53 B03 S64203 Old Vicarage V241019 070705 Stage 4.doc Version 1.40 Page 6 What has improved since the last inspection? 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. The Old Vicarage B53 B03 S64203 Old Vicarage V241019 070705 Stage 4.doc Version 1.40 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 Standards Statutory Requirements Identified During the Inspection The Old Vicarage B53 B03 S64203 Old Vicarage V241019 070705 Stage 4.doc Version 1.40 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 standard(s) 2, 3, 6 Not all residents have a written contract with the home. Most residents have a contract agreed by Northumberland Social Services with the Old Vicarage. Residents have a full assessment prior to moving into the home to ensure their needs can be met. Intermediate care is not provided at the Old Vicarage. EVIDENCE: All residents whose care is funded by the local authority have a contract agreed by the home and the authority. The new manager is reviewing the home’s contract, which needs updating. Once the new contract is in place the manager said that new contracts will be issued to all residents. Evidence was available from residents’ records that a full assessment for each resident is carried out prior to admission. The manager confirmed that she is reviewing the assessment and will be making some changes to improve the information available. Risk assessments are also carried out. The Manager confirmed that Care Management assessments are also available and these were seen in the files inspected. Residents said that they were satisfied that staff knew what their needs were when they were admitted to the home. The manager confirmed that intermediate care is not provided at the Old Vicarage. The Old Vicarage B53 B03 S64203 Old Vicarage V241019 070705 Stage 4.doc Version 1.40 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 standard(s) 7 Each resident has an individual plan setting out their health, personal and social care needs. EVIDENCE: Records were available to confirm that each resident has an individual care plan. The plans inspected showed that appropriate information is available and that plans are regularly reviewed. The care planning system is being reviewed and work is going on to complete all residents’ records in the new format. The new format provides more information about individual’s care needs. Risk assessments are in place. Residents said that staff were aware of their needs and quickly responded if additional help was required. Staff were able to demonstrate a good understanding of individual residents’ needs. The Old Vicarage B53 B03 S64203 Old Vicarage V241019 070705 Stage 4.doc Version 1.40 Page 10 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 standard(s) 12, 13, 15 Residents’ routines are organised to suit their needs and wishes. The manager is reviewing the arrangements for activities and considering how best to involve residents in this process. Residents are able to maintain contact with family, friends and the local community. Visitors are welcomed at any time. Residents are provided with a wholesome and varied diet. EVIDENCE: Residents said that they are able to decide about their daily routines and staff support them with this. Residents’ records showed that routines are organised to suit individual needs and preferences. The new manager is currently looking at setting up a group to look at the provision of activities. She intends to involve staff and residents in the group and to identify a staff member to take responsibility for arranging activities. Daily records are kept of any outings or activities for groups of residents or individuals. Evidence was available that there are some activities going on, but residents said they would like to have a wider range of events. Two residents said they did not want to take part in organised activities. Residents said that they are able to have visitors at any time and that they can entertain them in their rooms or use the sitting room/conservatory. Relatives and visitors seen during the inspection confirmed that they were able to visit as they wished. Staff were seen to welcome visitors. Information about visiting the residents is available in the booklet provided to prospective The Old Vicarage B53 B03 S64203 Old Vicarage V241019 070705 Stage 4.doc Version 1.40 Page 11 residents. Residents confirmed that they could continue to attend local social events in Wooler and that staff and relatives assist them to do so. Records of menus were available for inspection and these showed a varied diet is provided. A choice is not offered at each mealtime, but residents said they could ask for an alternative if they did not like the food provided. There are hot and cold drinks available throughout the day. Residents said they were very satisfied with the food provided, apart from one resident who felt that his needs were not always met. This was discussed with the manager who was aware of this person’s difficulties. Work is ongoing to address this. Special diets are catered for. Food hygiene training has been provided for the cook and arrangements are being made for updating training for other staff. The food provided during the inspection was well cooked and presented. The Old Vicarage B53 B03 S64203 Old Vicarage V241019 070705 Stage 4.doc Version 1.40 Page 12 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 standard(s) 16, 18 Residents are confident that their complaints or concerns will be taken seriously and acted upon. Residents are protected from abuse. EVIDENCE: The guidance on complaints has been reviewed since the last inspection. There have been no complaints made since the last inspection. The residents said that they were satisfied that they could raise any concerns or complaints with the manager or the staff. Staff were aware of how to help a resident make a complaint. Written guidance is in place for dealing with allegations of abuse. A copy of the Northumberland Social Services guidance is available in the home. Staff were able to describe how they would assist a resident to make an allegation. They were aware of the written guidance in place. The Old Vicarage B53 B03 S64203 Old Vicarage V241019 070705 Stage 4.doc Version 1.40 Page 13 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 standard(s) 19, 20, 21, 22, 23, 24, 25, 26 The Old Vicarage is well maintained and safe. Residents have access to comfortable well-furnished indoor communal facilities. There are attractive gardens fitted with appropriate garden furniture for residents to enjoy. Only five rooms do not have en-suite accommodation. There are sufficient toilets and bathrooms are available. Residents have specialist equipment supplied if they need it. Residents’ bedrooms are comfortably furnished and they have their own possessions around them. The home is clean, pleasant and hygienic. EVIDENCE: There is a list of annual maintenance and records show arrangements are in place for servicing of equipment at regular times. The manager described how priorities are identified for decoration and refurbishment. The grounds are well maintained and are easily accessed by residents. Residents said they regularly use the garden and enjoy having a gazebo and seating areas in the orchard. The sitting and dining areas are well furnished and decorated. Bedrooms are well furnished and residents said that they were able to bring in items from their previous homes. Residents said they were happy with their rooms. The Old Vicarage B53 B03 S64203 Old Vicarage V241019 070705 Stage 4.doc Version 1.40 Page 14 Rooms are well ventilated and lighting is adequate. Central heating is fitted and residents are able to adjust the temperature within their rooms. Emergency lighting is fitted and regular checks are carried out. Written guidance is in place for the control of infection and staff training is provided. Appropriate arrangements are in place for washing residents’ clothing and bedding. The Old Vicarage B53 B03 S64203 Old Vicarage V241019 070705 Stage 4.doc Version 1.40 Page 15 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 considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27, 30 Staffing levels at the time of this inspection were sufficient to meet the needs of the residents. A staff training programme is to be introduced by the new manager, however six staff are undertaking qualifying training. EVIDENCE: There is a minimum of three staff on duty throughout the day, one of whom is a senior member of staff. At night there is one waking night staff and one person sleeping in on the premises. The staff group are experienced in caring for older people. Staff morale is good. Staff said there are sufficient staff on duty to meet residents’ needs. Residents said they felt satisfied with the number of staff on duty and felt that staff had a good understanding of their needs. Some difficulties in the home last year affected the staff training programme. The new manager is aware of the need to put in place a programme of regular staff training and is currently working on this. Staff training provided in the last year included Management of Medication, Infection Control and Dementia Awareness. The Old Vicarage B53 B03 S64203 Old Vicarage V241019 070705 Stage 4.doc Version 1.40 Page 16 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 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31, 33, 34, 35, 38 A new Manager has recently been appointed and her application for registration has now been completed. There is no quality assurance system in place, however the manager said that she is looking at introducing a system to give the residents more say about the running of the home. Accounting and financial systems are in place to protect residents. Arrangements are in place to safeguard residents’ rights and best interests by the Home’s record keeping, policies and procedures. Health, safety and welfare of residents is promoted and protected. EVIDENCE: A new manager has been appointed since the last inspection. She is now registered to undertake training to complete the Registered Manager’s Award. She has experience in the care of older people and has worked in the Old Vicarage previously as Deputy Manager. She has applied to be the Registered Manager and this process was successfully completed shortly after this inspection. The Old Vicarage B53 B03 S64203 Old Vicarage V241019 070705 Stage 4.doc Version 1.40 Page 17 There is not a quality assurance system in place. The manager is aware that work is needed to identify a system that takes account of residents’ views about the service. The manager said that there has not been an annual development plan prepared. She is aware of the need to formally consult residents and their representatives and is looking at ways to do this. Informal systems are in place with the owner visiting regularly and talking to residents. Residents said that they feel able to raise issues now with the manager, the owner or the new Responsible Individual. Evidence was available that policies and procedures are being reviewed or introduced since the appointment of the new manager. Public liability insurance is in place. A business plan is in place. Residents are encouraged to keep control of their own money. Money is held on behalf of some residents. Records were checked against money held and these were in good order. Fire records are maintained and show that appropriate checks and tests are carried out and recorded. Competent person fire training is arranged. Staff fire training is being carried out. Written guidance is in place for Health and Safety and risk assessments are carried out. Evidence was available that regular updating of Moving and Handling, First Aid and Food Hygiene training is to be arranged. Accidents are recorded appropriately. The Old Vicarage B53 B03 S64203 Old Vicarage V241019 070705 Stage 4.doc Version 1.40 Page 18 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score x 2 3 x x N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 x 9 x 10 x 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 x 15 3 COMPLAINTS AND PROTECTION 3 3 3 3 3 3 3 3 STAFFING Standard No Score 27 3 28 x 29 x 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x 3 3 x 2 x x x x x The Old Vicarage B53 B03 S64203 Old Vicarage V241019 070705 Stage 4.doc Version 1.40 Page 19 Yes Are there any outstanding requirements from the last inspection? 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 2 Regulation 5 Requirement Each resident must be issued with a written contract/statement of terms and conditions with the home. This requirement is outstanding from the last inspection report. There needs to be more emphasis placed on meeting residents social needs by the provision of a programme of suitable recreational activities. A staff training plan must be devised to fully address the training needs of the staff group. A system for reviewing the quality of care provided must be introduced that takes account of the views of the residents and their representatives. This requirement is outstanding from the last inspection report. Timescale for action 31.10.05 2. 12 16 31.10.05 3. 4. 30 33 18 24 31.10.05 30.11.05 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations B53 B03 S64203 Old Vicarage V241019 070705 Stage 4.doc Version 1.40 Page 20 The Old Vicarage 1. The Old Vicarage B53 B03 S64203 Old Vicarage V241019 070705 Stage 4.doc Version 1.40 Page 21 Commission for Social Care Inspection 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. 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