CARE HOMES FOR OLDER PEOPLE
The Old Vicarage 75 High Street Airmyn, Goole East Yorkshire DN14 8LD Lead Inspector
Wendy Dixon Unannounced 7 September 2005 10 am
th 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 J53_J04_S19751_The Old Vicarage_V22852_070905_Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION
Name of service The Old Vicarage Address 75 High Street Airmyn Goole East Yorkshire DN14 8LD 01405 763699 01405 760399 www.jumacare.com Jumacare 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 Amanda Pepper PC Care Home 22 Category(ies) of OP - Old Age - 22 registration, with number DE(E) - Dementia - 22 of places Mixed gender The Old Vicarage J53_J04_S19751_The Old Vicarage_V22852_070905_Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION
Conditions of registration: None Date of last inspection Brief Description of the Service: The Old Vicarage is situated in a village setting close to Goole, East Yorkshire. It is registered to provide care for 22 elderly persons, both male and female. The home has two lounges, a separate dining room and an additional lounge/dining area. A small patio area is available adjacent to the lounge along with a larger paved courtyard and gardens. Accommodation is provided in a range of double and single rooms many of which have en-suite toilet facilities. Three bathrooms are provided for service users, two of which are adapted for service users with mobility problems. The Old Vicarage J53_J04_S19751_The Old Vicarage_V22852_070905_Stage 4.doc Version 1.40 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This report relates to an unannounced inspection that took place on Wednesday 7th September at 10am 2005.The inspection lasted 5.0 hours (10.00pm to 3.00pm). There were 19 service users resident in the home, receiving personal care. The inspection focused on a number of key standards. An inspection of the premises took place, including a number of bedrooms, the homes dining room and lounges. The care records of four service users were examined in detail and where possible these service users were spoken with about the care they receive. There were also discussions with members of staff on duty at the time of inspection and one relative of a service user. What the service does well:
The Old Vicarage provides a very good standard of care. The home had a lovely calm atmosphere and the building has been suitably adapted to improve access easier throughout so service users can use the lounges, gardens and dining room. Detailed plans of care are in place and this helps ensure that all the service users health and social care needs are identified and met. Service users were able to spend their day as they wished. Service users were in their rooms watching TV or reading, some were in one of the homes lounges chatting and socialising with other service users. Service users were relaxed and happy to chat about life in the home that they very much enjoyed, talking about the recent events such as a garden party held at the home. Staff were well informed about service users health and personal care needs and were observed talking and assisting service users in a kind friendly and professional manner. Visitors were welcomed by staff and able to see family/friends either in one of the homes lounges or their room. The Old Vicarage J53_J04_S19751_The Old Vicarage_V22852_070905_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 J53_J04_S19751_The Old Vicarage_V22852_070905_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 J53_J04_S19751_The Old Vicarage_V22852_070905_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) 3 Service users needs are properly identified and assessed prior to admission EVIDENCE: The preadmission records of the newest service user admitted to the home was inspected. A member of the homes management team had assessed the service user prior to admission. Service users are able to visit the home prior to admission to meet with staff and see their prospective room before making a decision to come into the home. Information about service users health and personal care needs had been documented and information gathered from relatives and other health professionals giving a good picture of the care that needed to be provided
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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) 7,8,9 and 10 The health and personal care needs of service users are well met EVIDENCE: The care plans of four service users were inspected and found to be of good quality. These contained detailed information about how service users needed to be cared for and showed any health problems were quickly and appropriately dealt with, consulting with other professionals where necessary. These were up dated on a regular basis. Where these service users were spoken to they confirmed that the information recorded was correct and up to date. Care plans were signed by the service users or where more appropriate their relatives showing they were aware of the contents. Medication is safely stored, stock balances checked were correct and administration records up to date showing service users were receiving medication as per the doctors instructions. Staff spoke with service users in a kind, friendly and respectful manner. Toilets and bathrooms all had privacy locks and signage in place and in shared rooms screens were available.
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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 and 15 Service users can choose to spend their days as they wish, and there is a range of activities service users can participate in if they wish. EVIDENCE: The home had a relaxed atmosphere. Service users were at different points in their morning routine, some in their rooms listening to the radio and reading the newspapers. Others seeing family and friends, watching television and enjoying morning coffee together showing that support for service users is individual to them and not based on fixed routines. The meal served during the inspection was lunch; this was nicely presented and enjoyed by the service users who commented on how good the food was at the home. Menus are displayed on the tables and service users can either eat in their rooms though the majority prefer to eat in one of the homes dining rooms as meals are very much a social occasion. The Old Vicarage J53_J04_S19751_The Old Vicarage_V22852_070905_Stage 4.doc Version 1.40 Page 11 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 and 18 Services users and families are aware of how to complain and polices are place to deal with any abuse should it occur. EVIDENCE: No complaints have been received since the last inspection. The home has a clear complaints procedure, which is included in the information given to service users on admission that informs service users and their families how to complain if they are unhappy with the care or service at the home. Peoples knowledge of the procedure was confirmed in the recent survey sent out to all service users by the home manager and owner. The Home has policies regarding abuse copies of which were kept in the home and made available to staff members. The Old Vicarage J53_J04_S19751_The Old Vicarage_V22852_070905_Stage 4.doc Version 1.40 Page 12 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) 19,23 and 26 The home offers very high quality accommodation to all its service users and is a clean comfortable and safe place for service users to live. EVIDENCE: Access is good throughout the building. Decoration and maintenance is to a very high standard. The home has secure well-maintained gardens for service users to enjoy. Service users rooms are very much their own and personalised with pictures, photographs and small items of furniture they have brought from home. The home was clean and fresh smelling throughout and gloves and aprons were in good supply, also each individual member of staff is provided alcohol hand rub pouches to help prevent the spread of infection. The Old Vicarage J53_J04_S19751_The Old Vicarage_V22852_070905_Stage 4.doc Version 1.40 Page 13 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) 27,29 and 30 Enough properly trained and qualified staff are on duty to meet the needs of the service users EVIDENCE: Enough staff are on duty to meet the needs of the service users. The employment and training files of two members of staff were inspected. These contained the necessary checks and references to help ensure service users are cared for by trustworthy staff who have appropriate experience. Staff had recently attended fire, moving and handling training and medication training and when spoken to were knowledgeable and up to date about care and treatment service users required The Old Vicarage J53_J04_S19751_The Old Vicarage_V22852_070905_Stage 4.doc Version 1.40 Page 14 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) 33,35 and 38 The home is well managed and provides a safe place for service users to live and staff to work. EVIDENCE: The home had a calm relaxed and friendly atmosphere. The registered manager has recently obtained the NVQ4 in care management in addition to her seven years experience in managing the home. The registered manager and or the owner are available in the home on a daily basis to deal with issues as they arise. Regular meetings/ consultations are held with service users to enable everybody who lives and works in the home to have a say as to how it is run. The Registered provider does not forward regulation 26 reports to the commission, which is acceptable under these circumstances. Health and safety and fire records inspected were up to date. A recent inspection made by the environmental health officer made no recommendations.
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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 x 3 x x x HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 4 13 x 14 x 15 3
COMPLAINTS AND PROTECTION 3 x x x x x x 4 STAFFING Standard No Score 27 3 28 x 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x 3 x x 3 x 3 x x 3 The Old Vicarage J53_J04_S19751_The Old Vicarage_V22852_070905_Stage 4.doc Version 1.40 Page 16 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 Regulation Requirement Timescale for action 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 Good Practice Recommendations The Old Vicarage J53_J04_S19751_The Old Vicarage_V22852_070905_Stage 4.doc Version 1.40 Page 17 Commission for Social Care Inspection Unit 4 Triune Court Monks Cross York YO32 9GZ National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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