Inspection on 14/06/06 for The Old Rectory

This inspection was carried out on 14th June 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 made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

The Old Rectory 24/05/07

The Old Rectory 07/10/05

The Old Rectory 07/07/05

The Old Rectory 18/11/04

The Old Rectory 12/08/04

The Old Rectory 09/02/04

The Old Rectory 11/12/03

The Old Rectory 30/10/02

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

CARE HOMES FOR OLDER PEOPLE The Old Rectory Main Road Stickney Lincs PE22 8AY Lead Inspector Mr David Bacon Key Unannounced Inspection 14th June 2006 08:30 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 The Old Rectory DS0000002460.V299676.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. The Old Rectory DS0000002460.V299676.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service The Old Rectory Address Main Road Stickney Lincs PE22 8AY 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) 01205 480511 Mr Richard Atterby Mrs Christine A Atterby Mr Richard Atterby Care Home 44 Category(ies) of Mental disorder, excluding learning disability or registration, with number dementia (1), Old age, not falling within any of places other category (44), Physical disability (16) The Old Rectory DS0000002460.V299676.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. 4. Service users within the category of Physical Disability (PD) between the ages of 25 and 64 years can be accommodated. Service Users within the category of PD may be accommodated in rooms 2, 3, 4, 5, 7, 8, 9, 14, 21, 22 and 23 only on the ground floor. Service Users within the category of PD may be accommodated in rooms 3, 4, 5, 6, 21, 24, 25, 26 and 27 on the first floor. The total number of service users accommodated in the home will not exceed 44. 7th October 2005 Date of last inspection Brief Description of the Service: The Old Rectory is a large, 18th century country house with three additional purpose-built wings set in it own grounds in the village of Stickney, which is approximately 8 miles from the market town of Boston. The home is situated next to the village church and a short walk from the pub and shop. There are landscaped gardens to the front of the house with a car park to the front and the side of the building. The home is privately owned by Mr. and Mrs. Atterby and managed by Mr. Atterby. It is registered to provide personal care for up to 44 residents, older people, one having a defined mental health disorder and up to sixteen having a defined physical disability between the ages of 25 years and 65years. The home does not provide any nursing care. The care fees range from £335 to £ 432 per week. The Old Rectory DS0000002460.V299676.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This site visit took place over 4 hours; it was unannounced and was carried out by one inspector. A tour of the premises was conducted, service users care records and staff records were inspected. The inspector spoke with the joint proprietor, five service users, two service users representatives and two staff members. What the service does well: What has improved since the last inspection? What they could do better: The homes care records do not clearly document service users wellbeing or that their care needs are being met. Recruitment procedures are not fully followed and staff must attend all statutory training. Fire safety and medication records are not adequately maintained. The Old Rectory DS0000002460.V299676.R01.S.doc Version 5.2 Page 6 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 Rectory DS0000002460.V299676.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 The Old Rectory DS0000002460.V299676.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): 2, 3 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. There are satisfactory procedures in place overall for the introduction of residents to the home. EVIDENCE: A new system of documenting service users care needs has been implemented since the previous inspection visit, which is an improvement overall from the previous system. The service users care records viewed identified that an assessment of each service users care needs had taken place, which included an assessment of risk and how these were to be minimised. The care records seen had been recently updated. Service users are provided with written terms and conditions of residence contracts and signed copies are maintained on the premises. The Old Rectory DS0000002460.V299676.R01.S.doc Version 5.2 Page 9 The service users and representatives spoken with confirmed that they were satisfied with admission arrangements. Comments included: “It was all very informal, very friendly”. “I did not want to be away from home but the staff were good, I was made very welcome”. The Old Rectory DS0000002460.V299676.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9, 10 Quality in this outcome area is poor. This judgement has been made using available evidence including a visit to this service. Care records do not provide staff with sufficient information overall to meet service users care needs. Residents’ privacy and dignity is respected. Medication administration systems should be improved to ensure that medication procedures are safe. EVIDENCE: The service users and representatives spoken with were satisfied with standards of care provided and that service users are treated with dignity and respect. Comments included: “I would tell them if it wasn’t but the care is good”. “They do treat you well so I am satisfied about that”. “The carers are really good, a good lot, they look after you well”. “If you need anything then just ask”. The Old Rectory DS0000002460.V299676.R01.S.doc Version 5.2 Page 11 A care plan is completed for each service user although the information within these do not fully document how individuals assessed care needs are met. For example, the daily records of two service users were not updated for periods of over twenty days. Also, the care records inspected did not provide a clear understanding of the care provided or the service users overall wellbeing. For example, the care records of one service user mainly identified continence needs and output. Also, not all records evidenced that service users, or their representatives had been consulted with regarding their care plan. The homes medication records were not adequately maintained overall, as the number of tablets received for each service user had not been fully signed for as receipted into the building. The numbers of tablets disposed of were not always documented. Medicines were signed for by staff as administered. The Old Rectory DS0000002460.V299676.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, 15 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users are supported to maintain and develop community links as they prefer and regarding the care they receive. The meals and activities provided by the home are enjoyed overall by service users. EVIDENCE: The service users spoken with confirmed that they were able spend their time as they liked and that they enjoyed the homes provision of activities. The representatives spoken with said that they were made very welcome when they visited. An activities co-ordinator work 35 hours in the week and helps to provide a variety of activities organised daily, which are tailored to meet the preferences of service users. These include: crafts, games, exercise, visits to local community events and excursions. A minibus has recently been purchased to further assist these. The Old Rectory DS0000002460.V299676.R01.S.doc Version 5.2 Page 13 A record of all meals provided is maintained along with meal and equipment temperature records although these had not been updated for several weeks. There is a four-week menu, which is changed twice yearly. Most of the fresh produce is purchased locally and much of the food is home made. The service users spoken with were mostly satisfied with the meals provided although one service user said that they did not like potatoes and requested more rice and pasta dishes. The manager agreed to address this during the visit. The Old Rectory DS0000002460.V299676.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, 18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. There are satisfactory procedures in place overall to ensure that service users are protected and they can raise concerns should they wish to. Staff are made aware of the homes abuse and whistle blowing policies and procedures. EVIDENCE: There have been no complaints since the previous inspection. The service users and representatives spoken with said they felt able express their views to staff and that these would be acted upon. Comments included: “Oh they would listen, they’re quite good really”. “I don’t have a complaint but you can just go to them”. “We’ve been satisfied when we’ve questioned anything”. Staff demonstrated a good knowledge of adult protection procedures, and their responsibilities for reporting allegations and of adult protection policies and procedures although not all recently recruited staff had received awareness training. The Old Rectory DS0000002460.V299676.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, 26 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The standard of cleanliness and hygiene is satisfactory and residents live in a well-maintained environment although fire safety procedures are not fully followed. EVIDENCE: The communal areas and service users personal accommodation was viewed, which was cleanly decorated and demonstrated where service users had personalised their own room. Furniture is of a domestic style and the furniture seen was in good order. Some redecoration and refurbishment has taken place since the previous inspection, which is ongoing. The service users spoken with were satisfied with the physical environment. The Old Rectory DS0000002460.V299676.R01.S.doc Version 5.2 Page 16 The external doors have security alarms fitted to minimise risks to service users who may be prone to wandering. Fire safety tests were not fully undertaken as per fire safety regulations. For example, an emergency lighting test had not been recorded as completed each month although the manager said that these were undertaken alongside fire safety tests. Safety valves are fitted to regulate water outlet temperatures and radiator protective covers are being fitted to radiators although a formal risk assessment of the premises could not be located during the visit. The Old Rectory DS0000002460.V299676.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, 29, 30 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The home is being staffed to meet the current needs of residents and staff receive induction and some training to ensure this. Minor adjustments are needed with the homes recruitment procedure to ensure as far as possible residents are protected. EVIDENCE: The service users and representatives spoken with confirmed that service users care needs were met and that there were sufficient numbers of staff deployed in the home. The staff records viewed were well maintained overall although during the visit part of a recruitment check had not been undertaken prior to one staff member commencing work at the home. Newly appointed staff receive induction and they sign to confirm where they receive instruction and guidance regarding the homes policies, procedures and care practices. The two staff members spoken with said that they had received an induction upon commencing work at the home and training to enable them to carryout The Old Rectory DS0000002460.V299676.R01.S.doc Version 5.2 Page 18 their role. A rolling programme of training is in place and records of these are maintained although staff must receive awareness training regarding infection control and moving and handling. The Old Rectory DS0000002460.V299676.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, 38 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The home is well maintained overall although a comprehensive risk assessments of the premises is needed and to be acted upon. Service users are satisfied with the management of the home although their views are not fully sought regarding life within the home. EVIDENCE: The service users and representatives spoken said they were satisfied with the management of the home and felt able to express their views regarding the home but not all were confident that these would be acted upon. Quality satisfaction questionnaires are not regularly sent to service users or their The Old Rectory DS0000002460.V299676.R01.S.doc Version 5.2 Page 20 representatives, which would further assist service users to express their views regarding the care provided. Staff members attend statutory training, which is ongoing and training regarding infection control and moving and handling is due to take place. The home is well maintained although a comprehensive risk assessment of the premises must be undertaken. The external doors are alarmed to minimise risks to service users who may be prone to wandering. Records are maintained where the home has any involvement in service users finances although individual service users monies are not kept separately. The manager agreed to address this. During the visit hazardous cleaning materials had been left unattended in two corridor areas and a storage cupboard was not safely locked. The Old Rectory DS0000002460.V299676.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 X HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 2 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 4 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 2 X X X X X X 3 STAFFING Standard No Score 27 3 28 3 29 2 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 2 X 3 X X 2 The Old Rectory DS0000002460.V299676.R01.S.doc Version 5.2 Page 22 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 OP7 Regulation 13 (4) c and 14 (2) and 15 (1) (2) Requirement A comprehensive care plan must be completed for each service user, which clearly identifies each care need met. Service users must be involved in the plan, where possible, which must be reviewed each month and updated on a regular basis (previous timescale of January 31st 2006 not met). The registered person shall make arrangements for the recording, handling and safe administration of medicines. Therefore, all medicines must be fully signed for and counted as received into the home. Emergency lighting tests must be undertaken as per the Fire Safety Officers instructions. Staff recruitment procedures must be followed to ensure that a POVA and CRB check is undertaken for all staff prior to them commencing work within the home. A robust quality assurance system must be established. This remains outstanding from DS0000002460.V299676.R01.S.doc Timescale for action 31/07/06 2 OP9 13 (2) 31/07/06 3 4 OP19 OP29 23 (4) 19 15/06/06 15/06/06 5 OP33 24(1) 31/07/06 The Old Rectory Version 5.2 Page 23 6 OP38 13 4 (a) (c) 6 OP38 13 (6) and 18 (1) (c) (i) the announced inspection of 12.08.04. All hazardous cleaning materials must be safely stored and a comprehensive risk assessment of the premises must be undertaken. Confirmation is required that staff have attended all statutory training including: moving and handling, infection control and abuse awareness. 15/06/06 31/07/06 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 Refer to Standard OP15 OP33 OP35 Good Practice Recommendations It is recommended that service users views regarding meals are more fully sought on a regular basis. It is recommended that service users views regarding life within the home are regularly sought. It is recommended that service users finances are kept separate. The Old Rectory DS0000002460.V299676.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Lincoln Area Office Unity House, The Point Weaver Road Off Whisby Road Lincoln LN6 3QN 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 The Old Rectory DS0000002460.V299676.R01.S.doc Version 5.2 Page 25 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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