Inspection on 18/07/05 for The Old Rectory

This inspection was carried out on 18th 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 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 06/06/06

The Old Rectory 13/12/05

The Old Rectory 05/10/04

The Old Rectory 06/07/04

The Old Rectory 23/02/04

Similar services:

Fairfields Country Rest Home

Poldhu

Queensmount

Trevaylor Manor

Didsbury Court Rest Home

Belma

Hunters Care Centre

Manor Lodge

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

CARE HOMES FOR OLDER PEOPLE The Old Rectory High Street Stalbridge Sturminster Newton DT10 2LL Lead Inspector Gloria Ashwell Announced 18 July 2005 09.30 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 Rectory D55 S26853 Old Rectory V233447 180705 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service The Old Rectory Address High Street, Stabridge, Sturminster Newton, Dorset, DT10 2LL 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) 01963 362624 Mrs Grietje Wagner Mr Richard Wagner Mr Richard Wagner Care Home only 28 Category(ies) of OP - 28 registration, with number of places The Old Rectory D55 S26853 Old Rectory V233447 180705 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: Additional assisted bathing facilities must be provided prior to registration of the proposed Phase 2 of building work, to ensure compliance with the ratio stated in 21.3 of the National Minimum Standards and present arrangements must, until additional available facilities are provided, accord with the identified needs and wishes of service users accommodated. One service user (details known to the Commission) may be accommodated in category DE (E) The Conditions are met. Date of last inspection 01 March 2005 Brief Description of the Service: The Old Rectory is a large traditional style house, recently extended, in the centre of the village of Stalbridge. The village has bus transport to local towns, including Blandford, Dorchester, Sherborne, Wincanton and Yeovil. The Old Rectory is within walking distance of local amenities including shops, post office, church and a public house. The registered providers are Mr Richard Wagner and Mrs Grietje Wagner. Mr Wagner has been the registered manager since October 2003. Resident accommodation is on the ground, first and second floors. A passenger lift provides access to all floors. There are 28 single bedrooms; all except 4 have en-suite hygiene facilities comprising at least a toilet and wash hand basin. There are 2 assisted baths, for use by residents with impaired mobility. On the ground floor are communal rooms, comprising a lounge at the front of the house and another lounge combined close to the dining room. There is also a small lounge on the top floor. To the front of the home is a small walled garden, at the rear is a large walled garden laid to lawns and flower beds with chairs and a table on the terrace. There are spaces for 6 cars to be parked at the rear of the premises, off-road parking is unlimited and there are usually plenty of spaces close to the home. The Old Rectory D55 S26853 Old Rectory V233447 180705 Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was one of the two statutory inspections required in accordance with the Care Standards Act 2000. Since the last inspection no formal complaints against the home have been received or investigated. The inspection was announced, having been arranged with Mr Wagner on 13 July 2004. The inspection commenced at 09.30 on 18 July 2005, and terminated at 15.00. The inspector spoke to 11 residents and 6 staff, including those involved in care and housekeeping, toured the premises and observed staff interaction with service users, the carrying out of routine tasks including the serving of the midday meal. The inspector left a selection of ‘Comment Cards’ and prepaid envelopes (for return to the Commission) with individual residents and with Mr Wagner for later distribution. What the service does well: Residents are assisted to maintain as much independence as possible and are encouraged to maintain contact with the local community. The premises are comfortable, with a variety of communal lounges and a large dining room and attractive gardens. Meals are appetising and of good quantity and quality. Staff are kind and helpful to residents. Residents are treated with respect, their privacy is protected and staff understand and meet their needs. Residents feel safe and well cared for. Complaints are managed properly and residents said they are confident their concerns are listened to and taken seriously. The home provides a good range of social and recreational activities, including regular excursions. Medicines prescribed by doctors are safely stored and carefully administered to residents by staff thereby protecting residents from risks of medicine errors. Residents wishing to do so may store and administer their own prescribed medicines. The Old Rectory D55 S26853 Old Rectory V233447 180705 Stage 4.doc Version 1.30 Page 6 The home employs enough staff to meet the needs of residents and to ensure their safety and comfort. Recruitment practices ensure the protection of residents from potentially unsuitable staff. 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 Rectory D55 S26853 Old Rectory V233447 180705 Stage 4.doc Version 1.30 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 Rectory D55 S26853 Old Rectory V233447 180705 Stage 4.doc Version 1.30 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, 4, 5 & 6 Standard 6 does not apply: The home does not provide intermediate care. When a new resident moves into the home they are provided with a statement of terms and conditions to ensure they know the fees and what they do and do not cover. Prior to admission, the needs of each proposed resident are assessed to ensure the home will be properly able to meet them and the home then writes to the prospective resident confirming the ability to properly care for them. Prospective residents (or their representatives) are encouraged to visit The Old Rectory in advance of admission to establish their impressions of life at the home and the available accommodation. EVIDENCE: The records of a recently admitted resident were examined and included a contract stating statement of terms and conditions of occupancy and details of pre-admission assessment, carried out by the manager when she visited the person at their private address. .A close relative had previously visited The Old Rectory and viewed the available room. The Old Rectory D55 S26853 Old Rectory V233447 180705 Stage 4.doc Version 1.30 Page 9 Another recently admitted resident said that she had visited the home in advance of admission and had chosen the room in which she is now accommodated. Following pre-admission assessment, if the home decides to offer a place to a new resident, they write to the person stating that The Old Rectory will be able to meet their assessed needs, thereby reassuring them that their needs are understood and will be properly met. The Old Rectory D55 S26853 Old Rectory V233447 180705 Stage 4.doc Version 1.30 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 standard(s) 7, 8, 9 & 10 The standard of health, personal and social care is good and is delivered in accordance with a written plan of care, to ensure staff have information necessary to provide correct care to each resident. Doctors and nurses visit the home to carry out specific actions for individual residents, ensuring their health care needs are met. Residents receive prescribed medicines at the correct times and in correct amounts thereby protecting residents from medicine errors. Residents wishing to do so can manage their own medicines. Residents said they are treated with respect and their privacy and dignity is protected at all times. EVIDENCE: All residents with whom the inspector spoke said they felt very well cared for and safe. Staff to whom the inspector spoke were aware of each residents health and social care needs. Although the home does not provide nursing care, The Old Rectory D55 S26853 Old Rectory V233447 180705 Stage 4.doc Version 1.30 Page 11 community nurses may visit to carry out particular tasks (e.g. wound dressing) for residents. Risk assessments form the basis for care plans and daily records describe the care of each resident. The care plan for a resident receiving wound care from visiting nurses did not include the essential details although they were described in the daily records; it is recommended that this information is written in the care plan to ensure it remains comprehensive and fully up to date. Residents wishing to do so can manage their own prescribed medicines in accordance with risk assessment, although most prefer this to be done by the staff. Residents said that staff give them the correct medicines, at the correct times. Medicine records were accurate and medicines were properly stored. Staff involved in handling medicines have received related training. Since the last inspection medicine records have been greatly improved and are now satisfactory. The Old Rectory D55 S26853 Old Rectory V233447 180705 Stage 4.doc Version 1.30 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 standard(s) 12, 13, 14 & 15 The quality of daily life in the home is good with residents assisted to maintain as much independence as possible. Social and leisure activities are varied and suited to the preference and ability of each resident. Residents are encouraged to maintain contact with the local community and visits by their friends and relatives are welcomed by the home. Meals are appetising and of good quantity and quality. Most residents take meals in the dining rooms, some receive them in their bedrooms. EVIDENCE: The inspector spoke to a number of residents; all expressed satisfaction with the home, including the range of activities, meal provision, staff and premises. An Activities Organiser working during each weekday afternoon coordinates social and leisure activities. During the morning of inspection a quiz took place in the main lounge; many residents participated and enjoyed the event. An excursion is arranged to take place later in the week, for 10 residents accompanied by 4 staff. The Old Rectory D55 S26853 Old Rectory V233447 180705 Stage 4.doc Version 1.30 Page 13 Visitors are welcome at any time and residents can go out of the home whenever they wish, and for as long as they wish. During the inspection a number of residents were coming and going from the home, to local shops, for short walks etc. Residents said they can choose what time they rise and go to bed, and where they spend their time – in the home or in the community. Residents select meals in advance, from a planned menu. The inspector observed the serving of lunch; all residents said that food is of high standard, for quality, choice and quantity. The home has recently conducted a survey on food provision, results were audited during June and will be used to inform menu planning, to ensure that the preferences of residents are continually met. The Old Rectory D55 S26853 Old Rectory V233447 180705 Stage 4.doc Version 1.30 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 standard(s) 16 & 18 Complaints are managed properly and residents said they are confident their concerns are listened to and taken seriously. The home protects residents from harm and abuse. EVIDENCE: No complaints against the home have been received or investigated since the last inspection. Residents are confident that any comments or complaints they make will be properly managed, one said “They take notice if we say anything” and in particular a number indicated that they have a good relationship with Registered Provider Mr Wagner, who takes appropriate actions to improve any shortcomings they may identify. For example, one resident said that on the morning of the visit she had informed Mr Wagner of a noise in her bathroom, possibly to do with the plumbing, and she was confident that “something will happen” to remedy it. The home has policies and procedures for the protection of residents from abuse or neglect. The Old Rectory D55 S26853 Old Rectory V233447 180705 Stage 4.doc Version 1.30 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 standard(s) 19, 20, 22, 23, 24, 25 & 26. The home is attractive, comfortable and well maintained and has been assessed by an Occupational Therapist to ensure it is suitable to meet the various needs of residents. A call system is installed in all resident’s bedrooms and bathrooms enabling them to summon prompt assistance as required. Resident’s bedrooms are suitably decorated and furnished; many residents have brought items of their own furniture and a number have private telephones installed, thereby enabling them to conduct private conversations and maintain contact with persons outside the home. Bedroom doors are fitted with locks of approved type enabling residents to key-lock their bedroom doors for privacy, when they temporarily leave the room. There are pleasant communal use rooms – three lounges and a separate dining room and well maintained gardens, mainly to the rear of the home. The Old Rectory D55 S26853 Old Rectory V233447 180705 Stage 4.doc Version 1.30 Page 16 EVIDENCE: On the ground floor are two lounges and a dining room. On the top floor is another small lounge. These rooms are suitably decorated and appropriately furnished and the home has a comfortable and relaxed atmosphere throughout. An occupational therapist has assessed the premises and in her report states they are suited to the needs of the residents. A call system is installed in all resident’s bedrooms and bathrooms enabling them to summon prompt assistance as required. Residents are confident of receiving a prompt response to calls they make, one said that staff come “in no time at all, (saying) What is it? Have you fallen? Have you hurt yourself? Oh yes, they come”. Since the last inspection bedroom doors have been fitted with locks of appropriate type, for which the residents can hold a key. Resident’s bedrooms contain a variety of personal belongings; many residents provide items of their own furniture. An inventory of each resident’s personal possessions is recorded. The Old Rectory D55 S26853 Old Rectory V233447 180705 Stage 4.doc Version 1.30 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 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 The home employs enough staff to meet the needs of residents and to ensure their safety and comfort. Recruitment practices ensure the protection of residents from potentially unsuitable staff. EVIDENCE: Staffing levels are provided in accordance with the assessed needs of residents. The inspector spoke to a number of staff, including senior care staff, care workers and household staff. Without exception all expressed support of management and all aspects of the home, indicating good team working, provision of good care and encouragement for training. The records of a recently employed staff member were examined and found to contain the necessary information including references, CRB disclosure and evidence of personal identity. All new staff undergo induction training, in accordance with TOPSS standards to ensure they are familiar with and will carry out safe working practices. The Old Rectory D55 S26853 Old Rectory V233447 180705 Stage 4.doc Version 1.30 Page 18 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, 32, 33, 36 & 38. Staff have good leadership – from the registered provider, head of care and senior care staff. Residents are satisfied with the home and feel staff care for them well and put them at their ease. Residents and their visitors are involved in decisions about their care, and their general impressions of the home are sought as part of the home’s quality assurance processes, designed to ensure that residents remain satisfied with all aspects of the home. . The premises and equipment are properly maintained in a safe condition, to ensure residents, staff and visitors are protected from harm and injury. Staff are properly supported and supervised, to ensure they provide suitable care of appropriate standard to all residents. The Old Rectory D55 S26853 Old Rectory V233447 180705 Stage 4.doc Version 1.30 Page 19 EVIDENCE: Mr Wagner has been the registered manager of The Old Rectory since October 2003, he is supported by a Head of Care who is nearing completion of training for NVQ4 in management in care, and a senior care worker who possesses NVQ4 in care. Residents indicated they are very satisfied with The Old Rectory; they said they feel safe and well cared for. Comments included “It suits me very well”. A quality assurance process is frequently used to assess the resident’s satisfaction with the home; during June 2005 the results of a survey into food satisfaction were collated. At all times there are staff on duty in the home trained in First Aid and with knowledge of how to deal with accidents and health emergencies. All staff receive regular formal supervision and each has a personal profile containing records of annual appraisal. Records of tests and checks of fire safety equipment show that these essential items are maintained in safe working condition. Staff receive regular fire safety training. A Health & Safety assessment of the premises and working practices has been recorded and the inspector was shown written evidence of safety of the gas equipment and installation and of the water supply. The Old Rectory D55 S26853 Old Rectory V233447 180705 Stage 4.doc Version 1.30 Page 20 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 3 3 3 3 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 3 3 x 3 3 3 3 3 STAFFING Standard No Score 27 3 28 x 29 3 30 x MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x 3 3 3 3 x x 3 x 3 The Old Rectory D55 S26853 Old Rectory V233447 180705 Stage 4.doc Version 1.30 Page 21 NO 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 7 Good Practice Recommendations The care plan should include details of wound care, even when this care is provided by visiting nurses. 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