Inspection on 23/07/08 for The Old Rectory

This inspection was carried out on 23rd July 2008.

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 11/09/06

The Old Rectory 15/10/05

The Old Rectory 20/06/05

The Old Rectory 25/01/05

The Old Rectory 09/08/04

Similar services:

The Shelley

Springfield House

Sutton Lodge Nursing Home

St Helier`s Residential Hotel

St Joseph`s

Ridgemount

Wingham Court

Old Hastings House

Extracts from inspection reports are licensed from CQC, this page was updated on 28/09/2008.

CARE HOMES FOR OLDER PEOPLE The Old Rectory Lanfranc Gardens Harbledown Canterbury Kent CT2 8NJ Lead Inspector Kim Rogers Unannounced Inspection 23rd July 2008 10:00 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 DS0000023608.V367765.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 DS0000023608.V367765.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service The Old Rectory Address Lanfranc Gardens Harbledown Canterbury Kent CT2 8NJ 01227 768004 01227 471159 rectory-home@yahoo.co.uk 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) Mr Jaykant Bhovanbhai Jobanputra Care Home 20 Category(ies) of Old age, not falling within any other category registration, with number (20) of places The Old Rectory DS0000023608.V367765.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 11th September 2006 Brief Description of the Service: The Old Rectory is a large detached building situated near the centre of Canterbury in the village of Harbledown. It is registered to provide accommodation and personal care support for up to twenty residents. Most of the bedrooms have en-suite toilets. All bedrooms have a call-bell and the majority have telephone points. Communal space includes a dining room, two lounges and a heated conservatory. There is ample parking space to the front of the building. There is a large well-maintained lawn to the front of the building with mature trees and shrubs. Garden seats are available at various vantage points for residents to use in fine weather. There is close access to the A2 with links to London and the home is close to Canterbury city centre with all of its amenities. Information about the home is made available to prospective residents on request. Current fees are from £337.24 to £620.00 per week. For more information about the fees and services please contact the Provider. The Old Rectory DS0000023608.V367765.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced visit formed part of the key inspection for the home. The visit took about 5 hours when the inspector spoke to service users, staff and the deputy manager, had a look around the home and sampled records. Information was gathered before the visit including surveying staff and service users to gain their views about the home. The Annual Quality Assurance Assessment (AQAA) was completed by staff as required. This gives information about what the home does well, what could be better and how they intend to improve. The requirement made at the last inspection has been met. There were no requirements made following his visit. Service users said that staff are kind and that they feel safe and well looked after. Service users spoken to and surveyed said they have no complaints but if they did they know who to complain to and have confidence that complaints would be addressed. Service users said the food is good and that the home is always clean and smells fresh. One person said the food ‘is marvellous’ The quality rating for this service is 2 star. This means people who use the service experience good outcomes. What the service does well: The staff team are longstanding so they are experienced and know each other and service users well. The home is clean and smells fresh. Furniture and fittings are of a good quality, which enhances service users lives, making the Old Rectory a nice place to live and work. The garden is accessible and attractive. Vegetables have been planted that some service users are helping to tend. There are good systems in place to monitor service user’s health and well being. This means that staff are proactive rather than reactive to changes in peoples’ needs. Special diets are catered for, one person said the food is ‘marvellous’ The cook was preparing fresh vegetables and choices to the main dish and dessert are offered. The Old Rectory DS0000023608.V367765.R01.S.doc Version 5.2 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 summary of this inspection report can be made available in other formats on request. The Old Rectory DS0000023608.V367765.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 DS0000023608.V367765.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 3 (standard 6 is not applicable to this home) People who use the service experience good outcomes. Service users know that their needs will be assessed before they move in so the staff know the home can meet their needs. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The deputy manager said that assessments are carried out of a person’s needs before they move in. This is done so that they can be sure the home can meet the person’s needs. Assessments were seen in some service user plans sampled. The assessments cover a wide range of needs and lead to the development of the person’s service user plan. We found that service users and their families are involved in the assessment and care planning process. Some assessments from care management and health authorities were also seen. This means that the staff have a good holistic picture of a person’s needs. The Old Rectory DS0000023608.V367765.R01.S.doc Version 5.2 Page 9 Information about the home and services is given to prospective residents. Visits are arranged to suit people before they decide to move in. We found that all residents are issued with a contract detailing the terms and conditions of their stay. The contract gives information about the fee and what is included. The Old Rectory DS0000023608.V367765.R01.S.doc Version 5.2 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,9 and 10 People who use the service experience good outcomes. Service users know that their needs and preferences will be recoded and supported. Medication practice is safe which protects service users and staff respect people’s privacy and dignity. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The care planning system is in the process of being reviewed and improved. Care plans were sampled and we found that people’s needs are very clearly recorded with action by staff to meet those needs. Care plans are easy to read and have detailed information so staff know how people prefer to be supported. Health, personal care and social needs are included with good detail even down to what brand of toiletries people prefer to use. We found that health needs are well supported with good monitoring in place so staff are proactive with health needs rather than reactive. Everyone is The Old Rectory DS0000023608.V367765.R01.S.doc Version 5.2 Page 11 registered with his or her choice of GP and links with community health teams is good. Risk assessments are in place where needed. Risks are assessed and recorded then steps taken to reduce potential risks to people. We found that monthly reviews of care plans are carried out and recorded in detail. This shows that the review is effective with any changes, improvements, increased risks being considered, noted and then steps taken to adjust the support needed. This means that changing needs or increased risks can be identified quickly and supported. Some people need support with moving and handling. We found that although risk assessments are in place more detailed guidelines are needed to ensure that people are moved and handled safely protecting them and staff. The deputy manager agreed to do this. Staff write daily records which are detailed showing any care and support given/offered. This ensures that staff on different shifts are aware of any concerns or issues so aiding the continuity of care. Aspects of medication practice were sampled and we found that medication storage and administration is safe. People are supported to control their own medication if they wish. Service users said that staff are polite and respectful of their privacy and dignity. Service users said staff are kind. Staff were observed knocking on doors before entering. Service users can see visitors in the privacy of their bedrooms or in a choice of communal lounges. The Old Rectory DS0000023608.V367765.R01.S.doc Version 5.2 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,14 and 15 People who use the service experience good outcomes. A range of activities is on offer including community-based activities. Service users have support to keep in touch with family and friends and to exercise control over their lives. The food is nutritious and well balanced. This judgement has been made using available evidence including a visit to this service. EVIDENCE: A range of activities is offered with a notice displayed for people to see. An extra member of staff comes in on Wednesday afternoons to support activities. Service users spoken to and surveyed said they are happy with the activities on offer. On the day of the inspection some people were taking a trip to Herne Bay by car with staff. We found that people access the community and have support to keep in touch with family and friends. One person said they go out shopping twice a week with a friend and one person had gone out to lunch. Service users said their families visit and some service users have phones in their rooms to keep in touch with people. Some people go out to church and others take Communion at the home. The Old Rectory DS0000023608.V367765.R01.S.doc Version 5.2 Page 13 Choices of activities are offered as well as choices of meals. The menu is displayed and staff asked service users individually about their choices and preferences. Service users said the food is good with alternatives being offered and special diets catered for. Fresh vegetables with roast lamb was served on the day of the inspection. There are two cooks who prepare the lunchtime meals and tea. Hot and cold drinks are available throughout the day. The lunchtime was observed and was relaxed and quiet with service users given the time they need to enjoy their meal. The Old Rectory DS0000023608.V367765.R01.S.doc Version 5.2 Page 14 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18 People who use the service experience good outcomes. Service users know that their complaints will be listened to and acted on. Service users are protected from harm and abuse. This judgement has been made using available evidence including a visit to this service. EVIDENCE: There is a complaints procedure displayed in the home. This is also given to service users in the welcome pack when they move in. Service users said they are aware of how to complain and would be confidant that their complaints would be listened to and acted on. There is a book with a record of all complaints and action taken to address the complaints. We found that service users are confidant to make complaints and that action is taken and recorded. Service users surveyed and spoken to said they have no complaints about the home. Since the last inspection the home made an alert to adult protection at social services. This followed suspicions about financial irregularities involving a previous manager. An investigation followed with the home fully cooperating and assisting and following correct procedures. This investigation has been closed for some time. Service users were kept informed and since then The Old Rectory DS0000023608.V367765.R01.S.doc Version 5.2 Page 15 systems have been improved and strengthened to prevent it from happening again. Staff attend training in safeguarding vulnerable adults and cover this subject as part of their National Vocational Qualifications. (NVQ) Service users said they feel safe and well cared for. The Old Rectory DS0000023608.V367765.R01.S.doc Version 5.2 Page 16 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 19 and 26 People who use the service experience good outcomes. Service users lives are enhanced by a clean, safe, well-maintained home. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The inspector made a tour of most parts of the building and found that the building is well maintained. The garden is kept tidy and accessible to residents, allowing them to enjoy sunshine and fresh air when they wish. Some vegetables have been planted that service users are tending to. There are two lounge areas and a separate dining area as well as a conservatory, which can be used all the year round. The décor and furnishings make the place feel comfortable and look pleasant. The home employs a cleaner and maintenance man. We found that the home is clean and hygienic and smells fresh. Service users confirmed that the home is always clean. The Old Rectory DS0000023608.V367765.R01.S.doc Version 5.2 Page 17 All bedrooms are for single occupancy and most have en suite facilities. Bedrooms are personalised making it feel more like home. The Old Rectory DS0000023608.V367765.R01.S.doc Version 5.2 Page 18 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 27,28,29 and 30 People who use the service experience good outcomes. There are sufficient trained staff to meet service users’ needs. Recruitment checks are robust which protects service users This judgement has been made using available evidence including a visit to this service. EVIDENCE: Staff work early and late shifts with two waking care staff on duty at night. There are three care staff on duty during the day with a manager on duty 7 days a week. Domestic, maintenance and administrative staff are also employed. There are no current staff vacancies and the home does not use agency staff. We found that there are sufficient staff to meet service users’ needs. New staff complete an induction that is in line with the Minimum Standard. Training is provided by way of a range of external providers. There is a training matrix showing what training has been attended. The administrator uses this to see when updates are required and books the training accordingly. More than 50 of staff have a NVQ and most of the staff have worked at the home for some time so know each other and service users well. The Old Rectory DS0000023608.V367765.R01.S.doc Version 5.2 Page 19 Staff files were sampled and we found that robust recruitment checks are carried out before a person starts in post. This protects service users. Service users meet potential staff and then give their views and opinions. Service users said that staff are kind and helpful. Staff were observed talking to service users respectfully and staff spoke with knowledge of service users’ needs. The Old Rectory DS0000023608.V367765.R01.S.doc Version 5.2 Page 20 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31,33,35 and 38 People who use the service experience good outcomes. The home is well managed and run in service users’ best interests. Service users finances are safeguarded and their health and safety protected. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Since the last inspection the manager has left the home and there have been two temporary managers. The deputy is now the acting manager; she previously managed the home for two years and has been at the home for fourteen years. An administrator, the Registered Provider and senior staff support her. The Old Rectory DS0000023608.V367765.R01.S.doc Version 5.2 Page 21 The Registered Provider makes weekly visits to the home and carries out audits and checks protecting service users. A new manager has been recruited and is due to start at the home in August this year. Although there has been some inconsistency with appointed managers, the deputy has enabled stable management and continuity for service users and staff. There is a quality assurance system in place. We found that service users and stakeholders’ views are sought by way of regular questionnaires. Any issues raised are addressed and recorded. Results of the quality assurance system are not yet formalised or published so service users do not know the results and outcomes. The administrator and deputy agreed to look into this and try to improve it. The AQAA showed that health and safety checks are carried out as required. A range of health and safety records was sampled including the servicing of the fire equipment, hoists and lift. All are in order. The maintenance man carries out regular checks of equipment including the call bell system and fire alarm. Staff attend training relating to areas of health and safety including safe moving and handling and first aid. As mentioned since the last inspection and following an adult protection investigation systems to protect service users’ finances have been strengthened. Records were sampled, showing regular checks by the provider. Audits trails are clear with receipts and entries countersigned and witnessed by a second member of staff. The Old Rectory DS0000023608.V367765.R01.S.doc Version 5.2 Page 22 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 3 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 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X X X X X 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X X 3 The Old Rectory DS0000023608.V367765.R01.S.doc Version 5.2 Page 23 Are there any outstanding requirements from the last inspection? No 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. 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. Refer to Standard Good Practice Recommendations The Old Rectory DS0000023608.V367765.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Maidstone Office The Oast Hermitage Court Hermitage Lane Maidstone ME16 9NT National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 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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