Inspection on 24/05/05 for The Old Rectory

This inspection was carried out on 24th May 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

The Old Rectory 30/04/07

The Old Rectory 28/10/05

The Old Rectory 15/12/04

The Old Rectory 28/06/04

Similar services:

The Shelley

Thorndene

Springfield House

Sutton Lodge Nursing Home

St Helier`s Residential Hotel

St Joseph`s

Ridgemount

Wingham Court

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

CARE HOMES FOR OLDER PEOPLE The Old Rectory The Street Ewhurst Cranleigh Surrey. GU6 7PX Lead Inspector Miss Marianne Barham Announced 24 May 2005 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 H58 H09 s17630 The Old Rectory v218974 240505 Stage 4 ann.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service The Old Rectory Address The Street, Ewhurst, Cranleigh, Surrey. GU6 7PX 01483 267195 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) The Old Rectory (Ewhurst) Co. Ltd Mr Patrick Stuart Geoghegan CRH (N) 33 Category(ies) of Old age, not falling within any other category registration, with number (OP) 33. of places Physical Disability (PD) 33. Physical Disability over 65 years of age (PD(E)) 33. The Old Rectory H58 H09 s17630 The Old Rectory v218974 240505 Stage 4 ann.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: The age range may be: 28 to 64 years in the category PD (physical disability) and ove 65 years in the category OP. Provision for outpatient treatment, hydrotherapy and physiotherapy in a dedicated unit from the age of five (5) years upwards. Date of last inspection 15 December 2004 Brief Description of the Service: The Old Rectory is a large detached property that has been converted and extended into a comfortable, well equipped care home. The home is set within its own large well maintained gardens and is situated close to the village of Ewhurst within walking distance of local shops and amenities. The home provides accommodation and nursing care for up to 33 older people who may also have a physical disability. The home also has a hydrotherapy pool and fully equipped physiotherapy centre and provides a varied programme of therapeutic care and treatment for service users living in the home and to outpatients. Bedrooms are arranged over two floors, accessible by passenger lift or staircase. Most rooms are single, with a few double rooms, and all have ensuite facilities. Communal facilities in the home consist of a large, comfortably furnished lounge leading on to a sunny garden room, a large dining room, an activities area and a further, recently added lounge. All communal accommodation is located on the ground floor. The Old Rectory H58 H09 s17630 The Old Rectory v218974 240505 Stage 4 ann.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an announced inspection carried out at 10.30am by Marianne Barham, lead inspector for the service. The inspection took place over a period of four and one quarter hours and was the first inspection in the Commission for Social Care Inspection (CSCI) year April 2005 to March 2006. The registered manager Mr Patrick Geoghegan, the matron Ms Patricia Kesek, the acting administrator Mr Andrew Geoghegan and the training manager Ms Heidi Cox were all present on the day of the inspection. A tour of the premises was carried out, records relating to service users care and the management of the home were sampled, and a total of ten service users, two visitors and nine members of staff were spoken with during this inspection. There was a calm atmosphere in the home throughout the inspection and service users appeared to be relaxed and well cared for. What the service does well: Service users receive a high standard of nursing care in a comfortable, well furnished and maintained home. There are a wide variety of activities on offer, both in the home and in the local community that are appropriate to the age and needs of the service users. All service users and visitors to the home spoke positively about the care received and services and facilities available. The home is committed to providing a good standard of training to the staff team and employs a training manager for this purpose. The staff training programme is well thought out and reflects the needs of the service users in the home. Members of staff spoken with during this inspection spoke highly of the training and supervision they receive from the management team. Most staff members spoken with had been working at the home for a number of years and all enjoy working at the home. The Old Rectory H58 H09 s17630 The Old Rectory v218974 240505 Stage 4 ann.doc Version 1.30 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 Rectory H58 H09 s17630 The Old Rectory v218974 240505 Stage 4 ann.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 H58 H09 s17630 The Old Rectory v218974 240505 Stage 4 ann.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) 1, 2, 3, 5 and 6 Service users have a written contract stating terms and conditions and they and their families are able to visit prior to admission, however they do not have sufficient information to make an informed choice about where to live. All service users receive a full needs assessment prior to admission and those admitted for intermediate care are provided with the necessary treatment to promote their independence and return to their own home. EVIDENCE: The home has a comprehensive service users guide which gives the reader clear information about the services offered by the home. A requirement was made at the last inspection on 15th December 2004 that all service users were to be supplied with a copy of the guide. It was disappointing to observe that this had not been met and the requirement has subsequently been carried forward. All service users receive a written contract stating the terms and conditions of residence, this is sent out to prospective service users in an information pack and clearly states what is and is not included in the fees. The Old Rectory H58 H09 s17630 The Old Rectory v218974 240505 Stage 4 ann.doc Version 1.30 Page 9 Most service users are admitted to the home from hospital. The home has devised its own assessment package that takes account of all aspects of the service users needs from medical history to dying or discharge. The matron stated that a service user would not be admitted to the home unless she was sure that the home could meet their needs. The home encourages prospective service users and their families to visit the home prior to admission and they are able to do so as often as is necessary. The matron reported that often service users initially come into the home short term before moving in permanently. The home also admits service users for intermediate care, usually following knee or hip surgery for rehabilitation before going to their own home. The home has a hydrotherapy pool and fully equipped physiotherapy suite and employs three trained physiotherapists who carry out specialist treatments with service users. This facility is also accessed by outpatients referred by their consultants. The Old Rectory H58 H09 s17630 The Old Rectory v218974 240505 Stage 4 ann.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, 10 and 11 Each service user has their own plan of care, they are treated with respect by the staff team and in the event of their death, they can be sure that they and their families will be supported sensitively by the home. EVIDENCE: Care plans are generated from the needs assessment. Those examined were found to be well written with clear guidelines and information for staff members to follow when carrying out service users care. A requirement was made at the last inspection that all care plans are signed by, the service user, or a representative. The manager and the matron stated that they had asked service users to do this, however they had declined to do so. There was no record on the plans to show this. A number of service users were asked about this matter with during the inspection and all confirmed that they were aware of their care plans but had no wish to sign them. The requirement has not been carried forward, but a recommendation has been made that the manager and matron continue to request that service users sign their plans and if they decline to make a note on their care plans to show this. The Old Rectory H58 H09 s17630 The Old Rectory v218974 240505 Stage 4 ann.doc Version 1.30 Page 11 Staff members were observed to relate to service users in a caring and respectful manner during this inspection and there was a relaxed and calm atmosphere throughout the home. The home has a comprehensive procedure in place on dying and death of service users. Staff members are made aware of this briefly at induction and then in more depth through the NVQ process. The home offers support to service users and their families when death is near, such as regular meetings and allowing families to stay at the home. Funeral arrangements and religious followings are documented in the service users care plan. The Old Rectory H58 H09 s17630 The Old Rectory v218974 240505 Stage 4 ann.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 and 13 Service users have a lifestyle at the home that reflects their individual needs and preferences, and they are supported to maintain contact with their family, friends and the local community. EVIDENCE: The home employs two activities coordinators who organise a wide range of activities both in the home and out, for service users to take part in. These activities may be carried out by themselves or by external entertainers. A newsletter is sent to every service user each month informing them of the coming months programme and also discussing activities carried out the previous month. Service users are supported to attend religious services if they wish and services are also held at the home. All service users spoken with stated that they enjoyed the entertainment and activities provided by the home. Service users may receive visitors any time between 08.00am and 20.00pm. Visitors do not have to make an appointment and are able to stay for meals if they wish. Service users access the local community for shopping trips, clubs and church services. The Old Rectory H58 H09 s17630 The Old Rectory v218974 240505 Stage 4 ann.doc Version 1.30 Page 13 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 17 Service users and their families can be sure that their complaints will be listened to and acted upon, and their legal rights are protected by the home. EVIDENCE: The home has a complaints procedure, a copy of which is contained in the service users guide. All service users spoken with were aware of their right to complain and knew who to complain to. Complaints are recorded along with any action taken. All service users are registered to vote and are supported to take part in the civic process if they wish. The Old Rectory H58 H09 s17630 The Old Rectory v218974 240505 Stage 4 ann.doc Version 1.30 Page 14 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, 24 and 26 The home is well maintained, clean and safe. Service users have comfortable bedrooms that are suitable for their needs and reflect their personal preferences. EVIDENCE: The home is clean, comfortably furnished and is well decorated and maintained both inside and out. The home employs maintenance staff and has programme for routine maintenance in place. Service users rooms are homely, very clean, have good quality furnishings and contain personal effects of the service users that reflect their interests and taste. All bedrooms have en-suite facilities. The Old Rectory H58 H09 s17630 The Old Rectory v218974 240505 Stage 4 ann.doc Version 1.30 Page 15 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27, 28 and 30 Service users safety is protected and their needs met, by a competent and trained staff team. EVIDENCE: The home has ten staff on duty during the morning and five in the afternoon, with two of these being registered nurses on each shift. There are four staff on duty at night, with one being a registered nurse. The home also employs domestic, catering and laundry staff. Nine members of staff at the home have NVQ level 2 in care or above and a further nine are working towards it. This is seventy-two percent of the total care staff and exceeds the National Minimum Standards (NMS). The home employs a training manager who is a registered nurse, NVQ assessor and verifier and has a post graduate certificate in education. She has devised an induction programme for the home, consisting of theory taught by herself and practice supervised by senior staff. There is also a full training programme for all staff covering mandatory courses, such as fire safety as well as specialist and developmental training such as wound care. Detailed records are maintained of all staff training and members of staff sign a training form to show they have attended. The registered manager and the training manager are to be commended for their commitment to staff training. The Old Rectory H58 H09 s17630 The Old Rectory v218974 240505 Stage 4 ann.doc Version 1.30 Page 16 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 32, 35 and 38 The management approach of the home benefits the service users and their financial interests are safeguarded. The home promotes and protects the health, safety and welfare of the service users. EVIDENCE: The registered manager is responsible for the business and administration side of the home and a matron is employed to be responsible for all care issues at the home. Both the manager and matron have an open door policy and make themselves available to speak with service users or members of staff as and when needed. The home is not involved in service users finances. All financial transactions are carried out by, the service user, or a representative. Any services not included in the fees are invoiced directly to the service user. The Old Rectory H58 H09 s17630 The Old Rectory v218974 240505 Stage 4 ann.doc Version 1.30 Page 17 At the last inspection on 15th December 2004, a requirement was made to replace the fireguard in the lounge with a larger one, it was pleasing to see that this has been done. The Old Rectory H58 H09 s17630 The Old Rectory v218974 240505 Stage 4 ann.doc Version 1.30 Page 18 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score 2 3 3 x 3 3 HEALTH AND PERSONAL CARE Standard No Score 7 3 8 x 9 x 10 3 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 x 15 x COMPLAINTS AND PROTECTION 3 x x x x 3 x 3 STAFFING Standard No Score 27 3 28 4 29 x 30 4 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 3 x x 3 x x 3 x x 3 The Old Rectory H58 H09 s17630 The Old Rectory v218974 240505 Stage 4 ann.doc Version 1.30 Page 19 YES Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard 1 Regulation 5 (2) Requirement The registered person must supply each service user living in the home with a copy of the homes service users guide. Timescale for action 24/06/05 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard 7 Good Practice Recommendations It is recommended as good practice that when a service user or their representative refuses to sign a care plan, that a record is made on the care plan to show that they have refused. The Old Rectory H58 H09 s17630 The Old Rectory v218974 240505 Stage 4 ann.doc Version 1.30 Page 20 Commission for Social Care Inspection The Wharf Abbey Mill Business Park Eashing Surrey GU7 2QN 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 H58 H09 s17630 The Old Rectory v218974 240505 Stage 4 ann.doc Version 1.30 Page 21 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!