Inspection on 29/10/07 for The Old Rectory

This inspection was carried out on 29th October 2007.

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 04/04/09

The Old Rectory 09/04/08

The Old Rectory 15/06/07

The Old Rectory 07/12/06

The Old Rectory 31/05/06

The Old Rectory 08/12/05

The Old Rectory 07/07/05

The Old Rectory 06/11/04

The Old Rectory 22/06/04

The Old Rectory 24/02/04

Similar services:

Chirnside House

Keer Sands Residential Home

Ruskin Lodge

Bushell House

Langrigg House

Parkside

Dystlegh Grange

Thornton 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 195 Wigan Road Standish Wigan Greater Manchester WN6 0AE Lead Inspector Judith Stanley 2nd Inspector Lucy Burgess Unannounced Inspection 29th October 2007 08:15 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 DS0000005756.V349030.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 DS0000005756.V349030.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service The Old Rectory Address 195 Wigan Road Standish Wigan Greater Manchester WN6 0AE 01257 421635 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 Megraj Jingree Mrs Premila Jingree Mrs Premila Jingree Care Home 10 Category(ies) of Old age, not falling within any other category registration, with number (10), Physical disability over 65 years of age (1) of places The Old Rectory DS0000005756.V349030.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. Within the maximum number of 10 registered places. Date of last inspection 15th June 2007 Brief Description of the Service: The Old Rectory is a large detached property in Standish. The home is situated on the main road to Wigan and Standish town centres and is approximately five minutes drive from local amenities. The home offers 8 single rooms on the first floor, of which 3 have en suite facilities and 1 shared room on the ground floor. Bathrooms and toilets are on the first floor and toilets are on the ground floor. There is limited parking at the front of the home and a small garden area at the rear. The Old Rectory Care Home provides care and support for up to 10 male and female residents over the age of 65 years. The current scale of fees per week ranges from £300.12 to £420.00 with a £15.00 a week top up charged incurred. Additional charges are made for hairdressing, newspapers, trips out, chiropody, alterative therapy and toiletries. The Old Rectory DS0000005756.V349030.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection included a site visit which the home did not know was going to take place and was conducted over a period of 6½ hours. Two inspectors carried out the inspection. This inspection was the second key inspection as the home had several requirements made at the last inspection of 15 June 2007. The owners were available to assist with the inspection. Part of the time was spent in the office looking at the paperwork that the home needs to keep about the care of the residents (care plans) and the running of the home. The inspectors spoke with staff and residents throughout the course of the day. Prior to the inspection the home was asked to complete an Annual Quality Assurance Assessment (AQAA) form. The AQAA provides the inspector with information about the home and how they think they meet the National Minimum Standards (NMS) and in what area they think they have improved and where improvement is still needed. To gather further information about the home and the care and services provided comment cards were sent to residents, relatives and staff. Five staff returned comment cards, one member of staff said, “We provide a home for residents who are very happy and live in a nice home. All their needs and wants are given, their well being is supported”. Another said, “ We offer a relaxed atmosphere with a good relationship between service users and staff”. Three relatives returned comment cards, these contained positive feedback, such as, “I find staff very helpful and caring” and “Excellent support, and they always communicate the situation”. There were no returned comment cards from residents. What the service does well: The premises are clean and safe and provide residents with a homely place in which to live. There have been few staff changes since the last inspection, so residents are looked after by people that they know and can trust. The home welcomes visitors at any time. As this is a small home, staff know the residents well, for example likes and dislikes, and how they wish to spend their day. The Old Rectory DS0000005756.V349030.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 DS0000005756.V349030.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 DS0000005756.V349030.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): 1,2 and 3 were assessed. Standard 6 does not apply at this home as an intermediate care service is not provided. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home provides residents and their supporters with up to date information about the home that helps them in making a decision about moving in to the home and the services provided. A full pre admission assessment is carried out prior to admission to ensure the home can meet the needs of the residents. EVIDENCE: The home has a statement of purpose and a service users guide. This is available to prospective resident and to residents already living at the home. The information is clear and concise and informs people of the services and facilities available. The Old Rectory DS0000005756.V349030.R01.S.doc Version 5.2 Page 9 The last CSCI inspection report is available in the foyer for anyone to read should they wish to do so. Three residents files were chosen for inspection. On examination files contained pre admission assessments. The assessment covers the residents well being, areas of risk, mobility, continence, personal care, nutritional status, medication, likes and dislikes etc. The home’s manager confirmed that all residents have a written contract/terms and conditions regardless of how their care is purchased and these have been all recently been reviewed. The contracts of the residents whose files had been chosen for inspection were looked at and were found to be in order. The resident’s next of kin had signed the contracts. The Old Rectory DS0000005756.V349030.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 were assessed. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The documentation in the care plans provides staff with the information they need to ensure the needs of the residents can be met. Personal support is offered in such a way as to promote and protect resident’s privacy and dignity. EVIDENCE: The three care plans chosen for inspection were examined. All the information is contained in a printed booklet, with space to add further comments and information. The information details residents personal details, social and medical history, up to date risk assessments for example moving and handling, nutrition, pressure care, weights or measurements if a resident is mainly bedfast, and in one file was a risk assessment for a resident who self administers their own medication. Records of appointments were available, these detailed visits from the optician, chiropodist, dentist, continence advisor, district nurse and the doctor. The Old Rectory DS0000005756.V349030.R01.S.doc Version 5.2 Page 11 A completed activity log in the files indicated resident’s preferences and how they like to spend their time, for example one to one chats, watching television and the enjoyable visit from the reflexologist. A record of the daily progress notes was up to date and kept in the files. A record of the food was available, however this appeared to have been copied verbatim from the printed menu. Whilst this indicates what food is offered it did not reflect the actual details of food each resident had eaten. The care plans had been updated monthly as required and any changes documented. Observation throughout the inspection showed that the personal care needs of the residents were being met. Attention was given to personal grooming and residents were seen to be clean and clothes were nicely washed and ironed and were coordinated. Ladies had had their done by the hairdresser. Staff were seen knocking on bedroom and toilet doors and waiting for a response before entering to ensure the residents privacy was maintained. The staff had a pleasant manner when speaking with residents and when assisting them. The home’s manager gave out the morning medication; this was done swiftly and efficiently. Residents were given their tablets in appropriate manner, and offered a drink to help them swallow them. Medication was then recorded on the individual’s drug sheet. The Old Rectory DS0000005756.V349030.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 were assessed. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents are offered a range of activities to meet their needs and expectations. Residents are provided with a well balanced diet and with a choice of meals available. EVIDENCE: It was evident through observation and during discussions with the residents that the range of activities had improved. A wide range of activities and trips out had been planned and the activity programme was displayed in the foyer. Residents confirmed that they had been to Blackpool and had enjoyed their day out. There were photographs displayed of a summer barbeque in the garden and family and friends had come along. On the day of the inspection a member of staff sat with residents in the lounge for some considerable time and they discussed the morning papers. Later after morning tea or coffee those residents who wanted to, moved into the dining room and enjoyed several games of dominoes. Some residents were having a sing-a-long session. The atmosphere in the home was very relaxed and comfortable. The Old Rectory DS0000005756.V349030.R01.S.doc Version 5.2 Page 13 Residents genuinely appeared to be having a good time. Some residents preferred not to join in the planned activities and spend time in their own room perusing their own interests. Resident’s spiritual and religious needs were being met with visits from the local clergy and with some residents attending church if they wish. Since the last inspection all residents are now registered with the Ring and Ride service, which the manager has confirmed they have used. This will allow residents more opportunity to get out and about maintaining links with the local community. Visitors are welcome to visit the home at any time; there are no restrictions as to when people can visit. Residents are free to meet with their visitors in the dining room or lounge area or in the privacy of their own rooms. The menus were available for inspection; each table in the dining room had a laminated copy of the menu on them. One inspector arrived at the home at breakfast time, apart from three residents who prefer to eat in the dining room all other residents had breakfast in their room, as is their choice. A choice of breakfast is available including porridge, cereals, toast and preserves and tea or coffee; a cooked breakfast is available on request. Lunch is the main meal of the day and residents were offered a choice of shepherds pie with carrots and broccoli or braised steak with creamed potatoes and vegetables, followed by sticky toffee pudding and custard or fresh fruit. The meal was hot, ample portions were served and the food was nicely presented. Meals that were taken upstairs to resident’s rooms was plated up and covered with a metal lid to maintain the temperature of the food. One resident when asked if she was enjoying her lunch said, “It’s beautiful”. Residents were offered juice with their meals and a hot drink is served later. A lighter afternoon tea is served and residents were being offered a choice of soup, boiled eggs and bread and butter, mousse, fresh fruit and cakes. Other alternatives are available. Hot and cold drinks were served throughout the course of the day. The dining room has been decorated and a new carpet fitted and new dining furniture had been purchased. The dining room was brighter and offered a congenial setting for residents to dine in. The tables were nicely set with placemats, coasters, condiments and china cups and saucers. Suppers are available before residents retire for the evening. The Old Rectory DS0000005756.V349030.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 were assessed. Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. Residents and their relatives can be assured that any complaints or concerns will be listened to, taken seriously and acted upon. EVIDENCE: The home has a complaints system in place. Any concerns or complaints are recorded and the outcomes documented. There has been one concern since the last inspection, this was over a residents misplaced watched, the watch was not lost but had been taken out of the home by a family member for some attention, the watch was returned to the resident. There have been no other concerns or complaints made either within the home or to the CSCI. There has been one incident when the manager has reported a member of staff to the protection of vulnerable adults (POVA) team due to fact that the member of staff was found to be using a residents mobile telephone for her own use. The manager acting correctly and took prompt action and the member of staff has now left the home. There have been no other POVA issues. The Old Rectory DS0000005756.V349030.R01.S.doc Version 5.2 Page 15 All staff had now undertaken training in POVA and certificates were available to verify this. The Old Rectory DS0000005756.V349030.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, 24 and 26 were assessed. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is clean and comfortable and provides residents with a homely place in which to live. EVIDENCE: From a tour of the premises, it was evident that several of the bedrooms had been decorated and new bedspreads and curtains had been bought. Resident’s rooms were clean, warm, tidy and comfortable and residents had personalised their rooms with their own mementoes brought with them from home. Some windows had been replaced and the communal areas had been decorated. There are still some areas that require attention for example the paintwork in some rooms has been chipped off. The lounge furniture although The Old Rectory DS0000005756.V349030.R01.S.doc Version 5.2 Page 17 clean is looking ‘tired’ and consideration should be given to include replacing this in the maintenance programme and budget. Bathrooms were clean and tidy and there was no evidence of communal toiletries. One bathroom has a hoist for assisted bathing; the other is a domestic bath with no adaptation. Domestic staff hours are covered by other care staff that are not counted as providing care at the same time as their domestic role. The home is clean and no odours were detected. The laundry is suitably equipped and is away from food preparation and food storage areas and does not intrude on the residents. Hygiene practices within the home are good and staff was seen wearing protective clothing for different tasks. The Old Rectory DS0000005756.V349030.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 were assessed. Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. Residents can be sure that their care needs can be met my staff who are trained and competent to carry out their role. EVIDENCE: There had been a noted improvement in the maintaining of the duty roster. The rosters were available for inspection and were much clearer in the designation of the staff and what role they were carrying out and when. The manager was asked to record staff cover if, in the event the member of night staff on a sleep in and had been disturbed in the night and was on duty the next day, that cover was readily available as the night sleep in may not be fit to work the next day. Domestic staff are not employed and the care staff and owners do the cooking and cleaning. This is at a separate time to providing care. The manager of the home confirmed that they were looking to recruit staff to undertake domestic tasks. The Old Rectory DS0000005756.V349030.R01.S.doc Version 5.2 Page 19 Several of the staff had worked at the home for a number of years which helps provided residents with consistent and reliable care by people they are familiar with. Staff training is progressing well and there was evidence in the staff files inspected that indicated staff had undertaken training in fire and health assessment, protection of vulnerable adults, basic food hygiene, continence and moving and handling. Information taken from the AQAA showed that over 50 of the staff had achieved NVQ level 2 and some have progressed onto level 3. A full copy of each members of staff’s employment file is kept in the home in a secure location. Two staff files were inspected and both contained, a CRB disclosure number, written application form, two references, medical questionnaire, a job description and other forms of identification. All new staff undertakes a full induction programme on commencement of work, evidence of the induction was available on the last persons file employed at the home. The Old Rectory DS0000005756.V349030.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): 31,33,35,36 and 38 were assessed. Quality in this outcome area is adequate This judgement has been made using available evidence including a visit to this service. There had been significant improvements in the running of the home to ensure that the home is being managed by a person who is fit to be in charge. EVIDENCE: Since the last inspection of 15 June 2007, significant improvements had been made and the requirements left at the last inspection had been addressed. The paper work required by regulation was organised and readily available. There are additional systems in place to check that everything is recorded when it should be and kept up to date. The Old Rectory DS0000005756.V349030.R01.S.doc Version 5.2 Page 21 The manager must sustain these improvements to demonstrate that the home is being consistently managed by a competent and skilled manager. There is a system in place of continuous self-monitoring on the home, which includes feedback from the district nurse, the hairdresser, the church, audiologist and therapists. Residents meetings had taken place and minutes were available; a resident chaired the meeting. The home has recently been inspected by RDB. RDB is an outside agency that visits the home, completes a report and awards the home a star rating and financial enhancement. RDB has no connection to CSCI. Generally the home does not hold money for residents; the families deal with money matters. There is a file in place with balance sheets ready to use. Currently only two residents use this system and receipts of transactions were kept. Staff supervision is progressing well and there was written supervision notes in the staff file. The maintenance file was available for inspection and a random sample of the certificates evidenced that the lift was serviced in July 07, hoists July 07, water testing September 07, electrics April 07. The gas certificate was overdue and the engineer was booked for 30 November 2007 and the manager was asked to forward a copy of the certificate to CSCI. The owner is attending a course in November 2007 for the testing of portable appliances; it was recommended that the homes machine used to do this testing be serviced to ensure it was working properly. At the last fire systems inspection it was documented on the report that the fire panel is in a ‘poor condition’ and needs to be replaced, the owners need to give priority to this report. The home’s accident file was available for inspection and accidents, injuries and incidents were suitably recorded and the CSCI had been informed as required. The Old Rectory DS0000005756.V349030.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 3 3 x x N/A 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 3 x 3 STAFFING Standard No Score 27 2 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 x 3 x 3 3 x 2 The Old Rectory DS0000005756.V349030.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. 1. Refer to Standard OP27 Good Practice Recommendations To ensure that there is cover readily available if the night staff on sleep in duty has a disturbed night and is not fit to cover the shift the next day. This should be recorded on the duty roster. The registered person is to ensure that the gas certificate is renewed and a copy is forwarded to the CSCI. (Booked for 30 November 2007). 2. OP38 The Old Rectory DS0000005756.V349030.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Manchester Local office 11th Floor West Point 501 Chester Road Manchester M16 9HU 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. Extracts may not be used or reproduced without the express permission of CSCI The Old Rectory DS0000005756.V349030.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. Re-publishing this information is in breach of the terms of use of that website. 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