Inspection on 06/06/06 for The Old Rectory

This inspection was carried out on 6th June 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is (sorry - unknown). 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 13/12/05

The Old Rectory 18/07/05

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 Old Rectory (The) High Street Stalbridge Sturminster Newton Dorset DT10 2LL Lead Inspector Gloria Ashwell Key Unannounced Inspection 6th June 2006 11:00 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 Old Rectory (The) DS0000026853.V298811.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. Old Rectory (The) DS0000026853.V298811.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Old Rectory (The) Address High Street Stalbridge Sturminster Newton Dorset DT10 2LL 01963 362624 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) Mrs Grietje Wagner Mr Richard Wagner Mr Richard Wagner Care Home 28 Category(ies) of Old age, not falling within any other category registration, with number (28) of places Old Rectory (The) DS0000026853.V298811.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 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). One service user (details known to the Commission) may be accommodated in category MD(E). 13th December 2005 2. 3. Date of last inspection 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 flowerbeds 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 spaces close to the home. Fees are charged weekly and at present range between £350 and £550 per person. Old Rectory (The) DS0000026853.V298811.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was a statutory inspection required in accordance with the Care Standards Act 2000. Since the last inspection no formal complaints against the home have been received or investigated by the Commission. The inspection was unannounced. The inspector spoke to registered manager Mr Richard Wagner, care and household staff, 20 residents and the visiting relative of one resident. The inspector was assisted throughout the inspection by the Head of Care. The inspection process included observing staff interaction with residents and the carrying out of routine tasks. Additional information used to inform the inspection process included the Preinspection Questionnaire completed in advance of the inspection by the Head of Care and 33 comment responses completed and sent to the Commission by residents, health and social care professionals and the relatives of residents. During this inspection compliance with all key standards of the National Minimum Standards was assessed. What the service does well: People considering moving into The Old Rectory receive a full assessment and are provided with the opportunity to visit and spend time at the home to make sure it is able to meet their needs. 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, 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 their needs. Residents feel well cared for. Old Rectory (The) DS0000026853.V298811.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. Old Rectory (The) DS0000026853.V298811.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 Old Rectory (The) DS0000026853.V298811.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 3 (The home does not provide intermediate care so Standard 6 does not apply) Quality in this outcome area is good. This judgment has been made using available evidence including a visit to the service. Prospective residents (or their representatives) are provided with information about The Old Rectory and are encouraged to visit in advance of admission to establish their impressions of life at the home and the standard of available accommodation. Prior to admission, the needs of each proposed resident are assessed and the home then writes to prospective residents confirming the ability to properly care for them. EVIDENCE: The records of a recently admitted resident included details of pre-admission assessment which had been carried out by the Head of Care when she visited the prospective resident at her private address. In advance of admission the prospective resident and a close relative visited The Old Rectory to view the premises and meet the staff. Old Rectory (The) DS0000026853.V298811.R01.S.doc Version 5.2 Page 9 The resident confirmed satisfaction with the home stating “(The manager) and staff are without fault; the comfort of the residents comes first…nothing too much trouble and always cheerful and (with) time for a friendly chat”. New residents can be initially accommodated on a trial basis; a resident’s relative confirmed “mother spent two weeks as a temporary resident to check if she liked the home – she stayed”. Old Rectory (The) DS0000026853.V298811.R01.S.doc Version 5.2 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 & 10 Quality in this outcome area is good. This judgment has been made using available evidence including a visit to the service. The standard of care is good and in accordance with a written plan of care for each resident ensuring that staff have sufficient information upon which to base their care practice. Residents health needs are met and periodic audit of accidents is recorded to minimise risks of recurrence. Medicines prescribed by doctors are safely stored and carefully administered to residents by staff trained in this work, thereby protecting residents from medicine errors. Residents receive prescribed medicines at the correct times and in correct amounts. Residents wishing to do so can manage their own medicines. Residents are treated with respect and their privacy and dignity is protected at all times. Old Rectory (The) DS0000026853.V298811.R01.S.doc Version 5.2 Page 11 EVIDENCE: Residents believe they are properly cared for; comments made included “I am very happy here and would never want to move” and “I am very happy with the care my mother receives and the staff are always pleasant and helpful”. Care records of 4 residents were examined and contained risk assessments forming the basis for care plans and daily records describing the care of each resident. To ensure correct identification of residents records contain a recent photograph of each resident. Daily records are often minimal, failing to provide sufficient information on health circumstances (e.g. “was sick” without specifying the form of ill health, and if vomiting was involved, whether this was undigested food or other matter) and included many blank lines; to ensure the reliability of records it is required that all written records are clear and comprehensive and recommended that blank lines are not left because these could be written on at a later date, thereby undermining the necessarily contemporaneous aspect of the records (i.e. these records should be written as close as possible to the time of the event they describe, not at an unspecified later date). Records are kept of all accidents and periodic audit is used to identify any trends or aspects of risk, to ensure that these can be properly managed and thereby reduced. Medication administration records were properly kept indicating that residents receive prescribed medicines at the correct times and in correct amounts those wishing to do so can manage their own medicines in accord with a risk assessment process; two of the currently accommodated residents manage their own medicines. To further improve the medicine recording systems it is recommended that all handwritten instructions and signed and dated by the writer and countersigned by another staff member who has checked the instructions for accuracy. All medicine handling is carried out by staff trained in this work and since the last inspection arrangements for handling medicines have been greatly improved by provision of a good sized and well lit storage cupboard and a suitable trolley for the transportation of medicines to residents. The Commission has recently received a number of ‘comment responses’ from the relatives of residents including the observation “I am very happy with the care (my relative) receives; I visit frequently and feel she is fortunate to live in such a caring environment” and “I visit regularly but randomly and have never had cause for concern with (my relative’s) care”. Old Rectory (The) DS0000026853.V298811.R01.S.doc Version 5.2 Page 12 Residents expressed similar satisfaction and in the presence of staff appeared relaxed, confident and at ease; staff interactions with residents were of a friendly and considerate manner. Old Rectory (The) DS0000026853.V298811.R01.S.doc Version 5.2 Page 13 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 & 15 Quality in this outcome area is good. This judgment has been made using available evidence including a visit to the service. 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 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 large dining room on the ground floor; others receive them in their bedrooms. Old Rectory (The) DS0000026853.V298811.R01.S.doc Version 5.2 Page 14 EVIDENCE: The inspector spoke to a number of residents; all indicated satisfaction with the home, including the range of activities, meal provision, staff and premises. The home employs an Activities Organiser who arranges local excursions, visiting entertainers, one-to-one and small group social and recreational activities. For excursions the home has a minibus with facilities for the loading and transportation of residents in wheelchairs. It is recommended that to ensure the safety of passengers the designated drivers of the minibus receive associated training and work in association with a specific policy/procedure giving guidance on accompanying residents on excursions. Visitors are welcome at any time and in responses during the inspection and in writing responses made to the Commission in advance of the inspection confirmed they are always made to feel welcome and placed at ease by the staff; one stated “when I leave I never worry….all the care is fantastic, and the activities are very good”. During the serving of lunch in the dining room there was animated conversation between residents and evident enjoyment of their meal. Residents said they were very satisfied with the quality, choice and quantity of food provided; one resident said that ”we are very well fed here”. Old Rectory (The) DS0000026853.V298811.R01.S.doc Version 5.2 Page 15 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16 & 18 Quality in this outcome area is good. This judgment has been made using available evidence including a visit to the service. The complaints procedure provides information on the procedure to follow to persons wishing to make complaint and service users know how to complain. The home adheres to a policy/procedure for the prevention of abuse and staff receive training in this subject to ensure they remain vigilant to protect vulnerable residents from risks of abuse. EVIDENCE: Residents and other service users feel confident that if they had concerns or complaints they will be listened to and taken seriously. In written responses made to the Commission in advance of the inspection a resident stated, “no complaints at all but if I did, I would know who to tell”. The home keeps records of complaints received; no complaint against the home has been received or investigated since the previous inspection. The home has developed and implemented written policies and procedures for the protection of residents from abuse or neglect and provides staff with associated training; new staff receive training on this subject during their induction. Old Rectory (The) DS0000026853.V298811.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19 & 26 Quality in this outcome area is good. This judgment has been made using available evidence including a visit to the service. The Old Rectory is well-appointed and comfortable home. On the day of inspection the home was clean, pleasant and hygienic and there was evidence indicating that this is the usual standard of provision. EVIDENCE: The Old Rectory is a partly traditionally built house, and partly purpose built extension. It offers good sized bedrooms, bathrooms equipped for the use of persons requiring assistance and comfortable communal rooms. On the day of inspection the home was clean, tidy and comfortable throughout; there were no unpleasant odours. Old Rectory (The) DS0000026853.V298811.R01.S.doc Version 5.2 Page 17 In written responses made to the Commission in advance of the inspection there was evidence that this is the usual high standard; a resident’s relative described it as “a clean, well maintained home – all the domestic facilities are kept in good condition i.e. china, bed linen etc.”. Old Rectory (The) DS0000026853.V298811.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 & 30 Quality in this outcome area is good. This judgment has been made using available evidence including a visit to the service. The home employs enough staff to meet the needs of residents and to ensure their safety and comfort and the good condition of the premises. Recruitment practices ensure the protection of residents from potentially unsuitable staff. Staff receive appropriate training and are competent to carry out their jobs. EVIDENCE: Experienced care staff lead the care teams and staffing levels are provided in accordance with the assessed needs of residents to ensure that at all times sufficient staff are available to properly meet their needs. All staff spoken with during the inspection were enthusiastic about their work and felt that they provided a good standard of care to residents and are properly supported by the management and training provision. The records of two recently employed staff members were examined and found to contain all essential information including two written references, an interview assessment, health details, evidence of identity and of induction training. Criminal Records Bureau (CRB) disclosures are obtained for all staff Old Rectory (The) DS0000026853.V298811.R01.S.doc Version 5.2 Page 19 in advance of employment, including for persons who are not directly employed by the home, but who during their work come into contact with residents e.g. visiting hairdresser. There is an enthusiastic approach to staff training; topics arranged for the near future include First Aid, moving and handling, optical awareness, and understanding and preventing abuse. At present 63 of the care staff (including bank staff) currently employed by the home hold a National Vocational Qualification in care; the home thereby meets the standard for at least 50 of the care staff to hold an NVQ in care. Old Rectory (The) DS0000026853.V298811.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35 & 38 Quality in this outcome area is generally good although the home is at present without written policies/procedures to guide staff on a number of essential subjects. This judgment has been made using available evidence including a visit to the service. The home is well managed and staff understand their work and receive training appropriate to their needs. Residents and their representatives are satisfied with the home and feel staff care for them well and put them at their ease. The home has implemented a quality assurance system to ensure that residents remain satisfied with all aspects of the home. The home does not manage the finances of residents. The premises and equipment are properly maintained in good condition. Old Rectory (The) DS0000026853.V298811.R01.S.doc Version 5.2 Page 21 EVIDENCE: Although Mr Wagner remains in overall control of The Old Rectory and maintains a frequent presence in the home, since the previous inspection the Head of Care has been in day to day charge of the home as manager and her application to become the registered manager is currently being processed by the Commission. The home has ongoing systems for quality assurance; a satisfaction survey regarding meal provision was issued during November 2005 and further topics are planned for survey during coming months. In written responses made to the Commission in advance of the inspection a resident’s relative requested provision of a ‘suggestion box’; registered manager Mr Wagner informed the inspector that it is his intention to provide this facility. To ensure continuity of approach the home operates in accord with a selection of policy and procedure documents; it is recommended that at the earliest opportunity these are extended to include all those referred to by the Commission in the pre-inspection questionnaire, including the subjects of pressure relief, clinical procedures, communicable diseases and volunteers. With the exception of safe keeping some amounts of cash (for which all transactions are confirmed by receipt), the home does not manage the finances of residents. Staff trained in First Aid are on duty in the home at all times. All staff are supervised and each has a personal profile containing records of appraisal. Details of equipment servicing and maintenance were provided to the Commission in advance of this inspection. The inspector examined some records to verify this information including the following: - passenger lift: routine service 2 March 2006 - a certificate confirming the safety of the gas installation dated 30 March 2006 - records of regular checks/tests of fire safety equipment. Mr Wagner stated he is at present awaiting written certification confirming the safety of the electrical installation and will provide a copy to the Commission when this document is received by him. Old Rectory (The) DS0000026853.V298811.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 X X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 2 9 3 10 X 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 Old Rectory (The) DS0000026853.V298811.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. 1. Standard OP8 Regulation 17 Requirement All written records must be clear and comprehensive. Timescale for action 06/07/06 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. 2. 3. Refer to Standard OP8 OP9 OP12 Good Practice Recommendations Blank lines should not be left between daily record entries. All handwritten medicine instructions should be signed and dated by the writer and countersigned by another staff member who has checked the instructions for accuracy. To ensure the safety of passengers the designated drivers of the minibus should receive associated training and work in association with a specific policy/procedure giving guidance on accompanying residents on excursions. At the earliest opportunity written policies and procedures should be developed and implemented for all subjects referred to by the Commission in the pre-inspection questionnaire. 4. OP38 Old Rectory (The) DS0000026853.V298811.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Poole Office Unit 4 New Fields Business Park Stinsford Road Poole BH17 0NF 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 Old Rectory (The) DS0000026853.V298811.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. 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!