Inspection on 07/07/05 for The Old Rectory

This inspection was carried out on 7th July 2005.

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

The inspector 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 24/05/07

The Old Rectory 14/06/06

The Old Rectory 07/10/05

The Old Rectory 18/11/04

The Old Rectory 12/08/04

The Old Rectory 09/02/04

The Old Rectory 11/12/03

The Old Rectory 30/10/02

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

CARE HOME MIXED CATEGORY MAJORITY OLDER PEOPLE The Old Rectory Main Road Stickney Lincolnshire PE22 8AY Lead Inspector Jean Cope Unannounced 7 July 2005 09.45 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 and Care Homes for Adults 18 – 65*. 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 C53 C04 S2460 The Old Rectory Stickney V238052 070705 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service The Old Rectory Address Main Road Stickney Lincolnshire PE22 8AY 01205 480511 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) Mr Richard Atterby Mr Richard Atterby Care Home 44 Category(ies) of Mental Disorder (MD) -1 registration, with number Old Age (OP) - 44 of places Physical Disability (PD) - 16 The Old Rectory C53 C04 S2460 The Old Rectory Stickney V238052 070705 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: Service users within the category of Physical Disability (PD) between the ages of 25 and 64 years can be accomodated. Service Users within the category of PD may be accommodated in rooms 2, 3, 4, 5, 7, 8, 9, 14, 21, 22 and 23 only on the ground floor. Service Users within the category of PD may be accommodated in rooms 3, 4, 5, 6, 21, 24, 25, 26 and 27 on the first floor. The total number of service users accommodated in the home will not exceed 44. Date of last inspection 18.11.04 Brief Description of the Service: The Old Rectory is a large, 18th century country house with three additional purpose-built wings set in it own grounds in the village of Stickney, which is approximately 8 miles from the market town of Boston. The home is next to the village church and a short walk from the pub and shop. There are landscaped gardens to the front of the house with a car park to the front and the side of the building.The home is privately owned by Mr. and Mrs. Atterby and managed by Mr. Atterby. It is registered to provide personal care for up to 44 residents, older people, one having a defined mental health disorder and up to sixteen having a defined physical disability between the ages of 25 years and 65years. The home does not provide nursing care and is run very much as a family run business. The Old Rectory C53 C04 S2460 The Old Rectory Stickney V238052 070705 Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. One inspector undertook this unannounced inspection with the assistance of the manager of the home, Richard Atterby, over a three hour period. The inspector toured the building, talked with residents in the home and spoke with the manager, health professionals and one member of staff. This inspection took place following concerns raised by health professionals that the home was unable to meet the needs of one specific resident who had specialised needs. The main method of inspection used was called ‘case tracking’ which involved selecting one resident and tracking the care that they receive through the checking of their records, discussion with them, the care staff and observation of care practices. What the service does well: What has improved since the last inspection? Since the last inspection a new extension has been built on to the home providing en-suite (walk in shower and toilet) facilities in seven new rooms on two floors, with a small lounge with facilities to make a drink and microwave a meal. The unit has also had a passenger lift installed which also links the unit to the main body of the home, improving facilities for older people residing in the home who may choose to use the lift instead of the chair lift. Additional care staff have been employed as well as an activities co-ordinator. The Old Rectory C53 C04 S2460 The Old Rectory Stickney V238052 070705 Stage 4.doc Version 1.40 Page 6 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 C53 C04 S2460 The Old Rectory Stickney V238052 070705 Stage 4.doc Version 1.40 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home Health and Personal Care Daily Life and Social Activities Complaints and Protection Environment Staffing Management and Administration Scoring of Standards Statutory Requirements Identified During the Inspection Older People (Standards 1–6) (Standards 7-11) (Standards 12-15) (Standards 16-18) (Standards 19-26) (Standards 27-30) (Standards 31-38) Adults 18 – 65 (Standards 1–5) (Standards 6, 9, 16 and 18–21) (Standards 7, 15 and 17) (Standards 22–23) (Standards 24–30) (Standards 31–35) (Standards 8, 10 and 37–43) The Old Rectory C53 C04 S2460 The Old Rectory Stickney V238052 070705 Stage 4.doc Version 1.40 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 (Older People) and Standards 1 – 5 (Adults 18 – 65) are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. (YA NMS 1) Each service user has a written contract/ statement of terms and conditions with the home. Each Service User has an individual contract or statement of terms and conditions with the home. (YA NMS 5) No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Prospective Service Users’ individual aspirations and needs are assessed. (YA NMS 2) Service users and their representatives know that the home they enter will meet their needs. Prospective Service Users know that the home they choose will meet their needs and aspirations. (YA NMS 3) Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Prospective service users have an opportunity to “test drive” the home. (YA NMS 4) Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. 6. The Commission considers Standards 3 and 6 (Older People) and Standard 2 (Adults 18-65) 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 and 4 Written information is provided for new residents and their families for them to be able to make an informed choice about the home, with the manager or senior staff assessing new residents to ensure that the home is able to meet their needs. EVIDENCE: The manager has recently reviewed and updated the home’s statement of purpose to include the addition of a new purpose built wing to accommodate younger residents with a physical disability. The home’s service user guide and statement of purpose was sent to a new resident whilst he was in hospital so that they were able to make a choice about the home. The manager and a member of staff visited the hospital to assess this prospective resident and to be trained in his specialist care needs. The Old Rectory C53 C04 S2460 The Old Rectory Stickney V238052 070705 Stage 4.doc Version 1.40 Page 9 A copy of terms and conditions sent from Social Services to the manager was seen on a resident’s file, which indicated how much the fees were. Through discussion with health care professionals prior to, and during the inspection, it became evident that the home was unable to meet the very specialised needs of this resident. The manager agreed with this, and an immediate requirement notice was left requiring an urgent social work/multi disciplinary review. The Old Rectory C53 C04 S2460 The Old Rectory Stickney V238052 070705 Stage 4.doc Version 1.40 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 (Older People) and Standards 6, 9, 16, 18 –21 (Adults 18-65) are: 7. The service user’s health, personal and social care needs are set out in an individual plan of care. Service Users know their assessed and changing needs and personal goals are reflected in their individual plan. (YA NMS 6) Also Service Users are supported to take risks as part of an independent lifestyle. (YA NMS 9) Service users’ health care needs are fully met. Service Users physical and emotional health needs are met. (YA NMS 19) 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, retain, administer and control their own medication where appropriate and are protected by the home’s policies and procedures for dealing with medicine. (YA NMS 20) Service users feel they are treated with respect and their right to privacy is upheld. Service Users rights are respected and responsibilities recognised in their daily lives. (YA NMS 16) Also Service Users receive personal support in the way they prefer and require. (YA NMS 18) Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The ageing, illness and death of a Service User are handled with respect and as the individual would wish. (YA NMS 21) 8. 9. 10. 11. The Commission considers standards 7, 8, 9 and 10 (Older People) and Standards 6, 9, 16, 18, 19 and 20 (Adults 18-65) are the key standards to be inspected at least once during a 12 month period JUDGEMENT – we looked at outcomes for standard(s) 7 and 8 Residents can be assured that their health needs will be taken seriously and attended to, but the manager must develop and maintain care plans to ensure that staff know how to care for individual residents. EVIDENCE: A resident did not have a care plan, which had been devised by the manager for staff to follow in the home. A care plan was given by hospital staff to the manager for this resident to follow in the care home, however, there were necessary changes to this which were not recorded on his file which had not been updated. The Old Rectory C53 C04 S2460 The Old Rectory Stickney V238052 070705 Stage 4.doc Version 1.40 Page 11 The resident had been offered temporary registration with a GP and was visited on a regular basis by the community nursing team. The team had left instructions about how to record how much the resident was drinking and how and when they were turned in bed to prevent pressure damage to their skin. An immediate requirement notice was left to ensure that the resident was turned as instructed by the community nursing team. The Old Rectory C53 C04 S2460 The Old Rectory Stickney V238052 070705 Stage 4.doc Version 1.40 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 (Older People) and Standards 7, 11– 15 and 17 (Adults 18-65) are: 12. 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 have opportunities for personal development. (YA NMS 11) Also Service Users are able to take part in age, peer and culturally appropriate activities. (YA NMS 12). Also Service users engage in appropriate leisure activities. (YA NMS 14) Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service Users are part of the local community. (YA NMS 13) Also Service Users have appropriate personal, family and sexual relationships. (YA NMS 15) Service users are helped to exercise choice and control over their lives. Service Users make decisions about their lives with asssistance as needed. (YA NMS 7) Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. Service Users are offered a healthy diet and enjoy their meals and mealtimes. (YA NMS 17) 13. 14. 15. The Commission considers standards 12, 13, 14 and 15 (Older People) and Standards 12, 13, 15 and 17 (Adults 18-65) the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12 and 15 Residents’ social and leisure needs are taken seriously and they are supported by the activities co-ordinator in joining in community activities. EVIDENCE: The home now employs an activities co-ordinator five afternoons a week and residents were enjoying attending Boston’s Festival of Music and Flowers, which had included a visit to the jazz festival and flower festival in the church. During the inspection residents were gathering to attend the coffee morning at the local church and later were going out for a drive and a short walk. The Old Rectory C53 C04 S2460 The Old Rectory Stickney V238052 070705 Stage 4.doc Version 1.40 Page 13 Residents said that they had enjoyed their midday meal and that food in the home was good. The Old Rectory C53 C04 S2460 The Old Rectory Stickney V238052 070705 Stage 4.doc Version 1.40 Page 14 Complaints and Protection The intended outcomes for Standards 16 – 18 (Older People) and Standards 22 – 23 (Adults 18-65) 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 feel their views are listened to and acted on. (YA NMS 22) Service users’ legal rights are protected. Service Users are protected from abuse, neglect and self-harm. (YA NMS 23) Service users are protected from abuse. Service Users are protected from abuse, neglect and self-harm. (YA NMS 23) The Commission considers standards 16 and 18 (Older People) and Standards 22 and 23 (Adults 18-65) the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) EVIDENCE: These outcomes were not inspected. The Old Rectory C53 C04 S2460 The Old Rectory Stickney V238052 070705 Stage 4.doc Version 1.40 Page 15 Environment The intended outcomes for Standards 19 – 26 (Older People) and Standards 24 – 30 (Adults 18-65) are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service Users live in a homely, comfortable and safe environment. (YA NMS 24) Service users have access to safe and comfortable indoor and outdoor communal facilities. Shared spaces complement and supplement service users’ individual rooms. (YA NMS 28) Service users have sufficient and suitable lavatories and washing facilities. Service Users toilets and bathrooms provide sufficient privacy and meet their individual needs. (YA NMS 27) Service users have the specialist equipment they require to maximise their independence. (YA NMS 29) Service users’ own rooms suit their needs. Service Users’ own rooms suit their needs and lifestyles. (YA NMS 25) Service users live in safe, comfortable bedrooms with their own possessions around them. Service users’ bedrooms promote their independence. (YA NMS 26) Service users live in safe, comfortable surroundings. Service Users live in a homely, comfortable and safe environment. (YA NMS 24) The home is clean, pleasant and hygienic. The home is clean and hygienic. (YA NMS 30) The Commission considers standards 19 and 26 (Older People) and Standards 24 and 30 (Adults 18-65) the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 19, 22, 24 and 26 Residents are encouraged to personalise their own rooms, making it a home from home. EVIDENCE: During a tour of the home, and the newly opened unit specifically to accommodate residents with a physical disability, the home was found to be clean, tidy and odour free. Residents are encouraged to bring in their own possessions and adjust the furniture in their rooms to suit their needs. The Old Rectory C53 C04 S2460 The Old Rectory Stickney V238052 070705 Stage 4.doc Version 1.40 Page 16 The manager had purchased a specialist bed for one resident, which health professionals later advised was too short for the resident and an electric wheelchair had been hired, but had now been returned. An ordinary push along wheelchair had been delivered to the home, but the manager was not clear about where it had come from and it was not suitable in maximising the resident’s independence. As the home is now registered to accommodate more residents with a physical disability, more disabled car parking must be considered. The Old Rectory C53 C04 S2460 The Old Rectory Stickney V238052 070705 Stage 4.doc Version 1.40 Page 17 Staffing The intended outcomes for Standards 27 – 30 (Older People) and Standards 31 – 35 (Adults 18-65) are: 27. 28. 29. Service users needs are met by the numbers and skill mix of staff. Service users are supported by an effective staff team. (YA NMS 33) Service users are in safe hands at all times. Service Users are supported by an effective staff team. (YA NMS 32) Service users are supported and protected by the home’s recruitment policy and practices. Service Users benefit from clarity of staff roles and responsibilities. (YA NMS 31) Also Service Users are supported and protected by the home’s recruitment policy and practices. (YA NMS 34) Staff are trained and competent to do their jobs. Service Users individual and joint needs are met by appropriately trained staff. (YA NMS 35) 30. The Commission considers standards 27, 29 and 30 (Older People) and Standards 34 and 35 (Adults 18-65) the key standards to be inspected at leat once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27 and 30 The manager is committed in ensuring that regular training sessions are offered to staff so that they are competent and skilled to provide appropriate care for residents. EVIDENCE: The home is staffed by a stable workforce, some of whom have been employed in the home for a number of years. The home is staffed throughout weekdays by the manager, supported by a senior member of staff; seven carers in the morning and four care staff in the afternoon. There are always two night care staff, but the manager is striving towards ensuring that there will be three staff on duty throughout the night. The manager also employs catering, housekeeping, laundry staff and a handyperson. The manager is committed in training his staff. Staff training had been planned for 10 care staff on health and safety and four staff for training in dementia care. Fifty percent of care staff working in the home have achieved The Old Rectory C53 C04 S2460 The Old Rectory Stickney V238052 070705 Stage 4.doc Version 1.40 Page 18 National Vocational Training Level 2, with another four members of staff commencing Level 2 training shortly. All new staff receive induction training. The Old Rectory C53 C04 S2460 The Old Rectory Stickney V238052 070705 Stage 4.doc Version 1.40 Page 19 Management and Administration The intended outcomes for Standards 31 – 38 (Older People) and Standards 8, 10, 23, 37 – 43 (Adults 18-65) are: 31. 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 a well run home. (YA NMS 37) Service users benefit from the ethos, leadership and management approach of the home. (YA NMS 38) The home is run in the best interests of service users. Service Users are consulted on and participate in, all aspects of life in the home. (YA NMS 8) Also Service Users are confident their views underpin all selfmonitoring, review and development by the home. (YA NMS 39) Service users are safeguarded by the accounting and financial procedures of the home. Service Users benefit from competent and accountable management of the service. (YA NMS 43) Service users’ financial interests are safeguarded. Service Users are protected from abuse, neglect and self-harm. (YA NMS 23) Staff are appropriately supervised. Service Users benefit from well supported and supervised staff. (YA NMS 36) Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. Service Users know that information about them is handled appropriately, and that their confidences are kept. (YA NMS 10) Also Service Users rights and best interests are safeguarded by the home’s polies and procedures. (YA NMS 40) and (YA NMS 41) The health, safety and welfare of service users and staff are promoted and protected. The health, safety and welfare of service users and staff are promoted and protected. (YA NMS 42) 32. 33. 34. 35. 36. 37. 38. The Commission considers standards 33, 35 and 38 (Older People) and Standards 23, 39 and 42 (Adults 18-65) the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) EVIDENCE: The Old Rectory C53 C04 S2460 The Old Rectory Stickney V238052 070705 Stage 4.doc Version 1.40 Page 20 These outcomes were not inspected. The Old Rectory C53 C04 S2460 The Old Rectory Stickney V238052 070705 Stage 4.doc Version 1.40 Page 21 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 3 2 3 3 3 4 2 5 x 6 N/A HEALTH AND PERSONAL CARE ENVIRONMENT Standard No 19 20 21 22 23 24 25 26 STAFFING Score 3 x x 2 x 3 x 3 Score Standard No 7 8 9 10 11 Score 2 2 x x x Standard No 27 28 29 30 3 x x 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 x 14 x 15 3 COMPLAINTS AND PROTECTION Standard No 16 17 18 Score x x x MANAGEMENT AND ADMINISTRATION Standard No Score 31 x 32 x 33 x 34 x 35 x 36 x 37 x 38 x The Old Rectory C53 C04 S2460 The Old Rectory Stickney V238052 070705 Stage 4.doc Version 1.40 Page 22 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 YA 2 Regulation 14(2)(a)( b) Requirement The registered person must ensure that assessment of the service users’ needs are kept under review and revised at any time having regard to any change of circumstances. Assessment documents must be complete and kept updated. This remains outstanding from the announced inspection of 12.08.04 The registered person must ensure that residents needs can be met in the home. This remains outstanding from the announced inspection of 12.08.04. The registered person must devise a care plan in consultation with the service user, or a representative and make the plan available to the service user. All care plans must be kept up to date and reviewed as recommended. This requirement remains outstanding from the announced inspection of 12.08.04 and has been made again on this inspection. Timescale for action 30.10.05 2. YA 3 12(1)(b) 30.10.05 3. YA 6 15(1)(2) 30.10.05 The Old Rectory C53 C04 S2460 The Old Rectory Stickney V238052 070705 Stage 4.doc Version 1.40 Page 23 4. YA9 13(4) 5. YA 11 16(m) 6. YA13 and YA 14 16(n) 7. YA29 23(n) 8. 3030YA39 24(1) The registered person must undertake risk assessments, when necessary, in relation to activities undertaken by service users living in the home. Areas particularly identified were in relation to service users who wish to leave the home unaccompanied. This remains outstanding from the announced inspection of 12.08.04 The registered person must ensure that service users have the opportunity to develop and learn and use practical life skills. These arrangements must be expanded and included in individual plans. The registered person must consult service users about the programme of activities arranged by the home including activities in relation to recreation, fitness and training. Personal preferences must be recorded and identified on their individual plans. This remains outstanding from the announced inspection of 12.08.04 The registered person must ensure that service users have suitable ewquipment to meet their needs and consults with appropriate health care professionals regarding wheelchairs and specialist beds. The registered person shall establish and maintain a system for reviewing and improving the quality of care provided in the home. A robust quality assurance system must be established. This remains outstanding from the announced inspection of 30.10.05 30.10.05 30.10.05 30.10.05 The Old Rectory C53 C04 S2460 The Old Rectory Stickney V238052 070705 Stage 4.doc Version 1.40 Page 24 12.08.04 . 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 Good Practice Recommendations The Old Rectory C53 C04 S2460 The Old Rectory Stickney V238052 070705 Stage 4.doc Version 1.40 Page 25 Commission for Social Care Inspection Unity House, The Point Weaver Road Lincoln LN6 3QN 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 C53 C04 S2460 The Old Rectory Stickney V238052 070705 Stage 4.doc Version 1.40 Page 26 - 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!