Inspection on 07/10/05 for The Old Rectory

This inspection was carried out on 7th October 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 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 24/05/07

The Old Rectory 14/06/06

The Old Rectory 07/07/05

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 Lincs PE22 8AY Lead Inspector Jean Cope Unannounced Inspection 7th October 2005 09:30 X10029.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 DS0000002460.V255521.R01.S.doc Version 5.0 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 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 DS0000002460.V255521.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service The Old Rectory Address Main Road Stickney Lincs PE22 8AY 01205 480511 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 Richard Atterby Mrs Christine A Atterby Mr Richard Atterby Care Home 44 Category(ies) of Mental disorder, excluding learning disability or registration, with number dementia (1), Old age, not falling within any of places other category (44), Physical disability (16) The Old Rectory DS0000002460.V255521.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. 4. 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. 7th July 2005 Date of last inspection 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 65 years. The home does not provide nursing care and is run very much as a family run business. The Old Rectory DS0000002460.V255521.R01.S.doc Version 5.0 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 six 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. The main method of inspection used was called ‘case tracking’ which involved selecting three residents 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? Activities in the home have been developed with the activities co-ordinator engaging most residents at some point in the week. Staff also become involved in the activities, which one resident said made it more fun. The manager and senior care staff have a developed a new system of recording care plans and residents’ individual choices and preferences. Most of the previous requirements left on the last inspection have been met. The Old Rectory DS0000002460.V255521.R01.S.doc Version 5.0 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 DS0000002460.V255521.R01.S.doc Version 5.0 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 Outcomes 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 DS0000002460.V255521.R01.S.doc Version 5.0 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 the following standard(s): 1, 2, 3 and 5 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 home has a statement of purpose and service users’ guide, which is available for new residents and their relatives. A visitor confirmed that they had been able to look around the home and had received written information and a copy of terms and conditions for their relative. The Old Rectory DS0000002460.V255521.R01.S.doc Version 5.0 Page 9 The manager or senior staff members assess new residents prior to them moving into the home. The Old Rectory DS0000002460.V255521.R01.S.doc Version 5.0 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 the following standard(s): 7, 8, 9, 10 and 11 Care plans provide an accurate record of residents personal preferences and choices and how they need to be cared for, and all staff members must be fully acquainted with these plans to ensure the best care is delivered. EVIDENCE: The manager and senior staff have developed a new system of recording care plans. They are in the process of changing over all care plans to the new system. Some residents have also been involved in developing their care plan. One new member of staff interviewed said that she had not seen residents’ The Old Rectory DS0000002460.V255521.R01.S.doc Version 5.0 Page 11 care plans, but was advised by staff at handovers how to care for individual residents. A running record of events is kept separately. There was evidence that specialist nursing teams are involved when necessary with residents and one resident had visited the opticians for an eye appointment. A visiting GP and community nurse felt that the home communicated with them well and sought advice appropriately. There was evidence that staff recorded the dietary and fluid intake of frail residents at risk. Some medication had not been written up on a medication record sheet, staff were advised to write this up immediately. Medication administration sheets were seen to be handwritten and not checked by a second person, which potentially leaves room for error. Residents are provided with facilities to look after their own medication. The visiting community nurse said that she had observed residents’ privacy and dignity being respected and staff gave a good account of how important this was. The nursing team provide specialist aids and adaptations to relieve pressure care. The district nurse said that the staff in the home were ‘caring very well for a resident who is in the later stages of life’. The Old Rectory DS0000002460.V255521.R01.S.doc Version 5.0 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 assistance 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 the following standard(s): 12, 13, 14 and 15 Residents are able to choose from a range of activities to occupy them and can expect their visitors to be made welcome. The home provides home cooked food with a choice of menus. EVIDENCE: The manager has appointed an activities co-ordinator to work 35 hours in the week. The home is now able to offer a variety of activities organised daily and includes games, crafts, visits to the church coffee morning, trips out to local sites of interest and shopping trips into Boston. Some residents attend a ‘keep active’ club at a local club, followed by lunch. Residents enjoy monthly pub The Old Rectory DS0000002460.V255521.R01.S.doc Version 5.0 Page 13 lunches and live entertainment is provided every three weeks. The activities co-ordinator also spends time with individual residents talking with them. A communion service is held in the home once a month, and there is regular contact with the church, which is just next door. Visitors are encouraged in the home, with one relative explaining that they visited on a twice daily basis, but that their relative also visits them at home and uses a local community bus. The menu offers a choice of two meals each day, but the cook will provide an alternative if a resident doesn’t like what is on the menu. Most of the fresh produce is purchased locally and all the cakes are home made. The Old Rectory DS0000002460.V255521.R01.S.doc Version 5.0 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 the following standard(s): 16 and 18 Residents and their relatives can be assured that the manager and staff will take complaints seriously. EVIDENCE: The home has received no complaints since the last inspection. A visiting relative said that they had no complaints and was clear about the action to take if they did. Staff in the home have received training on adult protection, but newer members of staff had not been provided with training in the home, although this is briefly mentioned in National Vocational Qualifications. The Old Rectory DS0000002460.V255521.R01.S.doc Version 5.0 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 the following standard(s): 19, 20, 21, 22, 24 and 26 The home is clean, comfortable and homely, but some areas need to be redecorated, particularly in the older part of the building. EVIDENCE: The manager is developing and improving the home on an ongoing basis. The new extension provides ensuite shower and toilet facilities. The manager said that the home has four shower rooms, disabled toilet facilities and four bathrooms. The Old Rectory DS0000002460.V255521.R01.S.doc Version 5.0 Page 16 There are several communal rooms for residents to choose from and the home provides a smoking lounge. There are areas in the home, such as the upstairs corridor, the smoking lounge and some of the bathrooms, which need to be decorated and refurbished. The manager said that this work has been planned. The home was clean and odour free. A range of aids and adaptations are provided for those residents who need them. Residents are encouraged to bring their own small items of furniture and belongings with them Since the home has now increased the number of residents accommodated in the home with a physical disability, more disabled car parking is required and solid paths need to be laid for ease of wheelchair access and use. The Old Rectory DS0000002460.V255521.R01.S.doc Version 5.0 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, 28, 29 and 30 (Older People) and Standards 32, 34 and 35 (Adults 18-65) the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 29 and 30 The home has a stable workforce with plenty of trained staff on duty to provide consistent care for residents living in the home. EVIDENCE: The home is staffed by the manager; assistant manager and senior care staff. Both of the senior carers have National Vocational Level 3 in first line management. The manager has already achieved 50 of his care staff achieving National Vocational Level 2 in care. During the day, there can be up to 10 care staff on duty, three on during the night with a reduction of staff to seven carers at the weekend. The home also employs a full time cook, housekeeping and laundry staff and a handyperson. The district nurse commented ‘I’m pleased with the care, the residents are well looked after’. The Old Rectory DS0000002460.V255521.R01.S.doc Version 5.0 Page 18 Staff receive induction training in the home and undertake a one day induction course on caring at the local college. A staff member said ‘it was really good training’. Staff are recruited safely. The Old Rectory DS0000002460.V255521.R01.S.doc Version 5.0 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 policies 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 31, 33, 35 and 38 (Older People) and Standards 37, 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 the following standard(s): 31, 32, 33, 35 and 38. Resident’s benefit from living in a home, which is managed by a qualified manager. EVIDENCE: The Old Rectory DS0000002460.V255521.R01.S.doc Version 5.0 Page 20 The manager is registered and has successfully completed the Registered Managers Award at National Vocational Level 4 and is also a National Vocational Qualification Assessor. Regular staff meetings are held where suggestions are made to improve the service in the home. A staff member said of the manager, ‘he is a good boss and is willing to listen to us’. Fire training was undertaken in April 2005. There are four staff in the home who are trained first aiders and the manager is trained to teach moving and handling techniques in the home. The Old Rectory DS0000002460.V255521.R01.S.doc Version 5.0 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 X 5 3 6 X HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 2 10 3 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 4 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 2 ENVIRONMENT Standard No Score 19 2 20 2 21 3 22 3 23 3 24 3 25 X 26 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No Score 31 3 32 3 33 2 34 X 35 3 36 X 37 X 38 2 The Old Rectory DS0000002460.V255521.R01.S.doc Version 5.0 Page 22 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 YA11 Regulation 16(m) Requirement 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. This remains outstanding from the inspection on 7.07.05. 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 12.08.04 . A record should be kept of all medications administered on an medication administration sheet. Training must be provided to all staff to ensure that residents are protected from harm or abuse. Areas of the home need to be decorated. Cark parking facilities need to be extended and solid pathways DS0000002460.V255521.R01.S.doc Timescale for action 30/10/05 2 YA39YA30 24(1) 30/10/05 3 4 5 6 OP9 OP18 OP20OP19 OP19 13(2) 13(6) 23(2)(b) 23(2)(b) 07/10/05 31/03/06 31/03/06 31/03/06 The Old Rectory Version 5.0 Page 23 provided in the parking area for wheelchair users. 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 OP9 Good Practice Recommendations It is recommended that the manager seek the home’s pharmacist’s assistance in preparing computerised medication administration sheets. If they are handwritten it is advisable that they are checked by another person to ensure that they are accurate. The Old Rectory DS0000002460.V255521.R01.S.doc Version 5.0 Page 24 Commission for Social Care Inspection Lincoln Area Office Unity House, The Point Weaver Road Off Whisby 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 DS0000002460.V255521.R01.S.doc Version 5.0 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. 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