Inspection on 09/04/08 for The Old Rectory

This inspection was carried out on 9th April 2008.

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 29/10/07

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 Unannounced Inspection 9th April 2008 09:15 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.V361666.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.V361666.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.V361666.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. Within the maximum number of 10 registered places, there can be up to 10, OP and up to 1 PD(E) place. 29th October 2007 Date of last inspection 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 10 older people. 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.V361666.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 2 star. This means that people who use the service experience good quality outcomes. This inspection which the home did not know was going to take place included a site visit and was conducted over a period of 4 hours by two inspectors. Part of the time was spent looking at the information the home holds on residents (care plans) and other records that the home needs to keep to make sure the home is being properly run, such as staff files and staff training, any complaints that have been made and what the outcome were and the day to day running and management of the home. Prior to the inspection the home was sent an Annual Quality Assurance Assessment (AQAA) form for the manager to complete and return to us by a given date. The AQAA informs the inspector of how the home meets the National Minimum Standards (NMS), what the home does well at and in what areas they need to improve. To gather further information about the home comment cards were sent to resident, relatives and to staff. Five residents returned comment cards, one said, “Everything is satisfactory, I get the care and support I need. The staff are very nice, jolly and helpful”. Other residents indicated that they were satisfied with the care they receive, with the medical support available, the staff and with the meals served. Two staff comment cards informed the inspector that staff felt they were always provided with enough information about the people they care for and support, that full recruitment checks were carried out prior to commencing work at the home and that they receive staff training which is relevant to their role. There have been no complaints made to the manager of the home since the last inspection and no complaints have been made to the CSCI. What the service does well: The manager has sustained the improvements that were noted at the last inspection. The premises are clean and safe and the standard of the accommodation is satisfactory. The Old Rectory DS0000005756.V361666.R01.S.doc Version 5.2 Page 6 There have been few staff changes, so that residents are familiar with the people who are caring for them. Visitors are welcome at any time; there are no restrictions as to when people can visit the home. 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.V361666.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.V361666.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. Standard 6 does not apply, as the home does not offer an intermediate care service. 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 services provided that helps them in making a decision about moving in. 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 residents 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.V361666.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. Two 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 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 and a social worker had agreed and signed the contracts. The Old Rectory DS0000005756.V361666.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 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: Two 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. Records of appointments were available, these detailed visits from the optician, chiropodist, dentist, continence advisor, district nurse and the doctor. The Old Rectory DS0000005756.V361666.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. On the day of the inspection residents and staff were heard chatting about events in the daily newspapers and later they enjoyed a sing-along. 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 and the only gentleman living at the home was clean-shaven. 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 an appropriate manner, and offered a drink to help them swallow them. Medication was then recorded on the individual’s drug sheet. The records and tablets of the same two residents whose care plans we had looked at were checked and no discrepancies in medication were noted. The home had no controlled drugs being administered at the time of the inspection. In accordance with new legislation, any care home that has any controlled drugs must ensure that they are securely stored in a proper controlled drugs cabinet. The inspector recommended that the home purchase such a cupboard in case circumstances change and controlled drugs are on site. The Old Rectory DS0000005756.V361666.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 with a choice of meals available. EVIDENCE: A range of activities is planned to suit the capabilities and expectations of the residents. The activities plan is displayed in the foyer. Some residents prefer not to partake in the planned activities, as is their choice. All residents are now members of ring and ride so have transport at their disposal. The home receives regular visits from the clergy from different denominations who give sermon and Holy Communion to residents who wish to partake. The Old Rectory DS0000005756.V361666.R01.S.doc Version 5.2 Page 13 The home welcomes visitors at any time; there are no restrictions as to when people can visit. Resident can meet with their visitors in the lounge or dining room or in the privacy of their own room. During the inspection there were no visitors to the home for the inspectors to speak with. A social worker was visiting the home and told the inspectors that she was happy with what she had seen in the home and the approach of the staff. The manager encourages links with the local community, some ladies go out to the hairdressers, and they go out for lunch or dinner or a trip to the shops and have a coffee. A four week planned menu is available giving residents a choice of meals, preferences are also noted. The menus were displayed on each dining table. Currently most residents have breakfast in their rooms as is their choice. Some ladies come down to the dining room. Lunch is the main meal of the day, with two hot choices offered and dessert. Residents spoken with after lunch expressed their satisfaction of the quality and quantity of food served. A lighter afternoon tea is served; again choices are available. Suppers are available before residents retire, with hot and cold choices. A choice of hot and cold drinks and snacks was served during the day. The dining room is comfortable and offers a pleasant environment for residents to sit together and enjoy their meal. The tables were nicely set with suitably crockery and cutlery and condiments were on each table. The inspectors noted that over the tablecloths was a clear plastic cover, which tends to spoil the overall effect and it would better if these were removed. As there are only three dining tables, this would not create an awful lot more washing. The Old Rectory DS0000005756.V361666.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 satisfactory complaints procedure for logging a complaint or concern brought to the attention of the manager. There have been no complaints made to the manager of the home and no complaints have been brought to the attention of the CSCI. There had been no safeguarding incidents reported since the last inspection. All staff at the home had undertaken training in the protection of vulnerable adults. A copy of the local authorities vulnerable adults policy and procedure was available and kept in the office for staff to refer to if ever needed. The Old Rectory DS0000005756.V361666.R01.S.doc Version 5.2 Page 15 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. There are still some areas that require attention for example the paintwork in some rooms has been chipped off. The lounge furniture although clean is The Old Rectory DS0000005756.V361666.R01.S.doc Version 5.2 Page 16 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.V361666.R01.S.doc Version 5.2 Page 17 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. The home has robust recruitment procedures to ensure the safety and wellbeing of the residents living at the home. EVIDENCE: The staff rotas were available for inspection and there were an adequate number of staff on duty. The manager of the home is looking to recruit a deputy manager, care staff and a cook; currently the owner of the home does the majority of the cooking. There is one member of staff on waking night duty and one member of staff on sleep in duty. The manager confirmed to the inspectors that any staff on a sleep in that had had a disturbed night due to an occurrence in the night would not be expected to be on duty the morning after. The manager confirmed that arrangements were in place should this occur. Training for staff is ongoing and there was evidence in the staff files inspected of up to date training certificates. Other members of staff training certificates The Old Rectory DS0000005756.V361666.R01.S.doc Version 5.2 Page 18 were available for inspection. Training has included: risk assessments, tissue viability, continence, medication, food hygiene, moving and handling etc. The home has more than 50 of staff that have completed NVQ level 2 in care or above. A copy of each members of staff’s employment file is kept in the home. The file of the last most recently recruited employee was looked at and contained an application form, two written references, interview notes, terms and conditions of employment, staff induction and a POVA first check (awaiting full CRB check). A second staff file was inspected and was found to contain all the necessary information required. Staff undertakes a full induction programme on commencement of work. Evidence of this was seen in staff files. This is in line with the new programme as set of by Skills for Care. The Old Rectory DS0000005756.V361666.R01.S.doc Version 5.2 Page 19 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 and 38 were assessed. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The Old Rectory is run by a well-qualified and suitably experienced manager ensuring the health, safety and welfare of the residents living at the home. EVIDENCE: Since the last inspection the manager has sustained the improvements made within the home. The manager is a qualified nurse and has achieved the NVQ level 4 in care and also the registered managers award. The manager is committed to her own The Old Rectory DS0000005756.V361666.R01.S.doc Version 5.2 Page 20 training and that of her staff and sees it an important element to delivering a good standard of care. The paper work was readily available for inspection and was completed and up to date. There is a system in place of continuous self-monitoring of the home, which included feedback from other people who visit the home such as the district nurses. It was discussed with the manager, that to inform all interested parties the results of any surveys the home carries out are made available in a format that is easy to understand. The home holds regular staff and residents meetings; the minutes of these meetings were available for inspection. We asked about resident’s finances and if any personal allowances were held by the manager for safekeeping. Most of the resident’s families deal with their finances, however some money is held and was checked by the inspectors and no discrepancies noted. Equipment and systems used in the home are serviced and maintained, and records are well kept and easily accessible. The following checks have taken place and certificates were available to verify that: A new fire panel was fitted on 28/03/08 Gas 30/01/08 Lift serviced – 11/01/08 Fire system – 27/02/08 Hoists serviced – 06/08 Portable appliances serviced – 04/07. Any accidents, injuries and incidents were recorded properly and are reported to the CSCI as required. The Old Rectory DS0000005756.V361666.R01.S.doc Version 5.2 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 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 3 3 3 3 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 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 x 2 x 3 x 3 3 The Old Rectory DS0000005756.V361666.R01.S.doc Version 5.2 Page 22 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 OP8 Good Practice Recommendations The home would benefit from a proper set of scales, which can be calibrated to ensure the weight of the residents is correct and accurate. The Old Rectory DS0000005756.V361666.R01.S.doc Version 5.2 Page 23 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.V361666.R01.S.doc Version 5.2 Page 24 - 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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