Inspection on 11/05/06 for The Old Rectory Care Home

This inspection was carried out on 11th May 2006.

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 Care Home 04/05/07

The Old Rectory Care Home 11/11/05

The Old Rectory Care Home 21/06/05

The Old Rectory Care Home 28/01/05

The Old Rectory Care Home 15/09/04

Similar services:

Claremont House

Oak Ridge

Sun Court Nursing Home

Ashville House

Bilney Hall

Hill Barn

Mabbs Hall Nursing Home

Henrietta House

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

CARE HOMES FOR OLDER PEOPLE The Old Rectory Care Home Norwich Road Acle Norwich Norfolk NR13 3BX Lead Inspector Linda Wells Key Inspection 11th May 2006 09:30 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 Care Home DS0000061106.V295353.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 Care Home DS0000061106.V295353.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service The Old Rectory Care Home Address Norwich Road Acle Norwich Norfolk NR13 3BX 01493 751 322 01493 751 322 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) Pearlcare (Acle) Ltd John Mills-Darrington Care Home 34 Category(ies) of Old age, not falling within any other category registration, with number (34) of places The Old Rectory Care Home DS0000061106.V295353.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. Up to thirty-four (34) Older People of either sex, not falling into any other category, may be accommodated. 11th November 2005 Date of last inspection Brief Description of the Service: The Old Rectory is a period residence located in the small rural market town of Acle, mid way between Norwich and Great Yarmouth and close to the Norfolk Broads. There are shops, a weekly market, pubs and a church all within walking distance and there are bus and train services to Acle. The property has been purposefully adapted and extended to provide residential accommodation for up to 34 older people. There are 3 double and 28 single rooms and many have direct access into a well-planned garden. The double rooms and 24 of the single rooms have en suite facilities. The Old Rectory Care Home DS0000061106.V295353.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced, key inspection undertaken on the 11th May 2006 over seven hours and was carried out as part of a routine inspection plan. Prior to inspection thirteen comment cards were received from relative/visitors and two from health and social care professionals. All indicated they were satisfied with the overall care provided, four wrote “there is minimum time for staff to have one-to-one contact with residents” and a further four people wrote, “staff give my relative the best quality of care they can”. No comment cards were received from residents. On the day of inspection thirty-two residents were living at the home and were seen to be having a meal, sitting in the lounges or their bedroom listening to the radio, reading or watching television. The inspection took the form of a tour of the premises, individual discussion with five residents, two visitors, five staff members, the cook and the manager, group discussion with four residents, observation of three residents, examination of care plans, records, certificates and compliance of requirements and recommendations from the last inspection. What the service does well: What has improved since the last inspection? Residents have benefited from the home looking more attractive with the redecoration of the downstairs hallway and have been stimulated by the introduction of weekly reminiscence sessions. Staff members have completed training in the care of those with Dementia to ensure the needs of all residents are met. The Old Rectory Care Home DS0000061106.V295353.R01.S.doc Version 5.2 Page 6 What they could do better: Residents said that they were happy living at the home, felt included and safe and staff members said that the senior care team gave support. However, the following twelve requirements and two recommendations were made to further improve the experience of living and working at the home for residents and staff. • Prior to admission prospective residents must be given a copy of the homes Statement of Purpose and Service User Guide to ensure they are informed of the services and facilities provided. • The plans of care must be redesigned to clearly demonstrate the assessed health and social care needs of residents, their choices and to ensure their needs are known and their wishes carried out. • Risk assessments must be held on residents and stored in their plan of care. • Residents must have all of their current information held in their individual plan of care to ensure their information is confidential and stored correctly. • Resident meetings must occur to enable residents and staff members to discuss any changes to the home, facilities, problems and future plans. • A key-worker scheme must be in place to provide each resident with a member of staff that they can relate to and who will ensure that their needs, choices and rights are known and promoted. • Water proof seals must be placed around the worktop edges and joins in the kitchen to ensure the health and safety of residents is protected. • The bedroom carpet that has a hole in must be replaced to ensure the health and safety of the resident using the room. • The upstairs hall that is looking tired and worn must be redecorated to ensure this area of the home is more attractive. • The numbers of staff meetings held over the year must increase to ensure staff members meet regularly to discuss residents, changes to the home, problems and the quality of care provided. • The new owner must provide each staff member with a contract of employment to demonstrate agreement by the staff member on the conditions of their employment. • The Quality Assurance system provided must be further developed to include feedback and the views of residents, visitors/relatives, other professionals and staff to ensure that the opinions of everyone are sought on the standard of care and service provided at the home. • It is recommended that a record of the weight of each resident is held in their plan of care to assist in the monitoring of their health. • It is recommended that deep cleaning of the flooring in the bathrooms and bedrooms that have an odour takes places to ensure the health and safety of residents is protected and that the areas are pleasant for residents to use. The Old Rectory Care Home DS0000061106.V295353.R01.S.doc Version 5.2 Page 7 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 Care Home DS0000061106.V295353.R01.S.doc Version 5.2 Page 8 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 Care Home DS0000061106.V295353.R01.S.doc Version 5.2 Page 9 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): 1, 2, 3, 4, 5, (6 not applicable) The quality in this outcome area is adequate. This judgement has been made using the available evidence and including a visit to this service. The admission procedure and written information available is good and fully enables residents and staff to make a decision on whether the home will meet the needs of anyone wishing to live there. EVIDENCE: The homes Statement of Purpose, Service User Guide and Terms and Conditions contract were seen and found to contain relevant information. The manager said that prior to admission as much information as possible was collected from a prospective resident, their family and other professionals. He said residents, their family or friends sometimes visited the home, that he or a senior care assistant often visited residents in their own home and that residents were admitted on a one-month trial basis. One resident spoken to who had lived at the home for three weeks said that he had visited the home prior to admission and that staff had made him feel welcome and assisted him to settle in. He said that he had not received any written information about the home until he was admitted. A requirement was The Old Rectory Care Home DS0000061106.V295353.R01.S.doc Version 5.2 Page 10 made that a written copy of the Statement of Purpose and Service User Guide be given to every prospective resident prior to their admission to ensure they had the information they needed to aid in their decision to live at the home. The Old Rectory Care Home DS0000061106.V295353.R01.S.doc Version 5.2 Page 11 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, 11 The quality in this outcome area is adequate. This judgement has been made using the available evidence and including a visit to this service. The health, social and personal care needs of residents were met, they were well cared for but the records held were not complete or all fully up to date. EVIDENCE: Residents said they were well looked after and four individual plans of care were examined and found to have improved and to contain relevant health, social and personal care information, moving and handling assessment, monthly reviews and visiting professionals. They did not contain risk assessments or weight records and a photograph of each resident and the daily records were held in a separate place to each other and the care plans resulting in the information held on each resident being stored in such a way that it was difficult to gain a clear picture of each resident and their full needs. Three requirements and one recommendation were made that all information held on a resident be held in their individual plan of care, that the plan of care sets out in detail the action that staff must take to ensure the comprehensive health, personal and social care assessment of need of each resident is met and that risk assessments and weight records be held for each resident in their plan of care. The Old Rectory Care Home DS0000061106.V295353.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14, 15 The quality in this outcome area is adequate. This judgement has been made using the available evidence and including a visit to this service. The social and creative activities and meals provide some daily variation and interest for those living at the home. EVIDENCE: Residents spoken to said that they enjoyed some of the activities provided such as bingo, church services and reminiscence and all said, “there are some activities and entertainment here ”. Staff said that it was often difficult to stimulate residents and although planned activities had taken place only a minority of residents showed an interest. The manager said that there was not a key worker scheme in place and a requirement was made that each resident have access to a key worker to ensure residents have a staff member to relate to and to ensure that their needs, choices and rights are known, protected and promoted. Residents spoken to said that staff were friendly, gave them every chance to make a choice in their daily lives and that staff made their relatives and visitors welcome when they visited the home. Two residents said “you can do as you wish here” and staff said that residents were encouraged to take part in the things they were interested in and to maintain contact with the community by going on outings and attending clubs such as the Friendly Circle Freethorpe. The Old Rectory Care Home DS0000061106.V295353.R01.S.doc Version 5.2 Page 13 The main meal and menus were seen and were well presented, balanced and varied. Records were held and showed that residents were given a choice and an alternative offered. The Old Rectory Care Home DS0000061106.V295353.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 inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16, 17, 18 The quality in this outcome area is good. This judgement has been made using the available evidence and including a visit to this service. The home has an active procedure on the protection of vulnerable adults that protects residents and supports the investigation of any cause for concern. EVIDENCE: One complaint had been received by the home since the last inspection and the records showed that it was dealt with in the correct manner, fully investigated and resolved. The residents spoken to all agreed that if they had reason to complain they would speak to staff or the manager and all felt confident that the problem would be resolved quickly and to the satisfaction of all involved. The legal rights of residents are protected and records demonstrated that some residents have advocates and are encouraged to take part in the local and national elections by voting. Residents are protected from abuse, neglect and self-harm by the objectives, policies and procedures of the home and records showed that staff had undertaken training in Adult Abuse to help them recognise, prevent and deal with any potential abuse. The Old Rectory Care Home DS0000061106.V295353.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 21, 22, 23, 25, 26 The quality in this outcome area is adequate. This judgement has been made using the available evidence and including a visit to this service. The standard of the environment within this home is mainly good providing residents with an attractive, safe and homely place to live. EVIDENCE: A tour of the building revealed that residents benefit from a home that is spacious and decorated and furnished to a good standard in most areas. Three requirements were made that the upstairs hallway that is tired and worn looking in places be redecorated, that the bedroom carpet that has a hole in it be replaced and that waterproof seals be fixed around the joins of the worktop under the kitchen hatch to protect the health and safety of residents. A recommendation was also made, that the flooring in a bathroom and bedroom be deep cleaned or replaced to remove the odour, protected the health and safety of residents and make the areas more pleasant for residents and visitors. The Old Rectory Care Home DS0000061106.V295353.R01.S.doc Version 5.2 Page 16 Residents said that they lived in a home that was comfortable and that the home was clean and tidy. This was found during the tour of the building and residents were seen to have personalised their bedrooms. Most residents had the use of en-suite facilities and all had the use of communal bathrooms, showers and toilets on each floor that had been adapted to suit the needs of residents. Residents and staff were seen to have access to specialist equipment that was provided throughout the home to assist in the promotion of independence for residents. Infection control measures were seen to be in place, a sluice room was provided and the laundry room contained two service washing machines and two tumble dryers to protect the health and safety of residents and staff. The Old Rectory Care Home DS0000061106.V295353.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29, 30 The quality in this outcome area is adequate. This judgement has been made using the available evidence and including a visit to this service. The needs of residents are met, staff members are competent and trained and the procedure for the recruitment of staff provides safeguards to offer protection for the people living in the home. EVIDENCE: Residents said that they were well cared for and the staff spoken to said that there were enough staff on duty to meet the needs of each resident if all shifts were covered in times of sickness and annual leave. Records demonstrated that staff members had a mix of experience and skills and that twelve care staff had completed NVQ2 and two care staff members NVQ3. The certificates held showed that an induction, foundation and updated training programs were undertaken by all staff to enable them to gain the knowledge necessary for the range of needs of residents living at the home. Records showed that an application form, references, medical form, job description, personal details, CRB checks, photograph and proof of identity were held for each staff member to ensure residents are protected. The new owner had not issued staff members with a new contract of employment and a requirement was made that each staff member be issued with a contract to demonstrate their agreement with the terms and conditions of their employment. The Old Rectory Care Home DS0000061106.V295353.R01.S.doc Version 5.2 Page 18 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, 32, 33, 34, 35, 36, 37, 38 The quality in this outcome area is adequate. This judgement has been made using the available evidence and including a visit to this service. The manager is supported by the senior staff in providing leadership, guidance and direction to staff to ensure that residents receive a good standard of care. EVIDENCE: The manager, who has been in post for three years, has completed the NVQ4 Registered Managers award and residents and staff said that he had an open approach that promoted communication and good standards of care. Residents spoken to said that they did not have the opportunity to attend resident meting and the manager said that he had stopped them. A requirement was made that resident meeting be held regularly to enable residents and their key worker to be consulted on any changes to the home, facilities, problems, their wishes and future plans. A further requirement was made that the numbers of staff meetings held over the year be increase to The Old Rectory Care Home DS0000061106.V295353.R01.S.doc Version 5.2 Page 19 ensure staff members meet regularly to discuss residents, changes to the home, problems and the quality of care provided. The staff members spoken to said that they were supported by the senior staff, the manager and handover and demonstrated that they were aware of their role and responsibilities. Records held showed that improvements had been made and that care, domestic and senior care staff were supervised and that a handover took place at the start of each shift. Records demonstrated that residents are protected by the management and administration procedures carried out in the home and that policies and procedures have been produced and were seen on all aspects of the home and service provided. The records held were found to promote and protect the rights and best interests of each service user. The manager successfully monitored identified financial budgets for the home and said that there was no reason to doubt that the financial security of the home was not sound. Residents were protected by the financial procedures carried out in the home and records demonstrated that the debits and credits of all money held for residents was held individually, was accurate and stored securely. A Quality Assurance system was seen to be in place and to have been carried out. Completed questionnaires were seen for relatives and visitors but none were held for residents, staff members and other professionals. A requirement was made that the quality assurance system be further developed to include the views of residents, relatives, visitors, staff members and other professionals visiting the home to ensure everyone is consulted and an action plan produced. The servicing and testing of all equipment had been carried out and relevant and timely certificates were held to ensure that the health and safety of residents is protected. The Old Rectory Care Home DS0000061106.V295353.R01.S.doc Version 5.2 Page 20 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 2 3 3 3 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 2 9 3 10 3 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 2 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 3 18 3 2 X 3 3 2 X 3 2 STAFFING Standard No Score 27 3 28 3 29 2 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 2 2 3 3 X 3 3 The Old Rectory Care Home DS0000061106.V295353.R01.S.doc Version 5.2 Page 21 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 OP1 Regulation 4.2 Requirement The registered person must ensure that prospective service users are given a copy of the Statement of Purpose and Service User Guide prior to admission. The registered person must ensure that all current information held on a service user is stored in their individual plan of care. The registered person must ensure that risk assessments are held for each resident and stored in their individual plan of care. The registered person must ensure that the records held in the plans of care detail the actions care staff must take based on the assessed needs of each individual service user. The registered person must ensure that a key worker scheme is introduced and that each service user has access to a key worker. The registered person must ensure that the upstairs hall way that is tired and worn looking in DS0000061106.V295353.R01.S.doc Timescale for action 01/09/06 2. OP7 17.3 30/09/06 3. OP7 13.4 30/09/06 4. OP7 12.1 01/08/06 5. OP13 12.5.b 31/08/06 6. OP19 23.2 30/11/06 The Old Rectory Care Home Version 5.2 Page 22 7. OP19 23.2 8. 9. OP23 OP29 13.4 19.1 10. OP33 24.1 11. OP32 24.3 12. OP33 24.1,2,3 places is redecorated. The registered person must ensure that waterproof seals are fitted around the joins on the worktops in the kitchen. The registered person must ensure that the bedroom carpet that has a hole in is replaced. The registered owner must ensure that all staff member are given a new terms and conditions of employment contract. The registered person must increase the amount of staff meetings carried out over a year. The registered person must provide service users with regular access to resident meetings throughout the year. The registered person must further improve the quality assurance system in place to include feedback from everyone who lives, works or visits the home. 01/10/06 01/07/06 30/09/06 31/08/06 31/08/06 01/11/06 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. Refer to Standard OP8 Good Practice Recommendations It is recommended that a record of the weight of each resident be held in their plan of care to assist in the monitoring of their health. It is recommended that deep cleaning of the flooring in the bathrooms and bedrooms that have an odour takes places to ensure the health and safety of residents is protected and that the areas are pleasant for residents to use. 2. OP26 The Old Rectory Care Home DS0000061106.V295353.R01.S.doc Version 5.2 Page 23 Commission for Social Care Inspection Norfolk Area Office 3rd Floor Cavell House St. Crispins Road Norwich NR3 1YF 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 Care Home DS0000061106.V295353.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. 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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