Inspection on 19/01/06 for The Old Rectory [Musbury]

This inspection was carried out on 19th January 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 [Musbury] 19/10/06

The Old Rectory [Musbury] 04/08/05

The Old Rectory [Musbury] 22/11/04

The Old Rectory [Musbury] 11/05/04

Similar services:

2 Perhaver Park

The Vicarage

St George`s

5 Seafield Road

Credence House

Radfords

Honeybourne House

32 Beaumont Way

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

CARE HOME ADULTS 18-65 The Old Rectory [Musbury] Musbury Axminster Devon EX13 8AR Lead Inspector Belinda Heginworth Unannounced Inspection 19th January 2006 09:30 The Old Rectory [Musbury] DS0000039128.V271515.R01.S.doc Version 5.0 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 [Musbury] DS0000039128.V271515.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 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 [Musbury] DS0000039128.V271515.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service The Old Rectory [Musbury] Address Musbury Axminster Devon EX13 8AR 01297 552532 01297 553511 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) Oakprice Limited Mr Robin Andrew Barrie Farrington Care Home 15 Category(ies) of Learning disability (15), Learning disability over registration, with number 65 years of age (15) of places The Old Rectory [Musbury] DS0000039128.V271515.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. To take service users over the age of 35 years only Date of last inspection 4th August 2005 Brief Description of the Service: The Old Rectory provides support and personal care for 15 people with a learning disability who are over the age of 35 years. The home is a detached, converted and extended property on the edge of the small village of Musbury. It is a short car journey to either Seaton or Axminster. Residents bedrooms are single with en-suite facilities. Residents share the use of the lounge, dining room and conservatory. There is a large private garden with a decked area outside of the conservatory. The Old Rectory is run as a family business with many family members working at the home. The Old Rectory [Musbury] DS0000039128.V271515.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place over two hours and forty minutes with the provider being present throughout. Some residents living at the home have limited verbal communication skills and were therefore were unable to contribute fully to the inspection process. Time was spent talking with three residents and observations were made throughout the inspection. Three members of staff were consulted and their views on the home discussed. The inspector looked around parts of the building and a number of records were inspected, including care plans. What the service does well: What has improved since the last inspection? What they could do better: A wider range of activities in and out of the home should be sought and encouraged. This would provide residents with a more stimulating and fulfilling life. The staff shift systems does not currently enable residents to go out in the evenings. This should be reviewed to take into account residents social needs at all times of the day. This would give residents more opportunities to go out in the evenings if they chose. The Old Rectory [Musbury] DS0000039128.V271515.R01.S.doc Version 5.0 Page 6 The records of staff training should be improved to provide additional evidence that training has taken place. It would also be a useful tool to help monitor what training is needed and when; and would help to form part of the home’s quality assurance system. This would ensure that residents are well protected and cared for by suitably trained staff. The kitchen door has a bolt across it on the outside. One member of staff said it was to discourage residents from coming into the kitchen unaccompanied when it could be unsafe. A toilet door also had a bolt on the outside, which was positioned out of reach of most residents. This meant that residents would be unable to gain access to this toilet. This effectively was used as a staff toilet. Where residents have no access or the access is restricted in some areas of the home, it should be made clear in the home’s Statement of Purpose. It should also be recorded in residents’ care plans and risk assessment, detailing the reasons why. 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 [Musbury] DS0000039128.V271515.R01.S.doc Version 5.0 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection The Old Rectory [Musbury] DS0000039128.V271515.R01.S.doc Version 5.0 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 0 Not inspected on this occasion but the key standard was inspected and met during the last inspection. EVIDENCE: The Old Rectory [Musbury] DS0000039128.V271515.R01.S.doc Version 5.0 Page 9 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6 Staff are provided with written information to help them meet residents’ needs effectively and safely. EVIDENCE: Each resident has a detailed plan of care that highlights care and health needs clearly. These were read in detail during the last inspection. Only one was read on this occasion. The daily records reflected what was written in the care plans. These records help staff to regularly monitor residents’ needs. The provider intends to develop the care plans further to include more social needs and change what is currently written as “problems”, into to needs. This would make the needs of residents be seen as less of a problem but more of a need. Any risks associated with residents’ needs or care is assessed and the action necessary to reduce the risks is clearly explained. Residents have a dedicated person (Key worker) who is responsible for coordinating the care. Key workers review the care plans monthly. Staff spoken with demonstrated a good understanding of residents needs. The Old Rectory [Musbury] DS0000039128.V271515.R01.S.doc Version 5.0 Page 10 The Old Rectory [Musbury] DS0000039128.V271515.R01.S.doc Version 5.0 Page 11 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 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, 15 & 16 Residents benefit from caring and respectful staff but would benefit further from more stimulating and fulfilling lives. EVIDENCE: On the day of the inspection most residents were sat in the lounge or conservatory watching TV. When asked how they spent their days, two residents said they helped with some household chores which they enjoyed doing. They also said they attended occasional day activities away from the home. For example “target group”, this provides a variety of creative pursuits. Some residents enjoyed going out shopping or going to cafes or pubs. In the evening, activities have to be planned due to the day shift ending at 8.15pm. Only two staff replace the three day staff, therefore taking residents out on an add hoc basis would be unsafe. Residents’ daily records had very little information about what residents did during the day, in or out of the home. One resident said he liked spending time in his room listening to music and drawing. Staff said that activities do take place during the day, but admitted they could be improved upon both in and out of the home. They also said they needed to improve on recording them. The Old Rectory [Musbury] DS0000039128.V271515.R01.S.doc Version 5.0 Page 12 The provider said he intends to create activity charts for each resident and ensure that parts of the day are filled with meaningful activities that suit the needs and wishes of residents. Residents who were able said that staff support them to maintain contact with their relatives and friends. The care plans provide good information about family contact. The Old Rectory [Musbury] DS0000039128.V271515.R01.S.doc Version 5.0 Page 13 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 20 Medication systems protect residents’ welfare. EVIDENCE: During the last inspection it was highlighted that all staff should receive appropriate training in the safe handling and administration of medicines. This has been undertaken by all staff through a distance learning course. The course ends in the next month after staff have taken an exam. The medication records and storage were not inspected on this occasion but were satisfactory on the last inspection. The Old Rectory [Musbury] DS0000039128.V271515.R01.S.doc Version 5.0 Page 14 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 23 Arrangements for protecting residents from the risk of harm or abuse are good. EVIDENCE: All but one new staff have attended abuse awareness training. New staff also receive induction training that includes information about recognising abuse and what to do if they suspect it. Staff spoken with demonstrated a good knowledge and awareness on this subject and said that the provider updates them regularly on adult protection issues. This is particularly important given that there are many family members working in the home and often together. Non – family members said they felt comfortable talking to the provider about any concerns they had about any staff, including members of the family. Currently an abuse investigation on a member of staff, who is no longer working at the home, is taking place through the police. When the suspected abuse was reported, the home acted correctly and quickly. Staff and residents have been supported by outside professionals during this difficult time. All but one resident have there own bank account. The provider supports residents to manage the accounts. One resident is under the Court of Protection. Financial records were clear and auditable. The Old Rectory [Musbury] DS0000039128.V271515.R01.S.doc Version 5.0 Page 15 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 24 & 30 Resident’s benefit from a pleasant environment. EVIDENCE: The home was found to be bright, cheerful and clean. Residents who were able to express their feelings said they found the house clean and homely. The kitchen door has a bolt across it on the outside. One member of staff said it was to discourage residents from coming into the kitchen unaccompanied when it could be unsafe. A toilet door also had a bolt on the outside, which was positioned out of reach of most residents. This meant that residents would be unable to gain access to this toilet. This effectively was used as a staff toilet. Where residents have no access or the access is restricted in some areas of the home, it should be made clear in the home’s Statement of Purpose. It should also be recorded in residents’ care plans and risk assessment, detailing the reasons why. The home has a cleaning rota system, which sometimes involves residents. Staff have attended health & safety course to ensure residents welfare and safety is protected. For example Food & Hygiene. The Old Rectory [Musbury] DS0000039128.V271515.R01.S.doc Version 5.0 Page 16 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 32 & 35 On the whole the home provides staff in such numbers that meet residents’ needs. Residents are protected with well-trained staff but some improvements are needed to the recording arrangements. EVIDENCE: The home usually provides four care staff during the morning and three in the afternoon and early evening. From 8.15pm the home provides one wake-in and one sleep in staff. This means that residents do not get the opportunity to go out in the evenings unless it is planned. (See section 11 – 17) The provider said they are currently reviewing the shifts and hope to introduce systems that will enable residents to go out more often in the evenings. Residents who were able said that staff were “very busy” but did care for them well and took them out when they asked. Residents’ daily records had limited information about the time spent with residents although staff said this did happen but they were poor at recording it. (See section 11 – 17) New staff receive induction training using a detailed booklet that covers most aspects of working in a care home and with people with a learning disability. One staff confirmed that this training had taken place but the assessment tool had not been filled out. The Old Rectory [Musbury] DS0000039128.V271515.R01.S.doc Version 5.0 Page 17 The home did have over 50 of care staff who had obtained NVQ level 2 and above but some of those staff have now left. The provider said he has an ongoing programme of staff working towards NVQ qualifications. Staff said they also receive training that helps them to understand and meet residents’ needs safely. For example, Autism, Gentle Teaching, Incontinence, Epilepsy and Health & Safety training such as Food & Hygiene, and many more. Some of the staff training records were poorly maintained. This makes it difficult for the provider to monitor and assess what updates are needed. The Old Rectory [Musbury] DS0000039128.V271515.R01.S.doc Version 5.0 Page 18 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. 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 are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 37 & 39 Resident’s benefit from a well run home with methods in place to review the quality of care. EVIDENCE: Staff and residents spoke highly of the provider. Residents said he was “kind” and staff said he was fair and gave a clear sense of direction. The provider has completed the Registered Managers Award. The provider has a quality assurance policy that sets out the standards of care expected in the home. These include staff training, care plan reviews, satisfaction questionnaires, staff meetings and so on. The provider intends to develop this further over the next few months to ensure that all monitoring that is completed in the home is recorded. The fire logbook was found to be up to date and accurate, therefore protecting residents’ safety. The Old Rectory [Musbury] DS0000039128.V271515.R01.S.doc Version 5.0 Page 19 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 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 CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score X X X X X Standard No 22 23 Score X 3 ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score 3 X X X X Standard No 24 25 26 27 28 29 30 STAFFING Score 2 X X X X X 3 LIFESTYLES Standard No Score 11 X 12 2 13 X 14 X 15 3 16 3 17 Standard No 31 32 33 34 35 36 Score X 2 X X 2 X CONDUCT AND MANAGEMENT OF THE HOME X PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 The Old Rectory [Musbury] Score X X 3 X Standard No 37 38 39 40 41 42 43 Score 3 X 3 X X X X DS0000039128.V271515.R01.S.doc Version 5.0 Page 20 N/A 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. 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 YA12 Good Practice Recommendations Residents should be provided with a variety of activities both in and out of the home, that all stimulating and fulfilling to residents. Records of all activities should be kept. Any areas of the home that are restricted to residents should be clearly explained in the home’s Statement of Purpose and residents’ care plans and risk assessments. The staff shift system should enable residents to go in the evenings unplanned if they choose. The provider should ensure that the record of staff training is well-maintained. 2 3 4 YA24 YA32 YA35 The Old Rectory [Musbury] DS0000039128.V271515.R01.S.doc Version 5.0 Page 21 Commission for Social Care Inspection Exeter Suites 1 & 7 Renslade House Bonhay Road Exeter EX4 3AY 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 [Musbury] DS0000039128.V271515.R01.S.doc Version 5.0 Page 22 - 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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