Inspection on 15/02/06 for The Old Rectory [Nunney]

This inspection was carried out on 15th February 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 found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

The Old Rectory [Nunney] 30/07/07

The Old Rectory [Nunney] 29/01/07

The Old Rectory [Nunney] 13/07/06

The Old Rectory [Nunney] 07/06/05

The Old Rectory [Nunney] 27/01/05

The Old Rectory [Nunney] 27/05/04

Similar services:

Fairfields Country Rest Home

Poldhu

Queensmount

Trevaylor Manor

Didsbury Court Rest Home

Belma

Hunters Care Centre

Manor 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 High Street Nunney Frome Somerset BA11 4LZ Lead Inspector Sally Murphy Unannounced Inspection 15th February 2006 10:45 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 DS0000016007.V283945.R01.S.doc Version 5.1 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 DS0000016007.V283945.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service The Old Rectory Address High Street Nunney Frome Somerset BA11 4LZ 01373 836747 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 RONALD HILL MRS MARIAN CONSTANCE HILL MR RONALD HILL Care Home 24 Category(ies) of Old age, not falling within any other category registration, with number (24) of places The Old Rectory DS0000016007.V283945.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 7th June 2005 Brief Description of the Service: The Old Rectory is a large detached property located in the village of Nunney, approximately four miles from Frome. Service user accommodation is provided over two floors. There is a passenger lift, assisted bathrooms, and a call system available. The Old Rectory is registered with the Commission for Social Care Inspection to provide care for up to 24 service users over the age of 65 years. The proprietors are Mr and Mrs Hill. Mr Hill is also the Registered Manager. The home has been decorated and furnished to a high standard. The garden has been well maintained and is accessible to service users. The Old Rectory DS0000016007.V283945.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was carried out as part of the planned annual programme of inspection. The inspection was unannounced and carried out by one inspector over one day. The previous inspection was also unannounced and took place on 7th June 2005. On the day of the inspection there were sixteen service users residing at the home. During the course of the inspection service users, staff members and the Care Manager were spoken with. Care practice was also observed, records examined and a tour of the premises was made. What the service does well: What has improved since the last inspection? What they could do better: The Old Rectory DS0000016007.V283945.R01.S.doc Version 5.1 Page 6 In order to reduce the risk of injury to service users, radiator guards must be fitted in communal bathrooms and the en suite bathroom of room 6. The fire door at the top of the stairs does not close fully and must be adjusted to ensure that service users are protected in the event of a fire. The carpet within room 6a is worn requires replacement within the refurbishment programme. Further action must be taken to ensure that the home follows good practice with regard to infection control. Care plans must be updated to ensure that they reflect service users current needs, and risk assessments completed as required. Records relating to portable appliance testing, electrical hardwiring, and the landlord gas safety certificate could not be located during the inspection and copies must be forwarded to CSCI. In addition recruitment records for most recently employed member of staff and staff fire training records were not available and will be examined at a further visit to the home. The whistle blowing policy must be amended to include details of external agencies that may be contacted. CSCI must be notified of any serious injuries or the death of a service user in accordance with Regulation 37 of the Care home Regulation 2001. It is recommended that the amount of management time allocated to the Care Manager be reviewed to ensure that care plans may be regularly reviewed and staff provided with appropriate training and supervision. 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 DS0000016007.V283945.R01.S.doc Version 5.1 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 DS0000016007.V283945.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 3, 4 & 5. (Standard 6 does not apply). Service users are provided with appropriate information regarding the services and facilities offered at the home. The Care Manager ensures that the home will be able to meet service users’ needs prior to them moving in. EVIDENCE: The home has a Statement of Purpose and Service User Guide that provide details of the services and facilities offered at the home. An assessment of needs is completed prior to a service user moving into the home. Pre-admission assessments were found within service user plans. Prospective service users and their families are invited to visit the home to assess the facilities provided. The Old Rectory DS0000016007.V283945.R01.S.doc Version 5.1 Page 9 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 home takes appropriate action to meet the health and personal care needs of service users. Care plans require updating to ensure that they reflect service users current needs. The management of medications follows best practice. Service users confirmed that staff treat them with dignity and respect. EVIDENCE: Care plans are maintained for each service user. Three care plans were examined in detail. One care plan had been appropriately completed and included evidence of being recently reviewed. The second care plan did not reflect the current needs of the service user whose mobility needs had increased, and appropriate risk assessments had not been completed. The third care plan, which related to a service user who had recently moved into the home, contained only the pre-admission assessment, records of professional visits and daily reports. The care plan for this service user required further development to ensure that staff would have clear guidance The Old Rectory DS0000016007.V283945.R01.S.doc Version 5.1 Page 10 on the type and level of assistance required to meet their personal care and health needs. All medications are stored securely. Staff at the home have undertaken medications training. A record is maintained of all medications received into the home. Medication Administration Records have been appropriately maintained. An opening date had been recorded for liquid preparations. The Care Manager is committed to ensuring that the management of medications follows good practice and has requested a visit from the Pharmacy Inspector at CSCI to offer further advice and guidance. It is recommended that the reason is recorded when medications are returned to the pharmacy. The home will offer care and support to service users until the end of their life whenever possible. The home works closely with the District Nursing Team to ensure the service users are comfortable and that they are able to continue fully meeting service users’ needs. The Old Rectory DS0000016007.V283945.R01.S.doc Version 5.1 Page 11 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 home has taken appropriate action to meet individual service users’ social needs. Service users are encouraged to exercise choice over their lives. Meals are of a high standard and offer a well-balanced diet. EVIDENCE: Service users are encouraged to maintain interests and hobbies. Staff are available each day to spend time with service users. Current activities provided include: bingo, board games, playing catch, flexercise, card games and quizzes. Entertainers regularly visit the home. Trips are also provided. Daily routines are flexible. Service users are able to spend time within communal area, or their own room, as they prefer. Visitors are welcomed at the home. A church service takes place within the home each month. Service users spoke very highly of the meals provided. The home is aware of service users’ dietary needs and preferences. The Old Rectory DS0000016007.V283945.R01.S.doc Version 5.1 Page 12 Service users are able to eat meals in the dining room or their rooms as they prefer. The Old Rectory DS0000016007.V283945.R01.S.doc Version 5.1 Page 13 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 & 18. The home has appropriate policies in place to safeguard vulnerable service users. The Registered Provider and Care Manager ensure that service users are listened to and their views taken seriously. EVIDENCE: A copy of the home’s complaints procedure is displayed in the hallway. This includes details of external agencies that may also be contacted such as CSCI. There have been no complaints received by the home or CSCI since the last inspection. The whistle blowing policy displayed within the office does not contain details of external agencies that staff may contact. The home must review this policy to ensure that it complies with the Public Disclosure Act 1998. The Old Rectory DS0000016007.V283945.R01.S.doc Version 5.1 Page 14 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, 20, 21, 22, 23, 24, 25 & 26. The home has been decorated and furnished to a high standard. Further action must be taken to ensure that the home follows good practice with regard to infection control. There is sufficient communal space and bathing facilities to meet service users’ needs. The home was found to have a high standard of cleanliness. EVIDENCE: Service user accommodation is provided on the ground and first floor. All service user rooms have en suite facilities, or sole use of a bathroom nearby. There are two assisted bathrooms, a passenger lift and call system available to service users. Communal space comprises of a large lounge, large dining room, and quiet room. Service user rooms have been personalised to reflect individual tastes and preferences. The home has been decorated and furnished to a high standard. The Old Rectory DS0000016007.V283945.R01.S.doc Version 5.1 Page 15 Since the last inspection a new carpet has been fitted in the communal lounge. The carpet within room 6a has become stained and worn and requires replacement. The fire door at the top of the stairs does not close fully and must be adjusted to ensure that service users are protected in the event of a fire. There is an ongoing program of maintenance and re-decoration within the home. Radiators guards have been fitted in some parts of the home. The Registered Provider must ensure that these are also fitted in communal bathrooms and the en suite bathroom of room 6. Hot water outlet temperatures were tested and found to be within appropriate limits. Window openings have been restricted on upper floors. The home has emergency lighting. It is recommended that this be tested on a monthly basis. Since the last inspection, a hand basin has been installed in the ground floor bathroom. Handwashing facilities consisting of liquid soap and paper towels have also been made available for staff in some areas. In order to reduce the risk of cross infection, these must be provided in bathrooms and in any service user rooms where staff provide assistance with personal care. On the day of the inspection a razor, scissors, and tablets of soap were found within communal bathrooms. The bath panel was not fixed and pipework had not been boxed in, meaning that hot pipes were accessible to service users. The sealant surrounding the bath has become mouldy. Both bathrooms required thorough cleaning to ensure that they did not present a risk of cross infection. Since the last inspection a new washing machine and dryer have been installed. The washing machine has a sluice facility. In order to reduce the risk of cross infection, one hand basin within the laundry must be used solely for staff to wash their hands, and must not have commodes stored within it. Incontinence pads must be disposed of appropriately within a flip top bin, that has a liner fitted. The Inspector will contact the Health Protection Unit to request that they complete a visit to the home to offer further advice and guidance on best practice relating to infection control. The Old Rectory DS0000016007.V283945.R01.S.doc Version 5.1 Page 16 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. Staff are provided with regular opportunities to attend training. Staff have appropriate skills and competence to meet service users personal care and social needs. EVIDENCE: Duty rotas are maintained. There are generally 3 care staff on duty in the morning, 2 during the afternoon, and one member of waking care staff on duty at night. Domestic and catering staff are also employed. The home has recently purchased a training program that links to the NVQ 2 qualification. Staff are provided with training in food hygiene, infection control, COSHH, manual handling, coping with aggression and dementia. Recruitment records for most recently employed member of staff and staff fire training records were not available at the time of the inspection. These will be examined at a further visit to the home. The Care Manager is supernumerary to the staff team for some shifts each week. It is recommended that the home review the amount of management time available to ensure that the Care Manager is able to maintain the documentation required and provide training and supervision to the staff team. The Old Rectory DS0000016007.V283945.R01.S.doc Version 5.1 Page 17 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 Care Manager has provided strong leadership to the staff team. Records relating to service users are stored securely. Equipment servicing records have been appropriately maintained. The Registered Provider must take further action to promote the health and safety of staff and service users within the home. EVIDENCE: There is a relaxed and open atmosphere within the home. Service users spoke highly of the Care Manager and staff team. Records relating to service users are stored securely. Currently daily records are maintained for every service user living at the home within a Report Book. This was discussed with the Care Manager during the inspection. The home The Old Rectory DS0000016007.V283945.R01.S.doc Version 5.1 Page 18 must review this practice to ensure that the information held in relation to service users complies with the Data Protection Act 1998. The home will keep money securely for service users that wish them to. Records are maintained of all transactions involving service user finances. Three records were examined and each tallied with records kept. The home displays appropriate Employers Liability Insurance. The fire system has been tested and serviced as required. The passenger lift, hoist and bath hoist have been tested under LOLER regulations. Records relating to portable appliance testing, electrical hardwiring and the landlord gas safety certificate could not be located during the inspection, and copies must be forwarded to CSCI. A bottle of turpentine and bathroom cleaner were found within service user bathrooms. The home must ensure that hazardous substances are stored securely and are not accessible to service users. Accidents have been recorded and reported as required. The Old Rectory DS0000016007.V283945.R01.S.doc Version 5.1 Page 19 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 X 3 3 3 X HEALTH AND PERSONAL CARE Standard No Score 7 1 8 3 9 3 10 3 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 2 17 X 18 3 3 3 3 3 3 2 2 1 STAFFING Standard No Score 27 3 28 3 29 x 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 3 3 3 3 2 2 The Old Rectory DS0000016007.V283945.R01.S.doc Version 5.1 Page 20 Are there any outstanding requirements from the last inspection? Yes. 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 OP7 Regulation 15 (1 & 2) Requirement An appropriate care plan must be developed for each service user that provides clear guidance to staff of the level and type of assistance to be provided to each service user. Risk assessments must be completed as necessary. 2. OP16 13 (6) The home must review the whistle blowing policy to ensure that it complies with the Public Disclosure Act 1998. The carpet within room 6a has become stained and worn and requires replacement. The Registered Provider must ensure that radiator guards are fitted in communal bathrooms and the en suite bathroom of room 6. The bath panel must be fixed in the ground floor bathroom, and guards fitted to the hot water pipes. The Old Rectory DS0000016007.V283945.R01.S.doc Version 5.1 Page 21 Timescale for action 31/03/06 14/04/06 3. OP24 23 (2d) 16/06/06 4. OP25 13(4c) 31/05/06 5. OP26 13 (3) The Registered Provider must ensure that hand washing facilities consisting of liquid soap and paper towels are available to staff in all areas where they provide assistance with personal care. (Previous timescale of 01/08/05 not met). In order to reduce the risk of cross infection, personal items such as a razor, scissors and tablets of soap must not be available in communal bathrooms. Incontinence pads must be disposed of appropriately. 24/03/06 6. OP26 13 (3) 24/03/06 7. OP26 13 (3) One hand basin within the laundry must be used solely for staff to wash their hands and must not have commodes stored within it. The Registered Manager must ensure that the documents required under Schedule 4 of the Care Home Regulations are available within the home. CSCI must be notified of any serious injuries or the death of a service user in accordance with Regulation 37 of the Care home Regulation 2001. The Registered Manager must review the practice of making daily entries within the Report Book to ensure that the information held in relation to each service user complies with the Data Protection Act 1998 24/03/06 8. OP37 17 (2) 31/03/06 9. OP37 37 15/02/06 10. OP37 12 (4a) 14/04/06 The Old Rectory DS0000016007.V283945.R01.S.doc Version 5.1 Page 22 11. OP38 13(4a) The fire door at the top of the stairs does not close fully and must be adjusted. Records relating to portable appliance testing, electrical hardwiring and the landlord gas safety certificate could not be located during the inspection, and copies must be forwarded to CSCI. The home must ensure that hazardous substances are stored securely and are not accessible to service users. 31/03/06 12. OP38 13(4a) 31/03/06 13. OP38 13(4a) 24/04/06 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. 2. 3. Refer to Standard OP9 OP25 OP27 Good Practice Recommendations It is recommended that the reason is recorded when medications are returned to the pharmacy. It is recommended that emergency lighting be tested on a monthly basis. It is recommended that the home review the amount of management time available to ensure that the Care Manager is able to maintain the documentation required and provide training and supervision to the staff team. The Old Rectory DS0000016007.V283945.R01.S.doc Version 5.1 Page 23 Commission for Social Care Inspection Somerset Records Management Unit Ground Floor Riverside Chambers Castle Street Taunton TA1 4AL 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 DS0000016007.V283945.R01.S.doc Version 5.1 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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