Inspection on 07/06/05 for The Old Rectory [Nunney]

This inspection was carried out on 7th June 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

The Old Rectory [Nunney] 30/07/07

The Old Rectory [Nunney] 29/01/07

The Old Rectory [Nunney] 13/07/06

The Old Rectory [Nunney] 15/02/06

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 7th June 2005 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 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 D53 - D02 S16007 The Old Rectory V230144 070605 Stage 4.doc Version 1.30 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 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 Mr Ronald Hill Mrs Marian Constance Hill Personal Care Home Only 24 Category(ies) of Old Age (24) registration, with number of places The Old Rectory D53 - D02 S16007 The Old Rectory V230144 070605 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: None Date of last inspection 27th January 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 D53 - D02 S16007 The Old Rectory V230144 070605 Stage 4.doc Version 1.30 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 27th January 2005. On the day of the inspection there were twenty service users residing at the home. During the course of the inspection service users, staff members and the Care Manager and Registered Provider 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 home must ensure that fire alarms are checked on a weekly basis, and that staff are provided with regular fire safety training. The home must continue to take appropriate action to promote the health and safety of staff and service users within the home. The Old Rectory D53 - D02 S16007 The Old Rectory V230144 070605 Stage 4.doc Version 1.30 Page 6 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 D53 - D02 S16007 The Old Rectory V230144 070605 Stage 4.doc Version 1.30 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 Standards Statutory Requirements Identified During the Inspection The Old Rectory D53 - D02 S16007 The Old Rectory V230144 070605 Stage 4.doc Version 1.30 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 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. Service users confirmed that they were able to visit the home before moving in. The Old Rectory D53 - D02 S16007 The Old Rectory V230144 070605 Stage 4.doc Version 1.30 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 standard(s) 7,8,9 & 10 The home takes appropriate action to meet the health and personal care needs of service users. Care plans are detailed and provide staff with the information required to fully meet service users needs. There has been a significant improvement in the recording of medications. Staff treat service users with dignity and respect. EVIDENCE: Care plans are maintained for each service user. These include detail of individuals’ needs, daily routines and preferences. Care plans had been signed by service users, and regularly reviewed and updated. A manual handling assessment had been completed for each service user, and a record maintained of all professional visits. All medications are stored securely. Staff at the home have undertaken medications training. It is recommended that Medication Administration Records include a photograph of the service user. The home must ensure that all hand transcribed entries are dated and supported by two staff signatures. The Old Rectory D53 - D02 S16007 The Old Rectory V230144 070605 Stage 4.doc Version 1.30 Page 10 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 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. An Activities Co-ordinator also visits the home three days a week. Current activities provided include: bingo, board games, playing catch, card games and quizzes. 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 highly of the meals provided. The home is aware of service users’ dietary needs and preferences. The Old Rectory D53 - D02 S16007 The Old Rectory V230144 070605 Stage 4.doc Version 1.30 Page 11 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 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 hall. This includes details of external agencies that may also be contacted such as CSCI. There has been one complaint received by CSCI. The home has worked cooperatively with CSCI to address the issues raised. The home has appropriate policies relating to the protection of vulnerable adults and whistle blowing. The Old Rectory D53 - D02 S16007 The Old Rectory V230144 070605 Stage 4.doc Version 1.30 Page 12 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 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. There is an ongoing program of maintenance and redecoration within the home. The Old Rectory D53 - D02 S16007 The Old Rectory V230144 070605 Stage 4.doc Version 1.30 Page 13 Radiators have been guarded in some rooms. The Registered Provider is in the process of guarding radiators in all areas that are accessible to service users. Window openings have been restricted on upper floors. The home must ensure that appropriate hand washing facilities are provided for staff in all bathrooms, toilets and areas where they provide assistance with personal care. The Registered Provider advised a hand basin would shortly be fitted to the ground floor bathroom. The laundry is in the process of being re-furbished and a new washing machine and dryer being installed. The Old Rectory D53 - D02 S16007 The Old Rectory V230144 070605 Stage 4.doc Version 1.30 Page 14 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 considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for 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 3-4 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. Three staff recruitment files were examined, and each found to contain the documentation required under Schedule 1 of the Care Home Regulations 2001. 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, and health and safety. 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 D53 - D02 S16007 The Old Rectory V230144 070605 Stage 4.doc Version 1.30 Page 15 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 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31, 32, 34, 35, 36, 37 & 38 The newly appointed 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 Registered Provider, Care Manager and staff team. Records relating to service users are stored securely. The home collects pension for one service user. Records are maintained of all transactions involving service user finances. Three records were examined and each tallied with records kept. The Old Rectory D53 - D02 S16007 The Old Rectory V230144 070605 Stage 4.doc Version 1.30 Page 16 Staff are provided with a thorough Induction program. The Care Manager plans to introduce staff supervision. There is good liaison between the Registered Provider and Care Manager, and staff meetings are held every 3-4 months. Servicing records relating to the fire system, passenger lift, hoist, and bath hoist had been appropriately maintained and were up to date. One fire door had been propped open and was closed during the inspection. Records showed that the fire alarm had last been tested on 24.1.05, and that fire safety training had not taken place since 26.2.04 The certificate of Employers Liability Insurance displayed at the home expired on 10/3/05. The home must ensure that a copy of the current certificate is forwarded to CSCI. The second page of the registration certificate should also be displayed. The carpet on first floor landing had started to become loose and may pose a trip hazard. Hazardous substances had been stored securely and were not accessible to service users. Accidents have been recorded and reported as required The Old Rectory D53 - D02 S16007 The Old Rectory V230144 070605 Stage 4.doc Version 1.30 Page 17 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score 3 x 3 3 3 x HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 2 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION 3 3 3 3 3 3 2 2 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 Standard No 16 17 18 Score 3 x 3 3 3 x 3 3 3 3 2 The Old Rectory D53 - D02 S16007 The Old Rectory V230144 070605 Stage 4.doc Version 1.30 Page 18 Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard OP25 Regulation 13(4) Requirement The Registered Provider must ensure that radiators are guarded in all areas of the home that are accessible to service users. 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. A hand basin must be installed in the ground floor bathroom. The Registered Provider must ensure that staff are provided with appropriate fire safety training. Fire alarms must be tested on a weekly basis. The Registered Provider must ensure that the home has appropriate Employers Liability Insurance. A copy of the current certificate should be forwarded to CSCI. Appropriate action must be taken to ensure that the carpet which has become loose on the first floor landing, does not pose a risk to service users. Timescale for action 16.9.05 2. OP26 13(3) 1.8.05 3. OP38 23(4d) 1.8.05 4. 5. OP38 OP38 23(4c) 25(2e) 11.7.05 22.7.05 6. OP38 13(4) 1.8.05 The Old Rectory D53 - D02 S16007 The Old Rectory V230144 070605 Stage 4.doc Version 1.30 Page 19 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 OP9 OP27 Good Practice Recommendations It is recommended that Medication Administration Records include a photograph of the service user to assist with identification. All hand transcribed entries must be supported by two staff signatures. 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 D53 - D02 S16007 The Old Rectory V230144 070605 Stage 4.doc Version 1.30 Page 20 Commission for Social Care Inspection Riverside Chambers Castle Street Tangier 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 D53 - D02 S16007 The Old Rectory V230144 070605 Stage 4.doc Version 1.30 Page 21 - 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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