Inspection on 20/12/05 for The Old Vicarage

This inspection was carried out on 20th December 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 Vicarage 10/05/07

The Old Vicarage 19/07/05

The Old Vicarage 14/03/05

The Old Vicarage 05/08/04

Similar services:

Chirnside House

Keer Sands Residential Home

Ruskin Lodge

Bushell House

Langrigg House

Parkside

Dystlegh Grange

Thornton Lodge

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

CARE HOMES FOR OLDER PEOPLE The Old Vicarage Main Street Hornby Lancaster Lancashire LA2 8JT Lead Inspector Mrs Joy Howson-Booth Announced Inspection 20th December 2005 02:00 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 Vicarage DS0000009865.V275315.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 Vicarage DS0000009865.V275315.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service The Old Vicarage Address Main Street Hornby Lancaster Lancashire LA2 8JT 01524 221284 01524 33800 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) Forrester Retirement Homes Mrs Karen Anne Robson Care Home 15 Category(ies) of Old age, not falling within any other category registration, with number (15) of places The Old Vicarage DS0000009865.V275315.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 19th July 2005 Brief Description of the Service: The Old Vicarage is situated in the quiet country village of Hornby. Hornby is a small hamlet approximately 9 miles north of Lancaster. The Old Vicarage is situated just off the main road, which runs through the village and is accessible to local shops, pubs, churches and general amenities. The home is an impressive Victorian-style building, which previously provided accommodation to the Vicar of the next-door church. The home has a small extension built on the side and provides accommodation for four people. The home is a two storey building with resident accommodation on both the ground and first floors. There are bathrooms and toilets accessible on both floors. Most rooms are single (some with ensuite facilities) and two shared rooms. There is a separate dining room and lounge, and the addition of a conservatory which leads onto the gardens has provided an additional facility for residents to use. The home is fortunate to be set in its own walled garden, which is well maintained and provides an excellent outdoor facility for residents to use. The home is very well maintained and provides a pleasant and homely environment for those people accommodated. The Old Vicarage DS0000009865.V275315.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was announced and was carried out by the inspector for the home. The services provided by the home were inspected against the National Minimum Standards. The majority of residents in the home and staff on duty were spoken with. Two care files were examined, along with other documentation held by the home. A very high number of comment cards were received, including seven from different GPs and all included very positive comments about the care provided, the staff and the management of the home. One comment card received from a relative stated “we could not be happier with the home. Our relative is cared for in every way. We have no complaints – the staff are all attentive, polite, friendly and efficient”. All the residents spoken with said they very much liked living at the home and felt they were very well cared for and their needs met. What the service does well: The home is a relaxed, friendly and homely environment where residents needs come first and are supported to carry on their own lifestyles and choices. The home is lucky that it has a very good reputation within the community – most residents have known of the home for some time and have opted to live there. The staff employed are experienced and have been provided with training and there is a very low turnover of staff at the home, with most being long-serving at the home. The manager of the home is experienced and qualified and ensures the home is well run. One resident commented “Karen (the registered manager) walks around the home and you think she has not noticed things but if there is anything wrong she deals with it straight away”. The environment is well maintained and provides a homely and pleasant environment for the residents to live in. The Old Vicarage DS0000009865.V275315.R01.S.doc Version 5.1 Page 6 What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The Old Vicarage DS0000009865.V275315.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 Vicarage DS0000009865.V275315.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): No standards were assessed from this section as the key standards were assessed and found to be met at the last inspection EVIDENCE: The Old Vicarage DS0000009865.V275315.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 and 9 The care plans provide good information which enable staff to be aware of residents needs and how these are to be met. Systems have been put in place to ensure medication is safely administered to residents EVIDENCE: A requirement highlighted at the previous inspection required the home to ensure the care plans reflected the residents’ current needs and how the staff team are to meet these. Care plans were examined during this inspection and found to contain comprehensive information which would enable staff to support the residents appropriately. Healthcare needs and input are now being maintained, along with 6 weekly weight monitoring. Discussions with residents and care staff confirmed that residents’ care and health care needs are proactively addressed. The Old Vicarage DS0000009865.V275315.R01.S.doc Version 5.1 Page 10 Comment cards received from residents were all very positive about the care provided by the staff at the home. Comment cards received from relatives were also very positive in their praise of the care provided by the staff and how nothing is too much trouble. Comment cards were also praised the management of the home and the support and input provided by the registered manager. One comment card stated “we could not be happier with the home. Our relative is cared for in every way. We have no complaints – the staff are all attentive, polite, friendly and efficient”. In respect of medication, the registered manager confirmed that all the advice and requirements provided by the Pharmacist Inspector have been put in place. During this inspection medication administration records, medication and controlled drugs held at the home were examined and found to be correctly stored and accurate. Comments received from seven GP’s confirmed that they are able to see their patients in private, there is always a senior member of staff on duty. In addition to this, if any specialist advice is provided it is incorporated into the care provided and medication is appropriately managed in the home. In addition to this, GP comments were all very positive about the care provided and the management of the home. The Old Vicarage DS0000009865.V275315.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 and 15 Activities at the home need to be reviewed to ensure that residents are provided with activities according to their social, cultural, religious and recreational interests. There are no restrictions for families and friends of the residents to visit the home. Residents benefit from seeing their families when they want. Residents also benefit from being free to exercise choice and control over their lives. Arrangements and planning to provide good nutritional food are good. The residents are provided with good food to ensure healthy living. EVIDENCE: The Old Vicarage DS0000009865.V275315.R01.S.doc Version 5.1 Page 12 Most residents at the Old Vicarage continue to be reasonably independent and able to determine their own routines and activities. Discussions with residents during this inspection again confirmed that they are happy with their lifestyles, are able to have visitors at any time, maintain choice and control over their lives. In addition to this, the residents are free to access the local community (either with staff or others’ support). As the home is in the centre of the village there are a number of activities the residents enjoy, including local shops, church attendance and church related activities in the week, hairdresser, etc. A number of residents are fortunate to have relatives who visit on a very regular basis and organise outings to nearby towns. Activities in the home are not organised on a regular basis although the registered manager and staff have recently organised a Christmas Party and, in the summer, a fete when all the relatives were invited. Discussions with staff confirmed that time is spent with residents, talking with them and, given the size of this home, there is a relaxed and homely atmosphere where relationships between residents and staff are of a positive nature. Discussions with residents evoked a high level of praise for staff within the home – residents making comments which include – “staff always answer the bell very quickly and nothing is too much trouble”; “we are well looked after here”. Comment cards received from residents generally felt the home did provide suitable activities, although a couple felt it was only sometimes that the home put on suitable activities and one comment card indicated that no activities are provided. In light of these comments, Mrs Robson was advised that now the home has a number of new residents it may be worth discussing activities and interests with them so that all can be offered social stimulation. Care files do include social and leisure interests but the registered manager was advised that these need to be more detailed. In addition, a record should be kept of the activities and outings the residents have enjoyed. Residents spoken with and who completed the comment cards all felt the food provided by the home was very good indeed. There are menus available and the cook visits each resident to find out personally what they would like to eat. A hot meal is taken in the dining room, which is cosy and pleasant and the atmosphere is relaxed and unhurried. Staff confirmed that records are maintained each day over the nutritional input of the residents and should there be any concerns a more detailed nutritional chart would be completed on a daily basis. The Old Vicarage DS0000009865.V275315.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 and 18 The arrangements for dealing with complaints are good. Residents can speak up and feel that they are listened to. There are systems in place, and training provided, to ensure that residents are protected from abuse. EVIDENCE: A requirement highlighted at the previous inspection required the home to implement a complaints/comments/compliments book to evidence that residents and others issues are being dealt with. A book for this purpose has now been organised although, to date, no entries have been made. During this inspection it was confirmed that residents feel confident that if a concern were raised it would be dealt with. One resident commented “Karen (the registered manager) walks around the home and you think she has not noticed things but if there is anything wrong she deals with it straight away”. Discussions with staff confirmed all are aware of abuse and what to be aware of. All know to contact either the registered provider or the senior on duty if any concerns are raised. The training records evidenced that not all staff have had formal training in abuse awareness and this is something the manager may wish to organise for the future. The Old Vicarage DS0000009865.V275315.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): All the standards in this section were assessed and found to be met at the previous inspection EVIDENCE: The Old Vicarage DS0000009865.V275315.R01.S.doc Version 5.1 Page 15 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): 29 and 30 The recruitment systems in place in the home mean that residents are protected and only people who are fit to do so work at the home. The home is proactive in ensuring staff undertake the necessary training which means that residents are cared for by a team of competent staff. EVIDENCE: Staff files for the most recently appointed member of staff was examined and evidenced that all the appropriate checks were made prior to commencement of employment. Although staffing levels was not assessed during this inspection, the observations of one comment card were passed onto the home’s manager. However, it was confirmed that the home is staffed to the appropriate level, with an additional member of staff on duty in the morning. The registered manager was advised that the Declaration of Criminal Convictions should be on the application form for the applicant to complete. In addition, the application form could also include a declaration as to whether the applicant has been disciplined or dismissed from any previous employment. Criminal Records Bureau disclosure forms were seen for all staff in the home and confirmation received that no-one commences employment until a satisfactory CRB disclosure has been received. The Old Vicarage DS0000009865.V275315.R01.S.doc Version 5.1 Page 16 Training files were seen for staff which confirmed mandatory and National Vocational Qualification training is being provided. Discussions with staff confirmed they access training which is enjoyed. A planned course on Safe Handling of Medicines has been postponed by the training provider but the registered manager has a new date for this to take place. The registered manager was advised that abuse awareness training would be of benefit to all staff and is to look into this training for the future. The Old Vicarage DS0000009865.V275315.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): 33 and 38 This is a well managed home that is clearly run in the best interests of residents. EVIDENCE: The size of this home means that whilst residents meetings are not held (by preference of the residents themselves) the registered manager visits and speaks with all the residents on a daily basis. There are no formal quality assurance systems in place, although the registered manager has sent out questionnaires to residents, relatives and GPs and intends to send this out again in 2006. The Old Vicarage DS0000009865.V275315.R01.S.doc Version 5.1 Page 18 Residents spoken with were aware that the inspection was to take place on the day in question. Discussion with the registered manager confirmed that policies and procedures are in place but are not reviewed. These need to be reviewed on a yearly basis. Any requirements or recommendations in previous reports are actioned by the registered manager promptly. The registered manager confirmed that the requirements for health and safety are maintained in the home, with staff undertaking mandatory training, along with update training as needed. In addition, the pre-inspection questionnaire submitted by the registered manager confirmed that all the required maintenance and safety checks are carried out on equipment and facilities in the home. The registered manager was advised that the policies and procedures for the home should be reviewed on a yearly basis, or sooner if there are any changes. The accident book was seen and noted that the registered manager undertakes a monthly audit of this book. The Old Vicarage DS0000009865.V275315.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 X X X X X X HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 3 10 X 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 X X X X X X X X STAFFING Standard No Score 27 X 28 X 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score X X 2 X X X X 3 The Old Vicarage DS0000009865.V275315.R01.S.doc Version 5.1 Page 20 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 OP12 Regulation 16(2)(n) Requirement Care plans must include more detail about social and leisure interests and how the home meets these Quality assurance systems must continue to develop within the home Timescale for action 31/01/06 2 OP33 2424(1) 31/03/06 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 4 5 Refer to Standard OP12 OP12 OP18 OP29 OP38 Good Practice Recommendations Discussions should take place with residents over activities that may be organised in the home Activities and outings enjoyed by residents should be recorded in their daily diaries Abuse Awareness training should be provided to those members of staff who have not done this training The application form should include a declaration for criminal convictions and could include a declaration for dismissal or disciplinary in previous employment The home’s policies and procedures should be reviewed on a yearly basis to ensure they are still accurate and provide DS0000009865.V275315.R01.S.doc Version 5.1 Page 21 The Old Vicarage clear instructions/information to staff The Old Vicarage DS0000009865.V275315.R01.S.doc Version 5.1 Page 22 Commission for Social Care Inspection North Lancashire Area Office 2nd Floor, Unit 1, Tustin Court Port Way Preston PR2 2YQ 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. 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