Inspection on 21/04/06 for The Old Vicarage

This inspection was carried out on 21st April 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 Vicarage 16/06/08

The Old Vicarage 18/09/07

The Old Vicarage 18/04/07

The Old Vicarage 27/01/06

The Old Vicarage 26/07/05

The Old Vicarage 13/01/05

The Old Vicarage 06/09/04

The Old Vicarage 03/10/03

The Old Vicarage 14/04/03

The Old Vicarage 19/02/03

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

CARE HOMES FOR OLDER PEOPLE The Old Vicarage 32 Church Lane Littleport Cambridgeshire CB6 1PS Lead Inspector Joanne Pawson Key Unannounced Inspection 21st April 2006 09:00 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 DS0000015127.V288390.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 DS0000015127.V288390.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service The Old Vicarage Address 32 Church Lane Littleport Cambridgeshire CB6 1PS 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) 01353 865200 01353 865229 care@the-old-vicarage.org.uk The Old Vicarage (Ely) Limited Mrs & Mr Paling Care Home 22 Category(ies) of Learning disability (1), Old age, not falling registration, with number within any other category (22), Physical of places disability (1) The Old Vicarage DS0000015127.V288390.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. 1 PD & 1 LD Only Date of last inspection 27th January 2006 Brief Description of the Service: The Old Vicarage is situated off a quiet road leading into the centre of Littleport. The property has been beautifully maintained and extended to offer comfortable and spacious accommodation for 20 older people, one adult with learning disabilities and one adult with physical disabilities. The majority of bedrooms benefit from en-suite facilities. There are four double bedrooms and the rest are single. All bedrooms exceed minimum size requirements. The home is decorated to a high standard and the residents may bring in personal belongings and small pieces of furniture. A cat and small dog also live at the home. The proprietors, whom also manage the home, live within the grounds, in separate accommodation. The property benefits from about an acre of landscaped gardens. Views of the garden can be seen from most windows. The weekly fees at the time of the inspection ranged from £340-£410 per week. The Old Vicarage DS0000015127.V288390.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection took place on the 21st April 2006 and lasted for six hours. Methods used for the inspection included speaking to the manager, staff and residents, reading documentation and a tour of the home. On the day of the inspection there were fourteen residents living in the home. Some requirements from the last inspection had not been met. What the service does well: What has improved since the last inspection? What they could do better: The majority of residents spoken to on the day of the inspection commented on the standard of the food and how the quality varied from day to day. The manager stated that there was more than one cook so there could possibly be a difference in cooking techniques. On the day of the inspection not all of the care plans were accurate and up to date. However a senior carer was in the process of reviewing all of the care plans and updating them. The Old Vicarage DS0000015127.V288390.R01.S.doc Version 5.1 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 Vicarage DS0000015127.V288390.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 DS0000015127.V288390.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): 1,2, 3,4 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Prospective residents have the information needed to make an informed choice about whether the home is suitable to meet their needs. Staff meet with prospective residents to ensure the home can meet their needs. EVIDENCE: The home has a statement of purpose and service users guide, which is given out to any prospective residents. The homes contract with the residents was seen in the care plan folder for three residents files that were tracked. Prospective residents and their families are encouraged to visit the home before making a decision about whether the home is suitable. An requirement at the last inspection was for new residents to have a complete needs assessment before moving into the home when possible. As no residents have moved into the home since the last inspection it was not possible to judge whether the requirement had been met so it will be carried over to the next inspection. The Old Vicarage DS0000015127.V288390.R01.S.doc Version 5.1 Page 9 The Old Vicarage DS0000015127.V288390.R01.S.doc Version 5.1 Page 10 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 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Not all of the care plans that were inspected were up to date or accurate. Residents receive treatment from the relevant healthcare professionals. Residents are treated with respect and sensitivity at the time of their death and the period leading up to it. EVIDENCE: The senior carer stated that she was in the process of reviewing all of the care plans to ensure they are accurate and it will then be the responsibility of the key workers to review them on a monthly basis or more often if needed. None of the staff at The Old Vicarage had ever been on a course about writing care plans. The manager agreed that it would benefit the residents and staff if the staff attended a course on writing care plans. Evidence was seen of residents receiving the relevant health care support. One resident moved into the home in January using a wheelchair for all mobility. The staff had arranged for the resident to attend physiotherapy sessions and his mobility improved so that he is now able to walk with the aid of a stick. The medication administration charts were inspected and found to be satisfactory. Only the four members of staff who have attended medication The Old Vicarage DS0000015127.V288390.R01.S.doc Version 5.1 Page 11 training are responsible for the administration of medication. All of the staff are due to attend training in the administration of medication in May 2006. All of the residents spoken to stated that they felt the majority of the staff treated them with respect and dignity. One resident stated that he was not happy with the actions of one member of staff. The manager stated that the allegation had been investigated and the member of staff had taken the appropriate action in the situation raised. The manager and staff had shown great sensitivity in the period leading up to a resident’s death. Staffing numbers were increased to allow a member of staff to sit with the resident at all times. The manager was aware that the resident liked red wine so sat with him one evening and they both had a glass of wine and a chat. The Old Vicarage DS0000015127.V288390.R01.S.doc Version 5.1 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,14,15 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Due to several vacancies at the time of the inspection, but no reduction in staffing levels staff have more time to sit with the residents and do activities such as reminiscing. EVIDENCE: Because there are only fourteen residents at present and two members of staff and the manager on daytime shifts the staff feel they have more time to sit with residents and do activities such as look through photo albums and encourage residents to reminisce. Some of the residents stated that they go out of the home and attend a day service or go out with relatives. The manager stated that there were no trips out organised by the home last year due to problems with transport but that they will plan trips out when the weather is warmer. Staff asked residents if they would like a meeting to discuss any issues. However none of the residents contributed so the care staff tried to do this informally by chatting about different issues after residents had had their lunch but were still sitting in the dining room. The staff felt this was successful as residents talked about issues that concerned them. The Old Vicarage DS0000015127.V288390.R01.S.doc Version 5.1 Page 13 Residents are encouraged to bring personal possessions with them. One resident has a dog, which she keeps in her room. The resident stated that the manager drives her and the dog to any appointment as needed such as vets etc. The manager stated that there is always a choice of main course and dessert if a resident does not like the meal offered. One resident stated that the evening meal had improved as he could now choose a hot alternative. The manager stated that residents had always had the choice of a hot alternative. The inspector suggested reminding residents at each mealtime that there are alternative choices available. The majority of residents spoken to stated that the quality of the food varied from day to day. There was no fresh fruit available in communal areas on the day of the inspection. The manager stated that fruit is purchased and offered to the residents. He agreed to put bowls of fruit in the lounge so that residents can help themselves. The Old Vicarage DS0000015127.V288390.R01.S.doc Version 5.1 Page 14 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16,17,18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Policies and procedures are in place to prevent residents being put at risk. EVIDENCE: Residents stated that they would talk to Mr Paling or a member of staff if they wanted to make a complaint. No complaints have been received since the last inspection. The home has recently received a complimentary letter from a resident’s family about the care given to their relative. All care staff have received training in the protection of vulnerable adults. The Old Vicarage DS0000015127.V288390.R01.S.doc Version 5.1 Page 15 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19,20,21,22,23,24,25,26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The environment of the home provides residents with an attractive and homely place to live, with the equipment they need to help promote their independence. EVIDENCE: The home and its grounds are well maintained, free from offensive odours and clean. There are accessible toilets for residents close to the communal areas and their bedrooms. Procedures are in place for infection control. One resident stated that he felt his room was too small and would like a larger room. The manager agreed that if a larger room became available he would be offered the chance to move. The Old Vicarage DS0000015127.V288390.R01.S.doc Version 5.1 Page 16 One resident has her own furniture in her bedroom and the corridor outside her bedroom. The Old Vicarage DS0000015127.V288390.R01.S.doc Version 5.1 Page 17 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27,2829,30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. On the day of the inspection there were sufficient staff on shift to meet the needs of the residents. EVIDENCE: On the day of the inspection there were fourteen residents and two members of care staff and one manager on from 7.45am until 9.00pm. There is one person on waking night duty. The managers live in the grounds of the home and are on call throughout the night. The manager stated that when residents are unwell staffing numbers are increased to meet their needs. All of the staff have attended or are due to attend all of the mandatory training required. The staff team have recently completed a course in the care of people with dementia. At present the care staff are completing a distance learning course in infection control. Several staff intend to commence a NVQ 2 or 3 in care but due to funding restrictions cannot do this until they have completed their current course. During the last inspection it was agreed that Mr and Mrs Paling should be included on the staff rota. Although their hours have been included on some month’s rotas they were not on the current rota. The Old Vicarage DS0000015127.V288390.R01.S.doc Version 5.1 Page 18 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. There are informal ways of obtaining the residents and care staff views. Risk assessments are in place but need updating to ensure that they are accurate. EVIDENCE: Mr Paling stated that he has completed a Certificate in Health and Social Care and intends to start the Registered Manager Award in September 2006. The staff tried to hold a residents meeting so that they could discuss any issues but all of the residents declined to take part. However the staff encourage the residents to share any concerns about the home whilst sitting together at dinner. The manager stated that there is no formal quality assurance system at present but that he tries to seek the views of the residents on a daily basis and The Old Vicarage DS0000015127.V288390.R01.S.doc Version 5.1 Page 19 sends out questionnaires asking the residents if they are happy with the care they receive in the home. There are not regular staff meetings at present. Records and money held on resident’s behalf were checked and found to be accurate. Care staff are receiving supervision although this is being done during the shift in the lounge with the residents. Supervision should be on a one to one basis in a private setting so that both parties can discuss any issues or concerns if needed. The member of staff responsible for the supervisions has not received any training in how supervisions should be conducted. The manager agreed that it would be beneficial for the supervisor to attend training in this area. Each resident has risk assessments included in their care plan file, not all of these are dated and signed. There is a file, which contains risk assessments for working practises. However some of the risk assessments were completed in 2003 and have not been reviewed since. The Old Vicarage DS0000015127.V288390.R01.S.doc Version 5.1 Page 20 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 3 3 2 3 X N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 3 10 3 11 4 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 2 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 3 18 3 3 3 3 3 3 3 3 3 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 3 3 3 3 X 3 3 2 The Old Vicarage DS0000015127.V288390.R01.S.doc Version 5.1 Page 21 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 OP3 Regulation 14 Requirement Timescale for action 01/05/06 2 OP7 15 3 OP15 16(2)(i) Each prospective service user must have a full assessment to ensure the home can meet his needs. (This requirement has been brought forward from the last inspection. As no new service users had moved into the home since the last inspection it was not possible to assess this standard.) 01/07/06 Each service user must have a care plan which states how the service users needs in respect of his health and welfare are to be met. The care plan must be kept under regular review to ensure that it is accurate. This was a requirement from the previous inspection. Failure to meet this requirement could lead to the Commission taking enforcement action. Ensure that at all times suitable, 01/05/06 wholesome and nutritious food which is varied and properly prepared is available. The Old Vicarage DS0000015127.V288390.R01.S.doc Version 5.1 Page 22 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 OP36 Good Practice Recommendations Supervision should be held in a private room when the staff involved are not responsible for the residents welfare. The Old Vicarage DS0000015127.V288390.R01.S.doc Version 5.1 Page 23 Commission for Social Care Inspection Cambridgeshire & Peterborough Area Office CPC1 Capital Park Fulbourn Cambridge CB1 5XE 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 Vicarage DS0000015127.V288390.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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