Inspection on 26/07/05 for The Old Vicarage

This inspection was carried out on 26th July 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 16/06/08

The Old Vicarage 18/09/07

The Old Vicarage 18/04/07

The Old Vicarage 21/04/06

The Old Vicarage 27/01/06

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 Announced Inspection 26th July 2005 @ 10:00 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 Vicarage Version 1.10 Page 3 SERVICE INFORMATION Name of service The Old Vicarage Address 32 Church Lane Littleport Cambridgeshire CB6 1PS 01353 865200 01353 865229 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) The Old Vicarage (Ely) Limited Mrs Rigmor Paling & Mr Michael 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 Version 1.10 Page 4 SERVICE INFORMATION Conditions of registration: One person with learning disabilities and one person with physical disabilities only. Date of last inspection 13th Janauary 2005 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 and one adult with learning disabilities and one adult with physical disabilites. The majority of bedrooms benefit from en-suite facilities. There are four double bedrooms and the rest are single. All bedrooms exceeded new 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 are the registered managers, 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 Old Vicarage Version 1.10 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was the home’s first inspection for the year 2005/6. It was announced and conducted by two inspectors who spent a combined total of 12 hours at the home and interviewed residents, visiting relatives, members of staff and the managers. The inspectors undertook a brief tour of the home, checked medication and viewed a range of documents. As a result of this inspection three requirements and three recommendations have been made. What the service does well: What has improved since the last inspection? What they could do better: The recruitment procedure must be followed for all staff to include criminal records bureau checks. The Old Vicarage Version 1.10 Page 6 Mandatory training such as infection control, food hygiene and adult protection must be completed and refreshed when necessary for all staff. The home could provide more varied activities at home and regular trips out for the residents who stated they would like this. Please contact the provider for advice of actions taken in response to this inspection. The full report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The Old Vicarage Version 1.10 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 Vicarage Version 1.10 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) 1,2,3,4,5 Prospective residents are given the written information they need to make informed choices and are encouraged to visit the home before deciding if it is the right home for them. EVIDENCE: One resident spoken to stated that he visited the home before making the decision to move in. Five residents files were tracked and all contained preadmission assessments either completed by the care manager or the home manager. The home has a statement of purpose and service users guide. They were not inspected on this occasion. One resident stated that he was not aware of the service users guide. The managers stated that he had been given a copy of the guide on admission to the home. The Old Vicarage Version 1.10 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 Systems of care planning were clear and well laid out and would be a useful tool in guiding staff about how to support those living in the home. Residents are supported to access health care professionals to ensure that they are receiving the appropriate treatment and care. Staff were seen encouraging service users to make their own decisions about their lives to the best of their abilities with help and guidance from staff when necessary. EVIDENCE: Care plans were tracked for five residents and contained the majority of information needed. The care plans should state who had completed them and when. Care plans should be completed for any specialist needs e.g. alcohol misuse and state the steps that staff should follow. Care plans should be signed by the resident or their representative when appropriate. Visits from healthcare professionals are recorded in the resident’s care plan. Staff were seen offering choices to residents such as how they would like their meal served. The Old Vicarage Version 1.10 Page 10 One resident said that staff do not knock on her door before entering as all the staff were her friends. Other residents spoken to stated that staff knocked on their doors before entering. One member of staff stated how she ensures that she treats the residents with respect and dignity. The Old Vicarage Version 1.10 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 standard(s) 12,13,14,15 Social activities in house are limited. Trips out are reliant upon care staff adding to their normal shifts and this had lead to there being no organised trips. The appointment of an activities co-ordinator would increase the range of activities in the home and the local community. This would further service users fulfilment. EVIDENCE: A number of residents stated that they would like more to do and to get out of the home more. The managers stated that activities are offered but residents rarely want to participate. Some activities were recorded in individual care plans but these were limited to activities inside the home unless a resident could go out without the assistance of a staff or family member. The managers also stated that it had been a few months since a trip out of the home had been organised but there was one organised for later that week. Residents relatives spoken to on the day of inspection stated that they were always made to feel welcome in the home when visiting there relative. The menu’s showed that there was a variety and choice of food available throughout the day. Bowls of fresh fruit were seen in the main lounge. The Old Vicarage Version 1.10 Page 12 The lunchtime period was observed and it was noted that the food was well presented and looked appetising and residents were offered a choice of what food they would like. The dining room had recently been redecorated. The majority of the people who commented on the food said how good it is. The Old Vicarage Version 1.10 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 standard(s) 16,18 The home has a satisfactory complaints procedure. Not all staff have received the necessary training to ensure that service users are protected from abuse. EVIDENCE: Five members of staff tracked had not received any training in the Protection of vulnerable adults. However one member of staff stated that she would report any allegations of abuse to the manager. Four members of staff had received training in the Protection of Vulnerable Adults. The Old Vicarage Version 1.10 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 standard(s) 19,20,21,22,23,24,25,26 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, homely and clean. One resident’s bedroom has an ongoing problem with an unpleasant odour. The cleaner stated that she cleans the room daily to alleviate this. One resident’s bedroom does not have a call bell facility. This should be risk assessed and if appropriate other means should be provided for the resident to notify staff when needed. Residents are encouraged to personalise their bedrooms. One resident has her own furniture in her bedroom and the corridor outside of her bedroom. The Old Vicarage Version 1.10 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 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 There are just sufficient numbers of staff on to meet the basic needs of the service users. However increased staffing levels would allow staff to spend more time with the residents and accompany them out more frequently, and do more activities. Not all staff have the mandatory training that is required. This places the residents at risk. Not all of the necessary recruitment documents were available for two members of staff. This could lead to the residents being placed at risk. EVIDENCE: Mr Paling stated that during the normal waking hours of the residents there are always at least two members of care staff on duty and that Mrs Paling also works care shifts when needed. Mr Paling is also on call for any emergencies. The rota was not clear what shifts Mr and Mrs Paling work in the home and when their days off were. This should be clarified so that the rota accurately states who is working each shift and when they are available. At present there are nineteen residents living in the home. Some residents spoken to said that they could not always find a member of staff when they needed to. The manager stated that staff have to work extra hours if a trip out is organised for the residents. Staff training in fire awareness had been arranged for the day of the inspection. Not all staff had received training in infection control, first aid and food hygiene. The manager stated that he would organise the training dates by the 9th August 2005. The manager had not requested a member of the bank staff to complete a criminal records bureau check(CRB) as they were working at another local The Old Vicarage Version 1.10 Page 16 home and had completed one for their employment there. The manager was advised that a CRB and POVA First check should be completed for all new staff. The manager had also assumed that as she was from the other home the carer received all of the necessary training from the other home although she had only produced one training certificate. The Old Vicarage Version 1.10 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 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) 32,33,34,35,37,38 The management approach of the home creates an open and inclusive atmosphere. EVIDENCE: Staff and residents spoken to on the day of the inspection stated that if they had any concerns they would discuss them with one of the managers. Resident’s questionnaires are given out every three months so that residents can state if they are happy with the service they are receiving or if any improvements could be made. The manager stated that a residents, relatives and carers meeting was being planned for October to discuss any issues relating to the home. The manager stated that he does not hold any money on behalf of the residents. The fire records were inspected and found to be accurate. The Old Vicarage Version 1.10 Page 18 The Old Vicarage Version 1.10 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. Where there is no score against a standard it has not been looked at during this inspection. 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 3 3 3 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 3 15 3 COMPLAINTS AND PROTECTION 3 3 3 3 3 3 3 3 STAFFING Standard No Score 27 2 28 2 29 2 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 X 2 x 3 3 3 3 x 3 3 The Old Vicarage Version 1.10 Page 20 No 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. 2 Standard 12 18 Regulation 16(2)(n) 18(1)(c)(i ) Requirement Consult service users about the activities provided. All staff must complete mandatory training including infection control, food hygiene and adult protection. Timescale for action 1st October 2005 Dates to be arranged by the 9th October as agreed during the inspection. Immediate i.e.26th July 2005 3. 29 17(2) A satisfactory CRB and POVA First check should be received before staff commence work in the home unsupervised. 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 12 7 30 Good Practice Recommendations Offer residents regular trips out of the home to places of interest. Provide a care plan on how staff should work with residents to prevent alcohol abuse. Increase staffing levels to allow staff to spend more time on activities with residents. The Old Vicarage Version 1.10 Page 21 Commission for Social Care Inspection 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 Version 1.10 Page 22 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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