Inspection on 27/01/06 for The Old Vicarage

This inspection was carried out on 27th January 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 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 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 Unannounced Inspection 11:00 27 January 2006 th 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.V272175.R01.S.doc Version 5.0 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.V272175.R01.S.doc Version 5.0 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 The Old Vicarage (Ely) Limited Mrs Rigmor 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.V272175.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. 1 PD & 1 LD Only Date of last inspection 26th July 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, 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 Old Vicarage DS0000015127.V272175.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was the home’s second inspection for the year 2005/6. It was unannounced and conducted by two inspectors who spent a combined total of six 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. Although most of the standards were met one of the requirements from the previous inspection about providing all staff with mandatory training had not been fully met. An immediate requirement was issued stating that by the 10th February 2006 the manager must send a list to the commission of all the training staff have received and book them on any mandatory training they have not yet received. What the service does well: What has improved since the last inspection? What they could do better: Not all staff have received the mandatory training required. This was a requirement at the previous inspection. An immediate requirement was issued stating that by the 10th February 2006 the manager must identify any training The Old Vicarage DS0000015127.V272175.R01.S.doc Version 5.0 Page 6 needed and arrange the necessary courses. Failure to do this may lead the Commission to take enforcement action. Although care plans have progressed over the last two years staff, must ensure they are up to date and accurate by reviewing them regularly. 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.V272175.R01.S.doc Version 5.0 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.V272175.R01.S.doc Version 5.0 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 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. Prospective residents and their families are encouraged to visit the home before making a decision about whether the home is suitable. A resident had moved into the home six days previous to the inspection taking place. Two members of staff had visited the prospective resident in hospital to assess his needs. However the pre-admission assessment form was not fully completed by the time or on their return to the home. The care plan had also not been completed at the time of the inspection. The staff who visited the prospective service user stated that they did not want to make the gentlemen feel uncomfortable by filling in paper work but were aware of the need for the information to be recorded to allow all staff to meet the new residents needs. The Old Vicarage DS0000015127.V272175.R01.S.doc Version 5.0 Page 9 The manager stated that he was aware that the pre-admission form had not been completed and had requested the staff to do so. Resident’s files tracked contained a statement of terms and conditions. The Old Vicarage DS0000015127.V272175.R01.S.doc Version 5.0 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 Care plans need reviewing on a regular basis to ensure that information is accurate. At present this is not being done therefore care plans do not provide staff with all of the information required to meet the needs of the residents. Residents receive treatment from the relevant healthcare professionals. EVIDENCE: The manager arranges for all new residents to receive a visit from the local G.P. within the first week of moving into the home. One resident who had recently moved into the home stated that he missed his mobility but that the GP had visited and arranged for a referral to an occupational therapist to provide a walking frame to enable the resident to be more mobile. Residents care plans were tracked and they contained evidence that resident’s have regular access to relevant healthcare professionals as needed. A resident that had moved into the home a few days previous to the inspection did not have a care plan in place. The manager stated that he was aware of this and has asked the staff member responsible to complete it as soon as possible. Care staff stated that they were aware of the residents needs. The Old Vicarage DS0000015127.V272175.R01.S.doc Version 5.0 Page 11 Two of the care plans inspected contained information on personal details, terms and conditions of residence, care plan stating instructions for care staff to meet identified needs, personal safety and risk assessment. The care plans inspected for the two residents who had lived in the home for over a year were not being reviewed regularly each month. One of the care plans inspected stated that the resident wishes to self medicate. Discussion with the care staff revealed that the resident was not able to self medicate. The care plan had not been changed to reflect this and reviews completed stated ‘no change to care plan’. Care staff must take time to read the care plan and make any changed when completing the monthly reviews. The medication administration sheets were inspected and found to be accurate. Not all care staff have received formal training in the administration of medication. The trainer should be appropriate, knowledgeable in the subject and have relevant current experience of handling medication. The manager should also establish a formal means to assess whether the care worker is sufficiently competent in medication administration before being assigned the task. Care staff explained how they ensure that resident’s privacy and dignity is respected at all times. One carer explained how he tried to encourage residents to do small tasks for themselves and enable them to make their own decisions were possible e.g. giving several choices of clothing. Care staff stated that there were told during their induction how they should treat service users with respect such as knocking on bedrooms doors before entering. The Old Vicarage DS0000015127.V272175.R01.S.doc Version 5.0 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 Care staff encourage residents to get involved with in-house activities which interest them. Residents received an appealing and well balanced diet. EVIDENCE: One member of staff spoken to stated that he had found it hard to get residents involved in structured activities. Therefore he tried to get residents to take part in activities on an informal basis whenever time allowed. He stated that he would use old photos to encourage residents to reminisce or had used walking sticks turned upside down and a balloon left over from a party to play indoor ‘hockey’. One resident said that she enjoys playing cards in the afternoon with another resident and she also enjoyed reading the large print books supplied by the mobile library and attending church every Sunday but missed playing bingo and guessing games which used to be organised by the staff. One resident stated that they would like to go on trips out of the home. A resident’s relative spoken to said that a trip had been organised before Christmas but then was cancelled. Care staff stated that there had been a problem with transport. The menu on the day of the inspection was fish and chips or creamed potatoes and peas. The food looked hot and appetising. When questioned about the The Old Vicarage DS0000015127.V272175.R01.S.doc Version 5.0 Page 13 food one resident stated that she had been asked her likes and dislikes when she moved into the home. One resident’s relative stated that there was not always fresh fruit available in the lounges. Residents are encouraged to bring belongings with them and personalise their rooms. The Old Vicarage DS0000015127.V272175.R01.S.doc Version 5.0 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): 16,18 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. One resident’s relative said that he was not aware of the procedure to follow if he wished to make a complaint. The three care staff spoken to on the day of the inspection had completed training in the protection of vulnerable adults and were aware of the procedures to be followed. The Old Vicarage DS0000015127.V272175.R01.S.doc Version 5.0 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): 19,20,21,22,23,24,225,26 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, free from offensive odours and clean. One resident stated ‘this room is my home’. The environment is homely and welcoming. There are accessible toilets for residents close to the communal areas and their bedrooms. Procedures are in place for infection control. The Old Vicarage DS0000015127.V272175.R01.S.doc Version 5.0 Page 16 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): There are sufficient numbers of staff on duty 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 potential risk. EVIDENCE: Three staff files were inspected, One of the files was for a member of staff who only worked one shift per week in the home. She had not received any supervision but had received training in fire safety, moving and handling, infection control and food hygiene. The second of the staff members tracked had not received training in first aid, infection control, food hygiene or medication. The manager said that she had completed training in the protection of vulnerable adults but did not have a certificate for it in her file. The third member of staff tracked had received training in moving and handling, fire safety, informal medication training and protection of vulnerable adults. The Old Vicarage DS0000015127.V272175.R01.S.doc Version 5.0 Page 17 A requirement for all staff to receive mandatory training was made at the last inspection but had not been fully met. An immediate requirement was issued to the manager stating that he must list all the staff and the training they had received and identify and mandatory training staff had not completed and book them on the relevant courses by the 10th February 2006. The manager stated that he would do this. At the time of the inspection there were only 17 residents living at the home. The staff on shift during the inspection felt that at present there was enough staff on shift but if the number of residents increase (to a possible maximum of 22) it would be beneficial to have a third carer between the hours of 8am and 10.30am to assist with helping resident out of bed, with personal care and with breakfast. On the day of the inspection the carers stated that they had finished assisting people with getting out of bed, breakfast and personal care by 10.30am On the day of the inspection there were two carers on duty from throughout the normal waking day and one carer on a waking night shift from 7.45pm8.00. There is a 15 minute overlap for shifts for a staff handover meeting. The managers live next door to the care home and stated that they are always available to staff the senior carer is on call and could be at the home within a short period of time if necessary. The Old Vicarage DS0000015127.V272175.R01.S.doc Version 5.0 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): 32,36 Residents and staff feel that the home is run in an open way and could approach the owners/managers with any concerns. EVIDENCE: All of the staff spoken to on the day of the inspection stated that they found the owners/managers approachable and would speak to them if they had any concerns. The manager sends out questionnaires to the residents on a regular basis asking them if they are happy with the care that they receive or if anything could be improved. The staff supervision files were not in the home on the day of the inspection. The senior carer stated that they were all up to date but she was typing these up. Care staff confirmed that they were receiving regular supervision. The Old Vicarage DS0000015127.V272175.R01.S.doc Version 5.0 Page 19 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 3 3 2 3 X X HEALTH AND PERSONAL CARE Standard No Score 7 2 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 Standard No Score 16 3 17 X 18 3 3 3 3 3 3 3 3 3 STAFFING Standard No Score 27 3 28 2 29 3 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score X 3 X X X 3 X X The Old Vicarage DS0000015127.V272175.R01.S.doc Version 5.0 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 OP3 Regulation 14 Requirement Timescale for action 01/02/06 2 OP7 15 3. 4. OP9 OP28 13 18 Each prospective service user must have a full assessment to ensure the home can meet his needs. Each service user must have a 01/03/06 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. All staff must receive training in 05/04/06 the administration of medication. All staff must complete 10/02/06 mandatory training including infection control, food hygiene and adult protection, moving and handling, first aid, POVA. This was a requirement at the previous inspection. Failure to meet this requirement may lead to the commission taking enforcement action. An immediate requirement was issued for this requirement. The Old Vicarage DS0000015127.V272175.R01.S.doc Version 5.0 Page 21 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations The Old Vicarage DS0000015127.V272175.R01.S.doc Version 5.0 Page 22 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. 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