Inspection on 30/08/05 for The Old Vicarage

This inspection was carried out on 30th August 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. 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 10/01/07

The Old Vicarage 14/12/05

The Old Vicarage 08/12/04

The Old Vicarage 25/05/04

The Old Vicarage 27/01/04

Similar services:

St Vincents

The Cotswold Home

Newbeech House

Winton House

Rush Court

Hillyfield Rest Home

The Maypole Nursing Centre

The Briars

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

CARE HOMES FOR OLDER PEOPLE The Old Vicarage Reading Road Moulsford Wallingford OX10 9JB Lead Inspector Kate Harrison Announced 30/08/05 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 H57_H08_S27181_The Old Vicarage_V234297_300805_Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service The Old Vicarage Address Reading Road Moulsford Wallingford OX10 9JB 01491 651429 01491 652635 manager@theoldvicarage.fote.org.uk Friends of the Elderly 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) Carole Bourne Care Home (CRH) 50 Category(ies) of Care Home with Nursing (N) registration, with number of places Mental disorder, excluding learning disablility or dementia - over 65 (MD(E)) 10 Old age, not falling withing any other category (OP) 50 Dementia - over 65 years of age (DE(E)) 10 The Old Vicarage H57_H08_S27181_The Old Vicarage_V234297_300805_Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: 1: On admission persons should be aged 60 years and over. 2: The total number of persons that may be accommodated at any one time must not exceed 50 of which up to 10 may be in either the DE(E) or MD(E) category. Date of last inspection 8th December 2004 Brief Description of the Service: The Old Vicarage is a care home owned and managed by the charity Friends of the Elderly. The home is situated in a residential area of Moulsford and is set in attractive grounds accessible to all the residents. Accommodation is provided over two floors in single rooms with en-suite facilities. Residents have use of the communal facilities, including two day rooms and a dining room. The home is managed by the registered manager and her deputy and a team of registered nurses, carers, and housekeeping staff. A physiotherapist and an activities organiser are also part of the care tem. The Old Vicarage H57_H08_S27181_The Old Vicarage_V234297_300805_Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This announced inspection took place over one day. The registered manager had previously returned the pre-inspection questionnaire information requested by CSCI, and 28 individuals returned completed comment cards including residents, relatives and health professionals. The inspector met residents, relatives, other care professionals and staff during the inspection, and discussed issues with them, the registered manager and the deputy manager. This report reflects findings on the day, and information supplied before, during and after the inspection. What the service does well: What has improved since the last inspection? A new member of staff responsible for maintenance of the home has been appointed. Refurbishment of individual rooms has continued, and at least six more rooms have been updated. The senior care managers have attended training on staff supervision. Training on dementia care mapping has been provided for staff, and consequently the care of those with dementia has improved. A culture of learning is being developed at the home. The Old Vicarage H57_H08_S27181_The Old Vicarage_V234297_300805_Stage 4.doc Version 1.40 Page 6 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 H57_H08_S27181_The Old Vicarage_V234297_300805_Stage 4.doc Version 1.40 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 H57_H08_S27181_The Old Vicarage_V234297_300805_Stage 4.doc Version 1.40 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) 3. Standard 6 does not apply to the home. Appropriate care needs assessments are conducted. EVIDENCE: The registered manager usually visits the prospective resident and assesses the care needs. The inspector saw three pre admission assessments conducted by the registered manager and noted that the care needs of the three individuals were appropriately assessed, and it was clear that the needs would be met at the home. The Old Vicarage H57_H08_S27181_The Old Vicarage_V234297_300805_Stage 4.doc Version 1.40 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 and 9. The care planning arrangements are good. Health care needs are met, and the arrangements for managing medicines are good. EVIDENCE: The inspector saw three care plans showing details of the individual care to be given by staff. Appropriate risk assessments are in place, and the care needs are addressed and reviewed regularly. Feedback from residents through the comment cards and verbally on the day of inspection showed that the care is good at the home. To assess residents’ nutritional status, the home uses the Prideaux Nutritional Risk Scale, and should use the individual’s body mass index (BMI) as part of the assessment. The inspector noted that an assessment of the individual’s build was used instead and recommends that an accurate BMI figure be used as part of the assessment tool. The Old Vicarage H57_H08_S27181_The Old Vicarage_V234297_300805_Stage 4.doc Version 1.40 Page 10 The inspector saw evidence that the staff team has very good relationships with other health care professionals, such as the district nurses and GPs, and spoke to a community psychiatry nurse and to a music therapist during the inspection. Both confirmed that staff readily seek their advice and willingly implement suggestions to improve residents’ lives. The home has good arrangements with the physiotherapist to review the wheelchair needs of residents in a timely way. Residents told the inspector that staff fully understood their health needs, and made sure they were addressed. The inspector saw the arrangements for the management of medicines in the home, including the controlled drugs register, and was satisfied that medicines are appropriately managed. The Old Vicarage H57_H08_S27181_The Old Vicarage_V234297_300805_Stage 4.doc Version 1.40 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) X None of these standards were assessed at this inspection, and will be assessed at the next inspection. EVIDENCE: The Old Vicarage H57_H08_S27181_The Old Vicarage_V234297_300805_Stage 4.doc Version 1.40 Page 12 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 and 18. The complaints procedure is easy to use but all complaints are not recorded, and residents’ issues are not always resolved. EVIDENCE: The home’s policy and procedure for making complaints is clear, and the registered manager is responsible for addressing complaints within the home. There is no record of complaints received, though several residents told the inspector about continuing issues with laundry and individual preferences regarding food. The registered manager said that there is a complaints register outside the dining room where residents can record issues, but the registered manager must keep a separate record of all complaints made by residents. The record should show what action was taken and that the response was made within the required timescale of 28 days. The registered manager agreed that a resident’s idea of a ‘suggestions box’ would be a good idea as a means of communication. Issues can then be followed up and discussed at the regular residents’ meetings. . The home has several policies regarding issues around protection of vulnerable adults, such as a restraint policy, but does not have a procedure for addressing allegations of abuse. The registered manager and other staff have attended training on the protection of vulnerable adults, and a copy of the Oxfordshire Adult Protection multi-agency codes of practice is available at the home. The inspector recommends that a procedure be developed for the home, complying with the codes of practice, to give clear guidance for staff in the event of an allegation of abuse. The Old Vicarage H57_H08_S27181_The Old Vicarage_V234297_300805_Stage 4.doc Version 1.40 Page 13 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 and 26. Residents live in a safe well-maintained environment. The home is clean, pleasant and hygienic. EVIDENCE: The grounds are well maintained, and the registered manager has contact with the local fire officer about best practice regarding fire safety within the home. An environmental health inspection has recently been conducted and no actions were required. The inspector spoke to a member of the housekeeping staff, who said that the team know how to report any damage or broken items within the home so that repairs can be undertaken swiftly. The home has a policy and procedure for addressing infection control issues, and on the day of inspection the premises were clean. The laundry is appropriately sited, has appropriate washing programmes and has hand washing and drying facilities available for staff. The Old Vicarage H57_H08_S27181_The Old Vicarage_V234297_300805_Stage 4.doc Version 1.40 Page 14 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27, 29 and 30. Sufficient staff are not on duty to deal with administrative/receptionist duties. The home’s recruitment procedures must be improved to protect residents. EVIDENCE: A rota is kept to show which staff members are on duty during the 24 hours. Registered nurses are on duty over the 24 hours in both care areas, and agency staff are employed to make up the shortfall in both nursing and care staff. Agency staff were used regularly over the Summer period and the charity is trying to recruit carers to address the staff shortage. Several residents expressed their concerns about staffing over the weekend, and relatives commented on difficulties in getting the telephone answered. Some residents said they had to wait longer periods for the front door to be opened at weekends. The registered manager should consult with residents and consider how best to address their concerns regarding staffing over the weekend periods. The inspector checked the home’s recruitment procedures through staff files. Some staff are recruited from Poland and staff from the charity go to manage the recruitment process. Not all the necessary information was available about some individuals working at the home, as references were not available for one individual, and the appropriate Criminal Records Bureau clearance and a photograph were missing from another file. The Old Vicarage H57_H08_S27181_The Old Vicarage_V234297_300805_Stage 4.doc Version 1.40 Page 15 The registered person must ensure that all the necessary information detailed in Regulation 19 and in Schedule 2 (amended) is available about all persons working at the home. Staff are able to access the local Primary Care Trust training on wound management and have worked with the district nurses to improve continence management. Some staff have received training on dementia care mapping, and work in partnership with the community psychiatric nurse to improve daily life for those with dementia. The home’s induction programme has recently been amended and improved. The Old Vicarage H57_H08_S27181_The Old Vicarage_V234297_300805_Stage 4.doc Version 1.40 Page 16 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) 38. Health and safety policies are in place, but the training of staff in first aid must be arranged. EVIDENCE: The home has appropriate policies on health and safety matters, and had a recent health and safety inspection. Appropriate service contracts are in place for all the equipment and appliances. The home has no staff qualified in first aid, and the registered manager must make arrangements so that a qualified first aider is on duty at all times. The Old Vicarage H57_H08_S27181_The Old Vicarage_V234297_300805_Stage 4.doc Version 1.40 Page 17 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score x x 3 x x N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 4 9 3 10 x 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 x 13 x 14 x 15 x COMPLAINTS AND PROTECTION 3 x x x x x x 3 STAFFING Standard No Score 27 2 28 x 29 2 30 x MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 2 x 2 x x x x x x x 2 The Old Vicarage H57_H08_S27181_The Old Vicarage_V234297_300805_Stage 4.doc Version 1.40 Page 18 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. Standard 16 Regulation 17 (2) Requirement The registered manager must keep a record of all complaints made by residents, their representatives or staff, and the action taken to address the complaint The registered person must ensure that all the necessary information detailed in Regulation 19 and in Schedule 2 (amended) is available about persons working at the home. the registered manager must make arrangements so that a qualified first aider is on duty at all times. Timescale for action 30/09/05 2. 29 19 14/10/05 3. 38 13 31/11/05 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 7 Good Practice Recommendations The inspector recommends that an accurate BMI figure be used as part of the assessment tool. H57_H08_S27181_The Old Vicarage_V234297_300805_Stage 4.doc Version 1.40 Page 19 The Old Vicarage 2. 18 The registered manager should ensure that an adult protection procedure for the home is developed, complying with the Oxfordshire codes of practice, to give clear guidance for staff in the event of an allegation of abuse. The registered manager should consult with residents and consider how best to address their concerns regarding staffing over the weekend periods. 3. 27 The Old Vicarage H57_H08_S27181_The Old Vicarage_V234297_300805_Stage 4.doc Version 1.40 Page 20 Commission for Social Care Inspection Burgner House 4630 Kingsgate Oxford Business Park (South) Cowley, Oxford, OX4 2SU 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 H57_H08_S27181_The Old Vicarage_V234297_300805_Stage 4.doc Version 1.40 Page 21 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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