Inspection on 04/07/06 for The Old Vicarage

This inspection was carried out on 4th July 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 no outstanding requirements from the previous inspection report, but made 5 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

The Old Vicarage 27/06/07

The Old Vicarage 07/11/05

The Old Vicarage 19/07/05

The Old Vicarage 24/02/05

The Old Vicarage 01/06/04

Similar services:

Hillside

Applegarth

122 Scorer Street

Jubilee Villa Care Home

Thornham Grove

Beech Lodge

8 Thorndale Road (Homefield College)

Hunter`s Lodge

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

CARE HOME ADULTS 18-65 Old Vicarage (The) Market Place Riddings Alfreton Derbyshire DE55 4BQ Lead Inspector Bridgette Hill Key Unannounced Inspection 4th July 2006 09:05 Old Vicarage (The) DS0000020065.V300949.R01.S.doc Version 5.2 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 Old Vicarage (The) DS0000020065.V300949.R01.S.doc Version 5.2 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 Adults 18-65. 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. Old Vicarage (The) DS0000020065.V300949.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Old Vicarage (The) Address Market Place Riddings Alfreton Derbyshire DE55 4BQ (01773) 607479 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) Mr Raymond Miles Mrs Pauline Ann Miles Jane Anne Selby Care Home 10 Category(ies) of Learning disability (10) registration, with number of places Old Vicarage (The) DS0000020065.V300949.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 7th November 2005 Brief Description of the Service: The Old Vicarage is a large old building in a pleasant area. It is well decorated and maintained. The home is within a short distance from local shops and a park. The Registered Providers offer places for up to 10 people with learning disabilities, for male and female residents. The home has two flights of stairs, both going onto the 1st floor. This would make accommodating someone with mobility problems difficult, although there are some bedrooms and a bathroom and toilets downstairs. There is one double room at the home. There is a separate dining area as well as a seating area in the kitchen. The home has two dogs and a cat. Old Vicarage (The) DS0000020065.V300949.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was an unannounced one which took place over 5 hours. The purpose of the inspection was assess all key standards and compliance to previously listed requirements The Manager Jane Selby was on duty for the whole of the inspection. As part of the inspection one staff member and one service user were spoken with. A range of records were also examined to assess how standards were being met. What the service does well: What has improved since the last inspection? What they could do better: Whilst it was apparent through discussion with the Manager that there was a vision for the development of the home there was not a recorded annual development plan in place. There was not secure storage of chemical cleansers in the home. Old Vicarage (The) DS0000020065.V300949.R01.S.doc Version 5.2 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. Old Vicarage (The) DS0000020065.V300949.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Old Vicarage (The) DS0000020065.V300949.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 2,3 A Terms and conditions of residency contract gave information to service users regarding what was included in their stay at the home. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service EVIDENCE: Since the last inspection a Terms and conditions of residency contract had been introduced. This gave information on services provided at the home and notice periods. The document was long and wordy and may not be suitable for all service users to understand however the Manager said she talked to service users about the content to explain this along with the key worker. There had not been any new service users since the last inspection. Some service users had lived at the home since the home opened in 1988. Old Vicarage (The) DS0000020065.V300949.R01.S.doc Version 5.2 Page 9 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6,7,9 Well detailed care plans were in place which gave an excellent sense of the service users as individuals. Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to the service EVIDENCE: Care plans were in place for all service users. These were typed, easy to read and gave a detailed overview of strengths and abilities as well as areas of need and what help was required. The information portrayed a strong sense of the service users as individuals. Care plans were reviewed and had been updated to reflect changes. Planning and risk assessments were evident in advance where changes were planned. Care reviews with Care Managers and any other relevant parties were held annually and minutes of meetings were available. Risk assessments were included in care plans for a range of activities in and out of the home. This included any domestic tasks that service users did which were also detailed in service users care plans. Old Vicarage (The) DS0000020065.V300949.R01.S.doc Version 5.2 Page 10 Old Vicarage (The) DS0000020065.V300949.R01.S.doc Version 5.2 Page 11 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,15,16,17 Service users enjoyed a varied lifestyle in which they were given choices and were cared for by staff who knew their needs. Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to the service EVIDENCE: All apart from one service user attended day services outside of the home. A range of activities were followed there depending on the interests and abilities of the individual. Staff were aware of service users interests and this was reflected in the style and contents of service users bedrooms. Whilst no service user attended any work scheme there was one service user for whom this was being considered. All service users had recently been on holidays of their choice, some to Skegness and some to Spain. This was said to have been enjoyed very much by one service user. Old Vicarage (The) DS0000020065.V300949.R01.S.doc Version 5.2 Page 12 Service users were actively encouraged to participate in the running of the home and took it in turns to choose the menu for the week. There was positive approaches made from service users to staff and it was apparent the service users felt comfortable about approaching staff. Records of foods served were retained including where service users had something different to the main meal. The home had its own minibus and service users used this to access local shops. Pubs and other community services were also accessed regularly by service users. An external entertainer also occasionally visited the home it was said that service users enjoyed this very much. Staff spoken to knew of the service user likes and preferences. They were also aware of any allergies service users had. Old Vicarage (The) DS0000020065.V300949.R01.S.doc Version 5.2 Page 13 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 18,19,20 The healthcare needs of service users were well documented with appropriate measures being taken to address these. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service EVIDENCE: Care plans contained details of any medical conditions and treatments. There was documented input in care files from a range of healthcare professionals including Community nurse and speech and language therapists. There was established links with local dentists and opticians. It was apparent from the care files that some service users physical needs were changing and there were examples of increasing mobility and sensory impairment being experienced by service users as they aged. There had been some measures taken to address these. Information was also supplied to the home after the inspection on the assessment of any tissue viability needs. The storage and administration of medicines was examined at this visit. Some minor deficits were found which included not recording the actual dosage administered where variable dosages were prescribed. Topical preparations Old Vicarage (The) DS0000020065.V300949.R01.S.doc Version 5.2 Page 14 also required dated on opening. Information leaflets on the drugs used in the home were available however the drug reference book available was dated Information was supplied after the inspection to the home giving guidance on the administration of medicines. There were no records kept of medications being received into the home although any returns to pharmacy were documented. The secondary dispensing of medications was discussed with the Manager who was not aware that this was not accepted practice. Care files contained some details on post death wishes. These were mainly recorded after there had been consultations with families of service users. Due to impaired capacity some service users were not able to make this decision for themselves. Old Vicarage (The) DS0000020065.V300949.R01.S.doc Version 5.2 Page 15 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 22,23 There were procedures in place and good knowledge displayed by all spoken to at the home to demonstrate that any complaints or allegations would be handled appropriately. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service EVIDENCE: There had not been one complaint recorded since the last inspection. This was recorded with the outcome within an appropriate timescale. This was regarding a problem between service users but was handled well by the home. A complaints procedure was in place and had timescales and the address of the Commission for Social Care Inspection. There was a copy of Derbyshire County Councils Protection of vulnerable adults procedures in the home and the homes home procedure. This required some minor adjustment to ensure that when staff were clear that when Social services were informed as was the policy this would trigger the statutory Protection of vulnerable adults procedure that Derbyshire County Council implemented. Staff spoken knew about different types of abuse and had knowledge of the whistle blowing policy. All staff had received training in the Protection of vulnerable adults. The Manager was knowledgeable about the Protection of vulnerable adults list and knew how and when to refer to this if required. Old Vicarage (The) DS0000020065.V300949.R01.S.doc Version 5.2 Page 16 Service users all had access to their personal allowances. Service users also had savings accounts and were encouraged to save for larger expenditures such as holidays though not all service users did do this. The money not saved was given to service users to use as they wished. Old Vicarage (The) DS0000020065.V300949.R01.S.doc Version 5.2 Page 17 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 24,30 The home is domestic in character and provides a comfortable and homely environment for service users. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service EVIDENCE: There were two lounge areas and one dining area available in the home. The kitchen also had a dining table. The home is domestic in size and nature. A well tended garden with outdoor seating was available and barbeques have been held in good weather. There are 8 single bedrooms and one double bedroom. This is shared with the consent of the service users and has a partition and privacy curtain in place. The home was found to be generally well maintained. Some paper was peeling in one lounge and this should be considered for redecoration. There was evidence of ongoing investment in the environment with a new sink being fitted in the kitchen and some doors had been replaced Old Vicarage (The) DS0000020065.V300949.R01.S.doc Version 5.2 Page 18 One service users bedroom had been made larger by the removal of a chimneybreast. The home was found to be clean in all areas. In the laundry which was not lockable there were chemical cleansers being openly stored. These must be stored securely to prevent risk of accidental ingestion. Old Vicarage (The) DS0000020065.V300949.R01.S.doc Version 5.2 Page 19 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 32,33,34,35,36 There is a stable and knowledgeable staff group at the home who are deployed in a flexible way to ensure service users needs are met. Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to the service EVIDENCE: There was a flexible approach to staffing levels according to what was planned and any appointments that service users had. As a minimum there was two staff on duty for all periods between 7.00am and 9.00pm. During this period there were times when additional staff were on duty. Between 9.00pm and 7.00am there was one sleeping staff member but other staff were on call nearby for an any emergencies. Staff spoken to at the home appeared to be knowledgeable of service users needs including preferences and allergies. There were 9 care staff employed at the home of which 5 have achieved NVQ (National Vocational Qualification) level 2 in care. Some staff have progressed to work towards NVQ (National Vocational Qualification) level 3 in care. A sample of two staff personnel files were examined these had some deficits as proof of identity and photographs were not available. No new staff have employed at the home for the past 4 years and the staff group is a stable one. Old Vicarage (The) DS0000020065.V300949.R01.S.doc Version 5.2 Page 20 Positively Criminal Records Bureau checks were in place and references had been obtained. A range of training had been completed by staff including moving and handling, first aid, Protection of vulnerable adults, medications, and fire safety. The staffs Basic Food Hygiene certificates were displayed. Infection control training was planned to take place as recommended at the previous inspection. Some staff supervision had taken place and were recorded. The frequencies of these were at times irregular and did not meet the recommended six times annually. The Manager said that there was very a very close working relationship with staff as the home was a small home. One staff member said working at the home was not like going to work and they enjoyed it very much. Old Vicarage (The) DS0000020065.V300949.R01.S.doc Version 5.2 Page 21 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. 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 are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 37,38,39,41,42,43 There are clear and responsive management procedures implemented at the home. Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to the service EVIDENCE: The Registered Manager has worked at the home for 12 years but only in a managerial capacity for the last year. The Manager has achieved a relevant managerial qualification. The home is run in a family oriented fashion but there are also clear managerial and administrative systems in place. There appeared to be an open managerial style in place with everyone working alongside each other. Staff spoken to said they felt able to approach the Manager should they be concerned about anything. Two questionnaires had been completed within the last year regarding the quality of the service. These had been given to relatives and the feedback Old Vicarage (The) DS0000020065.V300949.R01.S.doc Version 5.2 Page 22 given was very good. The Manager said that a new questionnaire had been devised to use in the near future. All service records and risk assessments for the environment were up to date. Written risk assessments for many tasks such as hovering had been introduced. The Owners had begun monthly written reviews regarding quality at the home. The Owners also continued to work some hours providing care to service users. Where problems or works had been identified on these reports there had been work completed to address the findings for example the dining room floor had been varnished. Service users meetings were held and minutes kept. The Manager said that the service users liked meetings and participated well. Staff meetings were also held. Aspects of quality in the home were discussed at these for example cleaning. There was not a recorded annual development plan in place despite it being apparent through discussion that there were a vision and plan for the development of the home. There has been a positive response to all previously listed requirements and recommendations on inspection reports. A valid public liability certificate was displayed in the entrance hall. Records for establishing financial liability were not requested. Old Vicarage (The) DS0000020065.V300949.R01.S.doc Version 5.2 Page 23 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 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 x 2 3 3 x 4 x 5 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 3 25 x 26 x 27 x 28 x 29 x 30 2 STAFFING Standard No Score 31 x 32 3 33 3 34 2 35 3 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 x 3 x LIFESTYLES Standard No Score 11 3 12 3 13 3 14 3 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score x 3 2 3 3 3 3 x 3 3 3 Old Vicarage (The) DS0000020065.V300949.R01.S.doc Version 5.2 Page 24 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 YA20 Regulation 13 Requirement Where a variable dosage of a medication is prescribed the actual dosage administered to the service user must be recorded Medication administration records for each service user must record all medications administered and who administered them to provide a complete record of treatment received by the service user All topical preparations must be dated on opening and discarded within manufacturers guidelines All chemical cleansers must be held securely in the home to prevent the possibility of accidental ingestion Staff must have all pre employment checks described by Schedule 2 completed and evidence retained on files Timescale for action 30/07/06 2 YA20 13 30/07/06 3 YA20 13 30/07/06 4 YA30 13 30/08/06 5 YA34 19 30/08/06 Old Vicarage (The) DS0000020065.V300949.R01.S.doc Version 5.2 Page 25 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 2 3 4 5 6 7 Refer to Standard YA20 YA20 YA24 YA33 YA36 YA39 YA39 Good Practice Recommendations A drug reference book not dated more than one year old should be obtained The quantity of medication received into thehome should be recorded The lounge should be considered for redecoration Feedback should be formally sought on the home from visiting professionals Staff should have regular recorded supervision meetings at least 6 times a year Feedback should be formally sought on the home from visiting professionals The annual development plan should be formalised into a written document Old Vicarage (The) DS0000020065.V300949.R01.S.doc Version 5.2 Page 26 Commission for Social Care Inspection Derbyshire Area Office Cardinal Square Nottingham Road Derby DE1 3QT 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 Old Vicarage (The) DS0000020065.V300949.R01.S.doc Version 5.2 Page 27 - 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. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!