CARE HOMES FOR OLDER PEOPLE
The Old Vicarage Antony Torpoint Cornwall PL11 3AQ Lead Inspector
Philippa Cutting Unannounced 15 August 2005 09:30 a.m. 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 D52-D04 S9199 The Old Vicarage V234131 150805 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION
Name of service The Old Vicarage Address Antony Torpoint Cornwall PL11 3AQ 01752 812384 01752 816326 antony@torcare.co.uk Torcare Limited 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) Mrs Ellen Patricia Knell Care Home 22 Category(ies) of Dementia - over 65 years of age (4) registration, with number Mental Disorder, excluding learning disability or of places dementia - over 65 years of age (1) Old age, not falling within any other category (19) Physical disability (1) The Old Vicarage D52-D04 S9199 The Old Vicarage V234131 150805 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION
Conditions of registration: None Date of last inspection 27 April 2005 Brief Description of the Service: The Old Vicarage provides care for older people, some of whom may have a mild dementia or mental health problem. It is, as its name implies, an old building in the village of Antony near Torpoint. It is part of Torcare Homes Ltd with its sister home being approximately five miles way in Torpoint. There are a number of linked sessions for training etc between the two homes. Accommodation in The Old Vicarage is on three floors connected by a through floor lift and stairs. The majority of rooms are for single occupation and a few are en suite. There is a large sitting room and a dining room on the ground floor. Service users choosing to live at The Old Vicarage benefit from having reasonable mobility as there are slopes (with handrails) which have been put in to overcome steps and changes in level. Staff are however always willing to assist anyone who may need to rely on a wheel chair to cover longer distances. Exernally the home is surrounded by a sheltered garden and although some is sloping, there is a sitting area by front door. Access to the car park is via a steep slope or steps but there is an alternative rear entrance where a vehicle can pull up. The Old Vicarage D52-D04 S9199 The Old Vicarage V234131 150805 Stage 4.doc Version 1.40 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This was an unannounced inspection carried during the morning and afternoon in August. The inspector met and spoke with service users and staff, a number of whom she has met before. The premises and records were inspected and various topics discussed with the registered manager. The service users spoke well of the care that they received and said they were happy in the home. Some had chosen to live there because it kept them in contact with their locality, others had moved to be nearer relatives. Training for staff is regarded as important with various courses being arranged, some of which are mandatory. What the service does well: What has improved since the last inspection? What they could do better:
Encourage service users to be more involved in compiling their care plans and signing them to show their agreement. The Old Vicarage D52-D04 S9199 The Old Vicarage V234131 150805 Stage 4.doc Version 1.40 Page 6 Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The Old Vicarage D52-D04 S9199 The Old Vicarage V234131 150805 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 D52-D04 S9199 The Old Vicarage V234131 150805 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) 1,2,3,4,5 Information is sought about, and provided for, people enquiring about care and accommodation in the home. EVIDENCE: The statement of purpose and previous inspection reports are displayed in the home and service users are provided with copies of the service users guide. The registered manager, or occasionally a senior carer, visits people who are enquiring about a place to discuss their needs and ascertain whether The Old Vicarage can meet these. Information is obtained from relevant sources if any enquiry from out of the county is made. In discussion the home was aware of the need to have a contingency plans should the home, for what ever reason, find that they could not provide the service needed for someone in this position. Respite care is provided when there are suitable vacancies and a number of people who have chosen to become permanent residents, have had short stays before making a decision about where they will live. The Old Vicarage attracts people who are reasonably mobile but want to stay in or near their community.
The Old Vicarage D52-D04 S9199 The Old Vicarage V234131 150805 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) 7,8,9,10,11 Service users’ health and personal care needs are properly addressed. EVIDENCE: A care plan is prepared and reviewed for each service user. Not all are signed. The registered manager said she was discussing the care plans with people but she had experienced a reluctance on their part to sign them but she will persevere. The records showed that service users’ health care needs are met by the home’s staff, local health services and where necessary specialist referrals and other professions ancillary to medicine. Senior staff who administer medication have received training for this. The ordering, receipt and return of unused medication is the responsibility of one person who demonstrated competence in this. It is recommended that Termazepam is stored and recorded as a controlled drug. The service users with whom the inspector spoke said they were all very happy with the care that they received and felt that they were well looked after.
The Old Vicarage D52-D04 S9199 The Old Vicarage V234131 150805 Stage 4.doc Version 1.40 Page 10 There were letters from relatives of people who had been in the home both for a short stay or until their death, expressing their satisfaction with the care provided. The Old Vicarage D52-D04 S9199 The Old Vicarage V234131 150805 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) 12,13,14,15 Service users said that the home provided opportunities and respected choice in a way that met their needs. EVIDENCE: Visitors were seen to come and go during the day; families are encouraged to keep in touch with their relative and people can go out as they wish. Some of the service users were seen to enjoy conversation over their meals but many of these retreat to their rooms afterwards where they said they were content with television, radios and reading etc. Some of the frailer, quieter people tend to sit in the lounge although everyone is invited to join in any activities. Outings are organised periodically when the weather is good and various in house entertainment is provided. There are sitting areas outside the home where umbrellas are provided to create shade. Service users said the food was good although some felt their portions were more than they could manage. There are no special diets provided at present but this can be done if required. Most people come to the dining room for their meals but the wish not to do so is respected. The Old Vicarage D52-D04 S9199 The Old Vicarage V234131 150805 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) 16,17,18 The home takes its responsibilities regarding complaints and the prevention of abuse seriously. EVIDENCE: The home has a complaints policy which is used should the need arise. There have been no complaints since the last inspection. The staff who attended the Social Services training seminar on PoVA said they had fund this very useful and informative. The home has a policy a procedure for the protection of vulnerable adults. The Old Vicarage D52-D04 S9199 The Old Vicarage V234131 150805 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) 19,20,21,22,23,24,25,26 Service users are provided with a safe, clean environment both in their own rooms and in communal areas. EVIDENCE: There have been no major changes to the home since the last inspection. New carpet was laid through out then, which was a big improvement and rooms have been redecorated when they have become vacant. The home was in good condition with help provided for service users by means of different coloured doors to indicate toilets and handrails in passages. Equipment to help people remain independent and mobile was available or is obtained and hoists are used where the need is indicated. All staff have had training in their use. Service users’ rooms are adequately furnished, most people have brought items of their own with them, giving their rooms an individual feel. Radiator
The Old Vicarage D52-D04 S9199 The Old Vicarage V234131 150805 Stage 4.doc Version 1.40 Page 14 covers have been fitted throughout and hot water outlets fitted with thermostatic control valves to prevent service users from burning or scalding themselves. Service users’ rooms are provided on three floors and although there is a lift that stops at each floor there are also stairs. Where mobility becomes a problem and a service user does not always use the lift, access to rooms is assessed and where there is a problem, people are offered an alternative room on the ground floor whenever possible. The Old Vicarage D52-D04 S9199 The Old Vicarage V234131 150805 Stage 4.doc Version 1.40 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 Staff working in the home receive the necessary clearance and training to ensure the service users’ well being. EVIDENCE: The staffing at The Old Vicarage is formed by a regular team of people, most of whom have worked in the home for sometime and have got to know the service users’ likes and preferences. Service users stated that they felt the staff provided the care they needed in a kind and caring manner. All staff are encouraged to undertake National Vocational Qualifications and 52 have achieved this. References, Criminal Records Bureau checks and PoVA clearances are sought for all new staff who have to go through the home’s induction under supervision before working on their own. Staff files containing basic information and training records are now kept in the home although files with personnel details remain in the main administration office in the sister home in Torpoint. The registered manager is also responsible for organising training for the staff and she arranges a varied programme to meet people’s needs. This can consist of in house training sessions as well as external courses. The Old Vicarage D52-D04 S9199 The Old Vicarage V234131 150805 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) 31,32,33,36,37 The management of the home is satisfactory and promotes the well being of service users and staff. EVIDENCE: The registered manager said that she had almost completed her registered manager ‘s award. The training that she arranges helps her keep in touch with changes in legislation and practice. Staff meetings and supervision sessions with staff are recorded and ideas and suggestions to assist service users are discussed. A questionnaire is given to service users and their families in order to solicit their views on the services provided by the home. A reasonable return was reported. The Old Vicarage D52-D04 S9199 The Old Vicarage V234131 150805 Stage 4.doc Version 1.40 Page 17 The records required by statute are kept. Those inspected included the accident book, fire records, the insurance certificate and the registration certificate. Health & safety in the home is reviewed annually by an external consultant. The Old Vicarage D52-D04 S9199 The Old Vicarage V234131 150805 Stage 4.doc Version 1.40 Page 18 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 3 3 3 3 3 3 HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3
COMPLAINTS AND PROTECTION 3 3 3 3 3 3 3 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 3 3 3 3 3 x x 3 3 x The Old Vicarage D52-D04 S9199 The Old Vicarage V234131 150805 Stage 4.doc Version 1.40 Page 19 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 Regulation Requirement There are no statutory requirements Timescale for action 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 OP(9) Good Practice Recommendations It would be good practice to store and record Temazepam as a controlled drug The Old Vicarage D52-D04 S9199 The Old Vicarage V234131 150805 Stage 4.doc Version 1.40 Page 20 Commission for Social Care Inspection John Keay House Tregonissey Road St Austell Cornwall, PL25 4AD 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 D52-D04 S9199 The Old Vicarage V234131 150805 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. 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!