Inspection on 30/01/07 for The Old Vicarage [Antony]

This inspection was carried out on 30th January 2007.

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 [Antony] 12/12/08

The Old Vicarage [Antony] 15/08/05

The Old Vicarage [Antony] 27/04/05

The Old Vicarage [Antony] 24/11/04

The Old Vicarage [Antony] 19/07/04

Similar services:

Fairfields Country Rest Home

Poldhu

Queensmount

Trevaylor Manor

Didsbury Court Rest Home

Stallcombe House

Belma

Hunters Care Centre

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

CARE HOMES FOR OLDER PEOPLE The Old Vicarage Antony Torpoint Cornwall PL11 3AQ Lead Inspector Mike Dennis Key Unannounced Inspection 30th January 2007 09:30 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 DS0000009199.V325675.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 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 DS0000009199.V325675.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service The Old Vicarage Address Antony Torpoint Cornwall PL11 3AQ 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) 01752 812384 01752 812816 antony@torcare.co.uk Torcare Limited Anne Marina Hetherington Care Home 22 Category(ies) of Dementia - over 65 years of age (4), Mental registration, with number Disorder, excluding learning disability or of places dementia - over 65 years of age (1), Old age, not falling within any other category (22) The Old Vicarage DS0000009199.V325675.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. Old Age, not falling within any other categories (OP) - maximum 22 Service users may include up to 1 adult aged over 65 years with a mental illness (MD(E)). Service users may include up to 4 adults aged over 65 years with Dementia (DE(E)). 15th August 2005 Date of last inspection 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 away 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 DS0000009199.V325675.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced inspection carried out on the 30th. And 31st. January 2007. The inspection took 11 hours to complete during which time the inspector met and spoke with service users and staff. 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? The Old Vicarage DS0000009199.V325675.R01.S.doc Version 5.2 Page 6 The registered manager has made a positive start and is in the process of consolidating and reviewing practice. Staff and service users were positive toward her and stated that a good professional rapport has been achieved. 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 summary of this inspection report can be made available in other formats on request. The Old Vicarage DS0000009199.V325675.R01.S.doc Version 5.2 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 DS0000009199.V325675.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 1. 2, 3, 6 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Prospective service users are given information concerning the home by way of the Statement of Purpose/Service User Guide. Contracts are issued to all service users. Service users are assed prior to admission to the home. The Old Vicarage DS0000009199.V325675.R01.S.doc Version 5.2 Page 9 EVIDENCE: The statement of purpose, previous inspection reports and other relevant information concerning this home is 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. A random inspection of at least six service user files showed that preinspection care assessments had been undertaken. The information collated and recorded enabled management to make informed decisions regarding the suitability of the placement. 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. Contracts or Statements of Terms and Conditions are issued for all service users. Intermediate treatment is not provided at this home. The Old Vicarage DS0000009199.V325675.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,9 and10. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Informative care planning was evidenced and service users agreed that their care was positive. Staff have been trained to administer medication and these practices were carried out according to policy and procedure documentation. Service users are treated with due regard to privacy and dignity. Service users’ health and personal care needs are properly addressed. The Old Vicarage DS0000009199.V325675.R01.S.doc Version 5.2 Page 11 EVIDENCE: . The records showed that service users’ health care needs are met by the home’s staff, local health services and where necessary other specialist professionals. Four service user files were case tracked. They all contained pre-admission assessments which formed the basis of the initial care plan. All care plans have been regularly updated and altered as necessary. Staff sign to say when this process is complete. In one instant the initial care plan has remained unchanged for over two years despite evidence presented that it is reviewed at regular intervals. It is recommended that in such instances a new care plan is generated to further demonstrate that full thought and effort has gone into the reviewing process. The care plans are supported by documented evaluation notes written on a daily basis. These were seen to be supportive and informative. These daily notes should also contain information relating to activities undertaken, social interaction etc. Many do but some are a little sparse in this area. The inspector witnessed a staff hand over of information, which was conducted in a professional manner. 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. When hand written entries are made on the medication administration sheets, these must always be signed for to provide an audit trail. 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. 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 DS0000009199.V325675.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14, 15 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users said that the home provided opportunities and respected choice in a way that met their needs. Visitors visit frequently. Food provided is of a good standard reflecting service user choice. 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 The Old Vicarage DS0000009199.V325675.R01.S.doc Version 5.2 Page 13 house entertainment is provided. There are sitting areas outside the home where umbrellas are provided to create shade when weather permits. Service users confirmed, as observed by the inspector, that the food was good with ample portions on offer. Special diets are provided as necessary. Most people come to the dining room for their meals but the wish not to do so is respected. Communion was held at the home on the day of inspection. The Old Vicarage DS0000009199.V325675.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 16, 18, Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home takes its responsibilities regarding complaints and the prevention of abuse seriously. Staff are trained to recognise and deal with issues that could be construed as abuse. EVIDENCE: The home has a complaints policy which is used should the need arise. There have been no complaints since the last inspection. Staff receive regular training and updates relating to the prevention of abuse (PoVA). This training commences for new staff through the induction period and is consolidated by further “in house” training via the training officer and through external training such as NVQ and various other short courses such as the “Alerters” course, No Secrets etc. All staff are checked (CRB/POVA) re their suitability to work with vulnerable adults before starting work. The staff who attended the Social Services training seminar on PoVA said they had found this very useful and informative. The Old Vicarage DS0000009199.V325675.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 19,20,21,22,23,24,25,26. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users are provided with a safe, clean environment both in their own rooms and in communal areas. The building provides for a homely environment. EVIDENCE: There have been no major changes to the home since the last inspection. 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. The Old Vicarage DS0000009199.V325675.R01.S.doc Version 5.2 Page 16 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 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 premises present as being clean and hygienic, comfortable and homely. Service users were happy with their surroundings. The Old Vicarage DS0000009199.V325675.R01.S.doc Version 5.2 Page 17 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. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29, 30. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. A good balance within the staff team exists with the majority of staff having considerable experience. The home’s recruitment policies and procedures are robust. Training is given a high priority. 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 14 of the 16 care staff employed have indeed achieved an NVQ award at, at least level 2. References, Criminal Records Bureau checks and PoVA clearances are The Old Vicarage DS0000009199.V325675.R01.S.doc Version 5.2 Page 18 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 kept in the home although files with personnel details remain in the main administration office in the sister home in Torpoint. The registered manager, and the training manager are responsible for organising training for the staff and a varied programme is arranged to meet people’s needs. This can consist of in house training sessions as well as external courses. Staff informed the inspector that they valued the opportunities for training made available to them. The staffing structure comprises:- Registered Manager, Deputy Manager, 16 care assistants, 2 cooks, 1 domestic and maintenance person. The Old Vicarage DS0000009199.V325675.R01.S.doc Version 5.2 Page 19 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. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35, 36, 38, Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The management of the home is of a good standard and promotes the well being of service users and staff. Financial and accounting procedures are appropriately managed. Record keeping is maintained according to the requirements of the regulations. EVIDENCE: The Old Vicarage DS0000009199.V325675.R01.S.doc Version 5.2 Page 20 The Registered Manager has been in post for approximately 5 months. She informed the inspector that she has 27 years experience in the care setting, the last 10, being employed at the companies sister home in Torpoint. She holds an NVQ level 3 qualification and is also a NVQ assessor. She has started her NVQ 4 and Registered Managers Award. Staff meetings and supervision sessions with staff are recorded and ideas and suggestions to assist service users are discussed. The company operates an internal quality assurance group known as the Care Standards Committee. This group comprises of representatives from management, staff at all levels, service users, relatives and other interested persons. There role is to advise on the quality of care being provided. The inspector read the report from this group following an internal inspection of the home. A questionnaire is given to service users and their families in order to solicit their views on the services provided by the home. The next quality audit is now due. 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. Finances are managed from the administration base in the companies other home and were not directly inspected on this occasion. However the inspector did inspect finances recently at the inspection of the other home and found all to be in order. The Old Vicarage DS0000009199.V325675.R01.S.doc Version 5.2 Page 21 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 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 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 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 3 X 3 The Old Vicarage DS0000009199.V325675.R01.S.doc Version 5.2 Page 22 Are there any outstanding requirements from the last inspection? None 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 OP9 Regulation 13 Requirement Ensure that the person making hand written entries to the medication administration record duly signs this record. Timescale for action 28/02/07 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 OP7 Good Practice Recommendations Service user care plans are reviewed at monthly intervals, dated, signed and marked “no change” when applicable. This practice is satisfactory for a period of 6months. There after it is recommended that a new, revised care plan be generated. The Old Vicarage DS0000009199.V325675.R01.S.doc Version 5.2 Page 23 Commission for Social Care Inspection St Austell Office John Keay House Tregonissey Road St Austell Cornwall PL25 4AD National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 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 DS0000009199.V325675.R01.S.doc Version 5.2 Page 24 - 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!