CARE HOMES FOR OLDER PEOPLE
The Old Vicarage Ropers Lane Otterton Budleigh Salterton Devon EX9 7JF Lead Inspector
Vivien Stephens Key Unannounced Inspection 19th January 2007 11:00 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 DS0000022065.V322150.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 DS0000022065.V322150.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION
Name of service The Old Vicarage Address Ropers Lane Otterton Budleigh Salterton Devon EX9 7JF 01395 568208 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 Michael John Parkin Mrs Patricia Ann Parkin Mrs Susan Gladys Tisdall Care Home 26 Category(ies) of Old age, not falling within any other category registration, with number (26), Physical disability over 65 years of age of places (26) The Old Vicarage DS0000022065.V322150.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION
Conditions of registration: Date of last inspection 1st February 2006 Brief Description of the Service: The Old Vicarage provides accommodation together with personal care to up to 26 older people who may also have a physical disability. The home is situated in the small village of Otterton in East Devon, midway between Sidmouth and Budleigh Salterton. Facilities in the village include a church, village hall, post office and general stores. The building is described in the brochure as a gracious and elegant house, mainly Georgian with Tudor origins that has been lovingly restored and converted to use as a care home. The home is fully carpeted, centrally heated and exceptionally well decorated, furnished and maintained. There is level access on both ground and first floors and a passenger lift between the two floors. There is level access to the gardens from the ground and first floors. All bedrooms are single occupancy with en suite facilities. All overlook the gardens; some have views of surrounding countryside. There is ample parking in the grounds. Trained nurses are employed although there is no requirement for this in a care home not providing nursing. A copy of this inspection will be made available at the home on request. At the time of this inspection the fees ranged from £623 to £769 per week. The Old Vicarage DS0000022065.V322150.R01.S.doc Version 5.2 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. Several weeks before this inspection began a questionnaire was completed by the home and this was sent to the Commission. This information was used to send survey forms to each member of staff at the home, each resident, and to health and social care professionals involved with the home. Responses were received from 19 residents, 27 staff and 4 general practitioners. The inspection began at approximately 11am and finished at 5.45pm. During the day interviews took place with 5 residents, 4 staff and the owners, Mr and Mrs Parkin. A tour of the home was carried out, the storage and administration of medicines was inspected, and other records were seen. What the service does well:
The home takes very good care to ensure prospective residents are given all the information they need, and plenty of opportunities to get to know the home before any decision to move in is made. Good assessment procedures are in place to ensure the home is confident they can meet the prospective residents’ needs. Residents talked about the excellent care taken before they moved in to help them decide if the move was right for them. Residents and health care professionals who completed questionnaires prior to this inspection were full of praise for the standard of health and personal care provided. Comments from GP’s included “Excellent home”, “Really lovely home”, and “Very impressed with all aspects of residents’ care. Well done to the staff.” Comments from residents included “ The Old Vic is exceptional in terms of the care and attention given.” A wide range of activities and entertainments are provided. On the day of this inspection an ‘Action Sport’ session was taking place in one of the lounges. On the notice board in the hallway there is a list of the forthcoming activities planned for the coming month. Residents and staff talked about the seasonal parties and fetes – these are especially enjoyed by everyone. Residents and visitors talked about how families and friends are welcomed and involved in the home. The catering staff take a pride in their work and are enthusiastic about the range of nutritious meals they provide. Home grown fruit and vegetables are used when in season. Individual likes and dislikes are always catered for. Residents gave very high praise for the midday meals. The Old Vicarage DS0000022065.V322150.R01.S.doc Version 5.2 Page 6 Residents said they were happy with the procedures for dealing with complaints and concerns. No complaints have been received since the last inspection. Policies and procedures are in place to ensure residents are protected from the risk of harm or abuse. The Old Vicarage is a gracious period property set in large mature grounds. The standard of maintenance, decoration and furnishings throughout the home are very high. The rooms are spacious and decorated and furnished in keeping with the style of the house. The level of cleanliness throughout the home is excellent. The home is well staffed. The turnover of staff is low, and staff morale is exceptionally high. Almost every member of staff completed a questionnaire and submitted this to the Commission prior to this inspection. Their responses demonstrated the care taken by the home to recruit, train and support all of the staff team. The staff talked about the philosophy of care that is instilled in them from the very start – to understand that it is the residents’ home, and their privacy, dignity and choice are of the utmost importance. The home is well managed. Excellent methods are in place for consulting with residents and staff to ensure standards are continually monitored and improved. Residents and staff are protected by good health and safety policies, procedures and training. What has improved since the last inspection? What they could do better:
Some improvements to the care plans are necessary for those residents with high care needs. Some improvements are necessary to the administration and storage of medicines. Tablets and creams not included in the blister packs must be clearly labelled. Creams must be dated to show when they were opened, or when
The Old Vicarage DS0000022065.V322150.R01.S.doc Version 5.2 Page 7 they should be discarded. There must be clear written instructions to show how/why/where/when creams should be applied. Medication must not be retained after the person had left the home. Unwanted medicines must be returned to the pharmacist promptly. Medications that need to be kept cool must be stored securely, and at the right temperature. Checks should be carried out on the competency of staff to ensure they are following the homes’ policy on the safe administration and storage of medicines. Requirements have been made at previous inspections for radiators to be covered to prevent the risk of burns and scalds. Approximately one third of the radiators have been covered and an agreement was reached with the owners during this inspection that the remaining radiators will be covered in the next six months. Failure to do so may result in enforcement action being taken. 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 DS0000022065.V322150.R01.S.doc Version 5.2 Page 8 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 DS0000022065.V322150.R01.S.doc Version 5.2 Page 9 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, 3, 5, 6 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Potential new residents benefit from the home’s excellent admission processes, enabling them to make informed and unhurried decision before moving in permanently EVIDENCE: The manager has completed a handwritten descriptive explanation of every assessment she has carried out before admission to the home. This demonstrates that the home has taken time to get to know the person before they moved in, and to understand their care needs. A brochure is given to anyone who is considering moving to The Old Vicarage. They are also encourage people to visit the home, stay for a meal, or have a trial stay before they finally decide to move in permanently. Residents who completed a questionnaire before this inspection all said they received lots of
The Old Vicarage DS0000022065.V322150.R01.S.doc Version 5.2 Page 10 information about the home before they moved in. Some said they knew about the home through personal recommendation, some had visited friends or relatives who lived at the home, and others said they had several visits and holidays at The Old Vicarage before moving in. The following comments is typical of the responses received from residents who completed questionnaires before this inspection, “I made several visit and short stays before I asked if I could come as soon as a suitable room became available.” The staff talked about the care taken before a new resident moves in to get to know them before any decision to move in is made. The home does not provide intermediate care. The Old Vicarage DS0000022065.V322150.R01.S.doc Version 5.2 Page 11 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, 10 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The health and personal care need of residents have been well met. However, some improvements to the care plans are necessary for those residents with high care needs to ensure staff have comprehensive instructions on how to meet their care needs. Procedures for the administration and storage of medicines are adequate. Improvements are needed to increase the safety of medicine storage and administration. EVIDENCE: The care plans cover all areas of need, although each section has a fairly brief sentence explaining the care needs. For those residents with low needs this is sufficient. However, for those with high needs or close to death greater detail is recommended. Records of residents the home has cared for in the past were
The Old Vicarage DS0000022065.V322150.R01.S.doc Version 5.2 Page 12 seen and while the care notes showed that good care was provided by the staff, the care plans did not reflect the full care needed in the last days of the residents’ lives, and therefore did not show the instructions given to the care staff. Residents talked about the personal and health care they receive – they were full of praise for the care home staff, and also the attention given by the GP’s and district nurses. Comments from GP’s include “Excellent home”, “Really lovely home”, and “Very impressed with all aspects of residents’ care. Well done to the staff!” During the afternoon a staff handover session was observed. It was very thorough, covering every resident’s current care needs. The staff were given detailed instructions on the assistance to be given to each resident. Discussions took place about how the staff could encourage and assist residents with exercise, and also to overcome difficulties in socialising with other residents. The staff demonstrated tact and sensitivity, and clearly understood the principles of privacy, dignity and choice. During the day all call bells were answered promptly. Risk assessments in care plan files included – - Moving and handling - Pressure areas - Risk of scalding - Self administration of medicines. The home uses a monitored dosage system of storage and administration of medicines supplied by the local pharmacist. The records of medicines administered were satisfactorily completed. Records showed when the medicines were received into the home. The medicines are stored in a locked filing cabinet on the staircase. There is only one key – this is held by the most senior person in charge. While the overall procedures were satisfactory the following areas need to be addressed – 1. Medications not included in the blister packs have been stored in three plastic boxes. In one box there were a number of strips of unboxed, unlabelled tablets. While the staff said they knew who the tablets were intended for the chances of error were high. It is also very difficult to maintain accurate stock control, especially if more than one person uses the same tablets. 2. Some creams were unlabelled. There was no date to show when the creams were opened, or when they should be discarded. This poses a risk of incorrect application. Creams that have been opened for longer than the recommended period of time may become contaminated or lose their efficiency, resulting in skin conditions failing to heal.
The Old Vicarage DS0000022065.V322150.R01.S.doc Version 5.2 Page 13 3. One medication has been retained after the person had left the home. Regular checks should be carried out on the medications stored to ensure that all unwanted medicines are returned to the pharmacist promptly. 4. There were no instructions to staff to explain how/why/where/when creams should be applied, or what the staff should do if the area does not heal. 5. Medications that need to be kept cool were being stored in the kitchen fridge. This was not locked. All medications must be stored securely, and at the right temperature. Some staff have received training on the safe administration of medicines. In the coming year further comprehensive training for all staff is planned on the safe administration of medicines. At the last inspection it was recommended that the policy on the safe administration of medicines should be amended to cover all aspects of administration. The manager, Sue Tisdall was not on duty on the day of this inspection and therefore it was unclear to what extent the policy had been amended and how much training had been given to staff on the amendments. In view of the above matters that were found it is again recommended that the policy is checked to ensure that these areas are covered, and that staff are given clear instruction on the policy. The Old Vicarage DS0000022065.V322150.R01.S.doc Version 5.2 Page 14 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 excellent. This judgement has been made using available evidence including a visit to this service. Residents lead active lives to suit their preferences and abilities. Families and visitors are welcomed and involved in the home. Residents are enabled to have complete control and choice over all aspects of their daily lives. The home provides an excellent range of nutritious meals. EVIDENCE: On the day of this inspection an “Action Sport” session was underway in the upstairs lounge. A notice board in the hallway includes a list of the activities planned for the coming month. A newsletter is compiled each month with a wide range of interesting news, and includes poetry, quizzes and diary dates. Residents who responded to this information by completing a questionnaire said there is a wide range of activities they can take part in, although some
The Old Vicarage DS0000022065.V322150.R01.S.doc Version 5.2 Page 15 said they choose not to participate in some for personal reasons, including specific disabilities such as blindness. Residents and visitors who were interviewed during the inspection said they are always made to feel very welcomed whenever they visit. They also said they are informed and involved in the home and the care provided, in accordance with the wishes of the resident. Outings are provided regularly, and the home has very good links with the local community, either by enabling residents to participate in local events, or by involving the community in the home, especially during seasonal events such as summer fetes and Christmas parties. During the inspection there were lots of examples of how residents are able to exercise choice and control over their lives. This included times of getting up/going to bed, choice of meals, choice of room furnishing and decoration, and choice of activities. Residents talked about the freedom they have to live their lives exactly as they choose. The home continues to provide an excellent range and variety of meals. A wide variety of fruit and vegetables are grown in the gardens and are incorporated seasonally into the menus. Any excess is frozen and used during the winter months. Fresh fruit and vegetables are used in the menus daily. The cook has worked at the home for many years and talked about how much she enjoys her job. She is enthusiastic about providing tasty and nutritious food to suit every individual. Menus are displayed on the notice board in the hallway and residents are regularly consulted over the content of the menus. The dining room is very attractive and comfortable, with high quality furnishings and a lovely outlook over the gardens. Residents talked about how they can choose when and where they have their meals. Residents who completed questionnaires said they always or usually enjoy the meals provided. Most said they always enjoy the main meals, but a few residents commented that they find the suppers disappointing. The Old Vicarage DS0000022065.V322150.R01.S.doc Version 5.2 Page 16 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, 17, 18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents are confident that any complaints and concerns they may have will be dealt with satisfactorily. Residents’ legal rights and finances are protected by good procedures.. Residents are protected from the risk of harm or abuse. EVIDENCE: A copy of the home’s complaints procedure is displayed on the notice board in the hallway. Since the last inspection no complaints have been received either by the Commission or by the home. Residents who completed questionnaires said they know how to make a complaint, and to whom. Comments included “So far I have no need to complain. I can always contact staff if I need help in any way. There is always someone ready to listen.” Residents confirmed that they are able to vote in local elections if they wish. Lockable storage is provided in bedrooms for those residents who wish to hold cash or valuables securely. Alternatively the home has agreed to hold some cash securely for a few residents who do not want to keep the cash in their rooms. Records and balances of money held were checked during the inspection and found to be accurate.
The Old Vicarage DS0000022065.V322150.R01.S.doc Version 5.2 Page 17 New staff are given instructions during their induction period on how to recognise and prevent abusive practice. In the next few months training is planned for all staff on the protection of vulnerable adults. All of the staff who responded to this inspection said they were aware of adult protection procedures. The Old Vicarage DS0000022065.V322150.R01.S.doc Version 5.2 Page 18 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. 25, 26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents benefit from a well maintained home that has been decorated and furnished to a very high standard. While the overall level of safety for residents is good, the failure to cover some of the radiators poses a risk of burns and scalds. The level of cleanliness throughout the home is excellent. EVIDENCE: The home has been maintained to a very high standard throughout. In a tour of the home half of the bedrooms and all of the lounges, dining rooms and kitchen were seen. All of the rooms are spacious. All areas were found to be
The Old Vicarage DS0000022065.V322150.R01.S.doc Version 5.2 Page 19 attractively decorated and furnished, bright, airy and comfortable. The Old Vicarage is a period property and decorations and furnishing are in keeping with the style of the house. The gardens are large, well laid out with vegetable patches, lawns, flower-beds and mature trees. There are plenty of areas to walk or to sit and enjoy the views. Comments from residents include “I am very happy here, and have a pleasant room and outlook and every care I need” and “In good weather the garden is such a pleasure to sit in.” All areas seen during this inspection were found to be clean, bright and free from any odours. The laundry was found to be in good working order. New machines have recently been installed. Three members of staff have specific responsibility for the laundry and they ensure that all items are clearly marked before they are washed, eliminating the risk of items going missing. Residents who responded to this inspection by completing a questionnaire expressed complete satisfaction in the cleanliness of the home. Following the last two inspections of The Old Vicarage requirements have been made to ensure radiators are protected to eliminate the risk of accidental burns or scalds to residents. Approximately one third of the radiators have already been covered, but two thirds currently remain uncovered. On the day of this inspection none of the uncovered radiators seen posed a high risk because they were either turned off, or furniture was placed to prevent anyone falling against the radiator. However, the risk may be higher on cold days when radiators need to be turned up, or if residents choose to move furniture. Risk assessments have been carried out on each resident to include the risk of burns and scalds through falls. Evidence was seen on the day of this inspection that the owners are planning to make a number of improvements to the property in the near future, and this includes covering the radiators. This matter was discussed with the owners, Mr and Mrs Parkin, and an agreement was reached that the radiators will be covered within the next 6 months. Failure to do so may result in enforcement action being taken by the Commission. The Old Vicarage DS0000022065.V322150.R01.S.doc Version 5.2 Page 20 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 excellent . This judgement has been made using available evidence including a visit to this service. Staffing levels are sufficient to meet the needs of the residents. Good recruitment methods are used in order to safeguard residents. Staff have received a good level of induction and ongoing training covering all aspects of residents’ needs. EVIDENCE: Sample staff rotas supplied by the home prior to this inspection showed that the home provides a good level of staff to meet the needs of residents. Discussions took place with four staff during the day. The staff talked about the pride they take in their work, the high level of staff morale and excellent teamwork. They praised the support by the owners and management team and talked about he philosophy of the home. They said that the owners stress to them right from the start that it is the residents’ home, and their privacy, dignity and choice are paramount. They said everyone feels valued, both residents and staff. Four staff recruitment files were seen. A new administrator has recently been recruited and she has introduced clear systems that show when each step of
The Old Vicarage DS0000022065.V322150.R01.S.doc Version 5.2 Page 21 the recruitment process has satisfactorily been completed, including receipt of criminal records checks and at least two satisfactory references. All staff are given a job description, contract of employment and staff handbook. Induction procedures include comprehensive instruction to staff following a commercially produced induction pack. The level of training to staff has improved in the last year, and there are plans to improve this further in the coming year. A number of staff have achieved a nationally recognised qualification in care. Four staff have nursing qualifications, and some part-time relief staff are in the process of gaining nursing qualifications elsewhere. In addition, the home has purchased a commercial training pack to cover a wide range of topics and plan to implement these in the coming year. This will ensure that staff receive a good level of training on all areas of residents’ care needs. The Old Vicarage DS0000022065.V322150.R01.S.doc Version 5.2 Page 22 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, 38 Quality in this outcome area is excellent This judgement has been made using available evidence including a visit to this service. The home is well managed. Excellent methods are in place for consulting with residents and staff to ensure high standards are maintained at all times. Good procedures are in place to protect residents’ finances. Resident and staff are protected by good health and safety policies, procedures and training. The Old Vicarage DS0000022065.V322150.R01.S.doc Version 5.2 Page 23 EVIDENCE: The registered manager is Sue Tisdall. She holds a State Registered Nursing qualification, and also holds qualifications to oversee staff training in nationally recognised qualifications in care. She has recently reduced the number of hours she works. The Deputy Matron holds a State Enrolled Nursing qualification and also has similar qualifications to oversee staff training. There is also a Sunday Matron and a Duty Matron, both of whom hold State Registered Nursing qualifications. 27 staff completed a questionnaire and submitted this to the Commission prior to this inspection. This response is exceptionally high. Every member of staff has responded positively. Many have praised the management of the home highly, including the philosophy of care, services and facilities. The following are just a small sample of their comments, “The overall ‘feel’ of The Old Vicarage is of a real home and not an institution. The service users’ individual likes and dislikes particularly with regard to food are observed at all times. If at all possible they will receive anything they ask for.” “One of the best homes I’ve worked for.” “Everyone, from manager to daily staff are kept well informed of all events at the home and of relevant information regarding the residents. I feel part of their ‘family’, as I feel it is a privilege to help care for the residents in their home.” “We are all made to feel that we are an important part of a team. The owners and matrons are very caring and supportive to the residents, their families and the staff and I think this makes The Old Vicarage a lovely place. I do so much enjoy working here.” The home has an excellent range of methods of consulting with residents and staff over all aspects of the home. Residents often meet with the owners on a Sunday lunchtime for sherry, when they can discuss informally day-to-day matters relating to the home. Questionnaires are sent out every six months to residents to seek their views. The results are collated, actions taken where necessary, and residents are informed of the outcomes. The monthly newsletter is used to let residents know about any relevant information regarding the home. Staff meetings are held regularly and staff supervision is carried out. There is a staff appraisal system in place. Good procedures are in place to safeguard cash and valuable held by the home on behalf of residents. The home has agreed to hold some cash securely for a few residents who do not want to keep the cash in their rooms. Records and
The Old Vicarage DS0000022065.V322150.R01.S.doc Version 5.2 Page 24 balances of money held were checked during the inspection and found to be accurate. During the inspection the fire log book and accident reports were checked and found to be satisfactory. Information provided by the home prior to this inspection showed that all equipment including fire alarms, lift and hoists have been maintained regularly. Policies and procedures are in place relating to all health and safety topics. Staff have received training and regular updates on all relevant health and safety topics. The Old Vicarage DS0000022065.V322150.R01.S.doc Version 5.2 Page 25 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 x 4 x 4 N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 4 9 2 10 4 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 4 13 4 14 4 15 4 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 3 18 3 4 x x x x x 2 4 STAFFING Standard No Score 27 4 28 4 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 4 x 4 x 3 x x 3 The Old Vicarage DS0000022065.V322150.R01.S.doc Version 5.2 Page 26 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 OP25 Regulation 13(4) Requirement The home must ensure that all areas of the home to which residents have access are free from hazards to their safety. (This relates to hot water and hot surfaces to ensure systems are in place to prevent accidental burns and scalds. Some radiators have already been covered). This requirement was first made following an inspection on 6/10/04 when a timescale of 1/10/06 was agreed. Failure to meet the new timescale may result in enforcement action. 2 OP9 13(2) The registered person shall make 01/03/07 arrangements for the recording, handling, safekeeping, safe administration and disposal of medicines received into the care home. (This relates to – Tablets and creams not included in the blister packs must be clearly labelled. Creams must be dated to show when they were opened, or when they should be discarded. There
DS0000022065.V322150.R01.S.doc Version 5.2 Page 27 Timescale for action 01/07/07 The Old Vicarage must be clear written instructions to show how/why/where/when creams should be applied Medication must not be retained after the person had left the home. Unwanted medicines must be returned to the pharmacist promptly. Medications that need to be kept cool must be stored securely, and at the right temperature. 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 Refer to Standard OP7 OP9 Good Practice Recommendations Improvements to the care plans should be made to ensure that staff have clear instructions on all aspects of care needs for those residents with high needs. The policy on administration of medicines should be updated to ensure it covers all aspects of administration and storage, including the use of homely remedies. Staff should receive instruction on the updated policy to ensure good practice is followed at all times The Old Vicarage DS0000022065.V322150.R01.S.doc Version 5.2 Page 28 Commission for Social Care Inspection Ashburton Office Unit D1 Linhay Business Park Ashburton TQ13 7UP 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
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