Inspection on 03/03/08 for The Old Vicarage [Otterton]

This inspection was carried out on 3rd March 2008.

CSCI found this care home to be providing an Adequate service.

The inspector found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

The Old Vicarage [Otterton] 19/01/07

The Old Vicarage [Otterton] 01/02/06

The Old Vicarage [Otterton] 09/08/05

The Old Vicarage [Otterton] 25/02/05

The Old Vicarage [Otterton] 06/10/04

The Old Vicarage [Otterton] 19/03/04

Similar services:

The Vicarage

Fairfields Country Rest Home

7 Hyde Road

5 Seafield Road

Poldhu

Queensmount

Trevaylor Manor

Didsbury Court Rest Home

Extracts from inspection reports are licensed from CQC, this page was updated on 30/01/2009.

CARE HOMES FOR OLDER PEOPLE The Old Vicarage Ropers Lane Otterton Budleigh Salterton Devon EX9 7JF Lead Inspector Vivien Stephens Unannounced Inspection 10:00 3rd and 4 March 2008 th 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.V359749.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.V359749.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.V359749.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 19th January 2007 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 £600 to £800 per week. The Old Vicarage DS0000022065.V359749.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 1 star. This means the people who use this service experience adequate quality outcomes. Several weeks before this inspection took place the home was asked to complete an Annual Quality Assurance Assessment (AQAA). When the completed document was received by the Commission survey forms were sent to the people living in the home. The responses we received have helped us to reach the judgements within this report. This inspection took place over 1½ days. There were 25 people living in the home at the time of our visit. During the inspection we talked to the owners, Mr and Mrs Parkin, to the manager, Sue Tisdall, to the administrator, a senior carer, a care assistant, the cook, the housekeeper, and to seven people who live in the home. We carried out a tour of the home looking at a random sample of bedrooms, the communal areas, bathrooms and the kitchen. We also looked at some of the records the home is required to keep, including assessment and care plan files, daily reports, staff recruitment and training records, fire log book, records of money held by the home on behalf of people living there, and accident reports. What the service does well: People have been given plenty of opportunity and information to help them get to know the home before any decision to move in permanently is made. Careful admission checks are made by the home to make sure the person is suitable and they can meet the person’s care needs. Information gathered during the initial assessment has been used to draw up a care plan. The people we talked to were completely satisfied with the care they receive. There were good systems in place, including handover sessions between each shift, close monitoring and supervision of staff, and regular reviews of care plans. These systems ensured that staff always have up-todate information and instructions on the care and support each person needs. Daily life at the home was varied and interesting. Every month there is a full and varied calendar of activities and outings people can join in if they want. People have been consulted and their views and wishes have been taken into consideration when planning future events. People told us how much they enjoy the regular activities. We found that the home had good relationships with families and friends, and visitors have always been made welcome. The Old Vicarage DS0000022065.V359749.R01.S.doc Version 5.2 Page 6 A particular speciality of the home is a very high standard and range of meals provided. Fruit and vegetables from the gardens have been included in the menus when in season. The staff have made every effort to make mealtimes feel a special occasion. Several people told us the meals are “Excellent!” and one person said “Catering staff aware of my particular needs, likes and dislikes and always provide an appropriate alternative.” Individual nutritional needs have been well met. People told us they felt confident that any concerns or issues they may raise with the home would be acted upon to their satisfaction. No concerns or complaints have been received by the Commission since the last inspection. The Old Vicarage is a graceful period property with large and well-proportioned rooms. The property has been decorated, furnished and maintained to a high standard throughout. We found that all areas were clean and fresh. The staff had shown a pride in their work, making sure that good cleaning procedures have been followed and the risk of infection was minimal. There is a stable staff team, many having worked at the home for a number of years. The staff we talked to clearly enjoy their work and took a pride in providing a good quality of care and services. There is a good management team and staff told us there is a happy atmosphere in the home and they felt well supported. There are good quality assurance systems in place. The home regularly seeks people’s views about all aspects of the home and they have made changes and improvements as a result of what they have found. What has improved since the last inspection? The storage and administration of medicines has improved. Creams are now dated when opened. Out-of-date and unwanted medicines have been returned to the pharmacist. The store cupboard was neat and tidy. The procedures for safe administration have been reviewed and updated. Staff have received training on the administration of medicines. The level of staff training has improved in the last year. Approximately 2/3 of the care staff team hold a relevant qualification and more staff are in the process of gaining qualifications. There are good records of the range of training provided in the last year on all health and safety related topics. At previous inspections we were concerned about the risk of burns and scalds people may face if they fell against uncovered radiators. The home has slowly implemented a programme of covering those radiators that were assessed as a high or medium risk. At the time of this inspection just a few radiators still did not have covers but we were told that these are planned for the near future. We also saw that these radiators are mainly of a low risk due to furniture being placed in front of them. The Old Vicarage DS0000022065.V359749.R01.S.doc Version 5.2 Page 7 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 DS0000022065.V359749.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.V359749.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. The admission process helps people to make informed and unhurried decision about where they want to live and ensures the home is certain they can meet the person’s needs before an agreement to move in permanently is reached. EVIDENCE: People told us how they chose to live at The Old Vicarage. Some people said they knew the home through visiting friends or family already living there. Some said the home had been recommended by health professionals, friends or family. We also heard how many people had short stays at the home before making the decision to move in permanently. Everyone we talked to said they were satisfied with the information The Old Vicarage DS0000022065.V359749.R01.S.doc Version 5.2 Page 10 Comments from people living in the home included “Had a two week visit so I could see what the home offered,” and “Chosen with my daughter, who felt with myself it was the right place to be.” We were given a copy of a short brochure the home gives to people when they make a general enquiry about vacancies. When a person has decided they definitely want to move in they are sent a detailed letter explaining the terms and conditions of residency. When they move in they are given a copy of the Resident’s Handbook giving information about all aspects of the home, including the complaints procedure. We looked at four files to see how the home had assessed the person’s suitability before they moved in. The manager, Sue Tisdall, said they take very great care to ensure they are able to meet the person’s needs, and to ensure they will be happy living at The Old Vicarage. We saw that the home had gathered good information on a range of social, personal and health care needs. The home does not provide intermediate care. The Old Vicarage DS0000022065.V359749.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. People can feel confident that their health and personal care needs will be met by well-trained and competent staff who respect their right to privacy and dignity. Procedures for storing and administering medicines are safe. EVIDENCE: We looked at four care plan files chosen at random. The plans are handwritten using the home’s own printed forms. They cover a range of care needs. Each section has a brief but clear statement about the person’s individual circumstances. We saw evidence to show that the plans had been regularly reviewed. When a person had become very ill the manager had drawn up a separate sheet giving detailed instructions to care staff about the person’s new care needs and the tasks the care staff must carry out. We could also see that The Old Vicarage DS0000022065.V359749.R01.S.doc Version 5.2 Page 12 advice and treatment had been sought from health professionals when necessary. People told us they were satisfied with the medical support provided by the home. Comments included “I am satisfied with my care”, “From the staff, from the doctors if needed and from my son who is a retired GP,” and “Including transport to and from hospital.” We talked to the manager, senior care assistant and a care assistant about how the care plans are used when planning and allocating daily work rotas. We heard that staff are fully aware of individual preferences and care needs and the staff’s daily routines are organised to match people’s needs. They explained how people are able to live their lives as they wish, including what time they want to get up, go to bed, or have a bath. The staff told us they are always flexible, and they will always try to accommodate all requests and changes in daily care routines. One person living in the home told us they cannot have a bath as often as they wanted. We talked to the manager, Sue Tisdall about this. She told us that people can have a bath every day if they want, but they may have to have a fairly short bath if they needed a staff member with them all of the time. She said that most people like to have a long, luxurious bath and this usually takes around an hour. A new walk-in shower is about to be installed and this will give people an option of either bath or shower. Sue Tisdall said that they always try to accommodate individual preferences for bath times and frequencies and this may sometimes result in a compromise being reached. We looked at the way the home stores, administers and records medicines. At the last inspection we found some aspects of medicine administrations were poor. During this inspection we found that improvements had been made. The home uses a monitored dosage system provided by a local pharmacy. The medicines were stored securely in a locked cupboard. Records had been well maintained. The medicines cupboard was tidy. All staff responsible for administering medicines have received training on this topic and updates will be provided later this year. A special fridge has been purchased for those medicines that must be kept cool, and this was kept secure. Where necessary, staff have been given clear instructions on how, where and when creams should be applied via reports, care plans and the medicine administration sheets. All medicines policies have been reviewed recently and checked by the home’s pharmacist. We observed staff treating people in a way that respected the person’s privacy and dignity. Staff were seen knocking on doors and waiting for a response before entering. The staff we talked to described the ethos of the care at the home, always respecting individual’s right’s and feelings. We were given examples of how the staff always try to support people in all aspects of their The Old Vicarage DS0000022065.V359749.R01.S.doc Version 5.2 Page 13 personal care to maintain their dignity – these included escorting them to the hairdresser of their choice locally, and by making sure people always have freshly laundered clothing in good repair (eg buttons sewn on). The Old Vicarage DS0000022065.V359749.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. The home strives to make daily life at the home a pleasurable experience for everyone. People are offered choices and encouraged to take control in all aspects of their lives. People can feel confident their families and friends will be welcomed and included. The home takes a pride in the high standard and range of meals offered, meeting all preferences and nutritional needs. EVIDENCE: The home provides a wide range of activities to suit all individual interests. On the notice board in the main hallway we saw a list of the planned activities for the current month. These include videos, ‘action sport’, board games, and outings. On the day of this inspection a yoga session was held in one of the lounges and we saw a large group of people taking part. Some people we talked to later in the day told us how the session had helped to ease aches and pains. The Old Vicarage DS0000022065.V359749.R01.S.doc Version 5.2 Page 15 We also heard how several people have enjoyed a regular visit from an aroma therapist, and how these sessions have helped to keep their joints mobile. A beautician also visits regularly. Several people told us they love walking in the garden every day. In the warmer weather there are a number of seating areas where people said they love to sit and enjoy the gardens. We saw a recent quality assurance survey carried out by the home on activities. As a result the home purchased a large-screen television, a new DVD player and increased their stocks of DVD’s. They have also adjusted their programme of activities to meet suggestions and requests. A newsletter is published monthly and this includes information about forthcoming activities, news, and articles written by people living in the home. People told us they can attend church services if they want, or, if they are unable, the vicar or a representative from their local church will visit them at the home. We saw a copies of the local parish newsletter (some in large print) on the home’s notice board and in people’s rooms. People told us they can go out regularly, either with staff, on their own, or with family or friends. The home has a courtesy car and will provide transport whenever possible. People also told us that the staff will do shopping for them if requested. We heard how families and friends are always made welcome whenever they visit. There is a small dining room where people can entertain their visitors with a meal if they wish. We also saw examples in the care plans of how families have been consulted and involved in decisions relating to the care of the resident (where appropriate). The home continues to take a great pride in the standard of meals provided. Vegetables, fruits and herbs are grown in the gardens and incorporated into the meals when in season. The menus are regularly reviewed and adjusted to suit individual tastes. There is a six weekly menu that provides plenty of choice each day. We sat and shared a meal with the residents during our visit. The dining room has been tastefully decorated and furnished. There were pretty tablecloths and flowers on the tables. People were offered a choice of curry or casserole. Dishes with a selection of accompaniments were offered with the curry, and dishes with a selection of vegetables were provided with the casserole. Staff were attentive and provided discreet and sensitive help to those who needed it. The pudding was delicious. Suitable alternatives were given to people with specific dietary needs. Fruit juices or water were offered with the meal, and tea or coffee afterwards. The mealtime felt like a special social occasion. The Old Vicarage DS0000022065.V359749.R01.S.doc Version 5.2 Page 16 We also heard how, at least once a month, the home provides a special celebratory meal, (for example, Christmas or Easter). Recently the home held a Valentines meal when the room was dressed with balloons and special decorations. All of the people we talked to said they were satisfied with meals provided. Several people told us the meals are “Excellent!” and one person said “Catering staff aware of my particular needs, likes and dislikes and always provide an appropriate alternative.” The kitchen is well equipped and modern. We saw the report completed by the Environmental Health Officer on 11/7/07 – this showed that all hygiene standards had been met satisfactorily. The Old Vicarage DS0000022065.V359749.R01.S.doc Version 5.2 Page 17 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. People can feel confident that any concerns, complaints or issues they raise with the home will be listened to and acted upon appropriately. EVIDENCE: Since the last inspection no complaints or concerns have been received by the Commission, and none have been recorded by the home. A copy of the complaints procedure is displayed on the notice board in the hallway, and is also in the Resident’s Handbook that is given to each person when they move in. The owners and staff told us that they always try to act on requests or comments promptly and in this way they felt that issues never escalated into complaints. People told us they felt confident they could speak to Mr or Mrs Parkin or Sue Tisdall if they wanted to make a complaint or raise a concern, and they felt sure issues would be dealt with satisfactorily. The staff we talked to said they felt poor care would not be tolerated in the home. They said they felt confident that they could speak out if they saw or heard anything they felt uncomfortable about, and felt they would not be victimised. They said there is good communication and teamwork, and staff felt safe to challenge any practice they felt might be abusive. The Old Vicarage DS0000022065.V359749.R01.S.doc Version 5.2 Page 18 The deputy manager has attended a ‘Train the Trainer’ course on the protection of vulnerable adults in the last year and she has passed this training on to the rest of the staff team in formal training sessions. The home also has training materials from a commercial specialist training company on this subject. The Old Vicarage DS0000022065.V359749.R01.S.doc Version 5.2 Page 19 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 excellent. This judgement has been made using available evidence including a visit to this service. People live in a warm, clean, comfortable and spacious home. The property has been well maintained, and there is an on-going programme to ensure people are safeguarded from the risk of accident. EVIDENCE: The home has been maintained to a very high standard throughout. All of the rooms are spacious. All areas were found to be 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. The Old Vicarage DS0000022065.V359749.R01.S.doc Version 5.2 Page 20 In a tour of the home approximately half of the bedrooms and all of the lounges, dining rooms and kitchen were seen. All bedrooms are single occupancy, of a good size, bright and attractive. All bedrooms have en suite facilities. The laundry was found to be in good working order. Four members of staff have specific responsibility for the laundry and they ensure that all items are clearly marked and any repairs carried out, ensuring that all items are returned clean, neat and in good order to the correct person. We found all areas were clean, bright and free from any odours. We talked to the senior housekeeper about her role and responsibilities. She was enthusiastic about her work. We were told that all staff who have responsibility for cleaning have received training in infection control and the control of substances hazardous to health (COSHH). There is good teamwork and everyone shares in a sense of pride in the home. We heard how they have detailed cleaning routines and checklists. There has been a programme of spring-cleaning the whole home thoroughly. In addition, as rooms become vacant they are thoroughly cleaned, decorated and refurbished as necessary, and presented to a high standard before a new person moves in. The senior housekeeper meets monthly with the Administrator monthly to discuss any issues and plans for the coming month. Following previous 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. At the last inspection approximately one third had been covered. During this inspection we saw that more radiators have been covered and now all radiators in bedrooms have covers that reduce the risk of burns or scalds. On the day of this inspection none of the remaining uncovered radiators seen posed a high risk because they were either turned off, or furniture was placed in front to prevent anyone falling against the radiator. Risk assessments have been carried out and we were told that there are plans to cover the remaining radiators in the near future (apart from those that are never turned on). In the last year the ground floor assisted bathroom has been completely refurbished. A new bath that can be raised off the ground to assist the carer has been installed, plus non-slip flooring and a low surface temperature radiator. They plan to refurbish the first floor bathroom in a similar way in the near future. They also plan to install a level access shower. People told us they are very happy with the standard of the environment. One person told us how much she enjoys the views from her bedroom windows. Other people told us they appreciate the way the home is always kept clean. Several people talked about how much they enjoy the lovely gardens. The Old Vicarage DS0000022065.V359749.R01.S.doc Version 5.2 Page 21 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 adequate. This judgement has been made using available evidence including a visit to this service. People’s care needs are met by a stable, well trained and supervised staff group. However, some recruitment procedures may leave vulnerable people at risk of harm or abuse. EVIDENCE: We were given a copy of the staff rota. We saw that every day there is either a manager or deputy manager on duty. At night a manager is always on call. In the mornings there are three care assistants on duty, and two in the afternoons. At night there is one care assistant on waking duty and one provides sleep-in cover. The home employs a cook and a catering assistant every morning, and two catering staff in the evenings. Twice a week a person is employed to clean the kitchen. Two or three housekeeping staff are normally on duty every morning. The home also employs staff specifically for laundry duties two or three times a week. The owners are fully involved in the day-to-day running of the home. In addition there is an administrator who takes on various additional roles in order to support the management team. The Old Vicarage DS0000022065.V359749.R01.S.doc Version 5.2 Page 22 The people we talked to said they were completely satisfied with the number of staff employed and said there are always staff on hand to help them whenever requested. We saw people who had call bell leads to enable them to call for help from their chair, and we heard that staff have responded immediately when the person has pressed the button. The staff we talked to also said they felt the staffing levels were good, and that they never felt rushed. We found that the home has low staff turnover. Many of the staff we talked to have worked at the home for a number of years. They told us they enjoy their jobs and wouldn’t want to work anywhere else. They said there is a very happy atmosphere, friendship and great teamwork. We looked at the records of four new staff recruited in the last year. We saw that the home has taken up at least two references and a Criminal Records Bureau (CRB) check on each person. However, these checks had not been received before two members of staff had started work. The owners, manager and administrator said that because of the length of time it took to receive the full CRB check they decided to allow new staff to begin working while references and checks were being processed. They said that new staff always work alongside an experienced member of staff in the first couple of weeks. We talked to them about the requirement to obtain a Protection of Vulnerable Adult (POVA) First check and at least two satisfactory references before a new member of staff begins working directly with the people receiveing a care service in order to reduce the risk of abuse or harm. This matter has been raised in previous inspections (see report dated 9th August 2005). The Deputy Manager holds the responsibility for providing induction training to new staff. The home uses a commercially printed induction training programme that meets current good practice standards. There is a workbook covering each area of care, and certificates for each section completed. Training records are held in a separate file for each member of staff. We were given details of the training given to staff in the last year. All staff have received training on all mandatory health and safety topics. During our visit a group of staff received manual handling training. The manager, Sue Tisdall said that if a staff member misses a training session for any reason another session is arranged and they are required to attend this to ensure their training is always kept up-to-date. Also during our visit a group of staff were meeting with a trainer who specialises in assessing their work towards a nationally recognised training qualification know as NVQ’s. The home employed 23 care staff at the time of this inspection. Of these, 16 hold a relevant professional qualification, either NVQ level 2 or 3, a City and Guilds qualification, or a nursing qualification. Some of the staff are 3rd year nursing students who work at the home during holidays. The Old Vicarage DS0000022065.V359749.R01.S.doc Version 5.2 Page 23 The staff we talked to said they receive regular supervision and staff meetings. They told us that at the start of each shift there is a handover session where they are given information about any changes in care needs, and work routines are agreed. The staff told us that there is good communication throughout the home and all staff felt they were valued and their opinions sought. The Old Vicarage DS0000022065.V359749.R01.S.doc Version 5.2 Page 24 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 adequate. This judgement has been made using available evidence including a visit to this service. People can feel confident that the home is well managed and safe, and their opinions will be valued and acted upon. However, people are not fully protected by some administrative processes. EVIDENCE: The registered manager, Sue Tisdall, holds a nursing qualification (SRN) and the Registered Manager’s Award. She has many years of management experience. The deputy manager also holds a nursing qualification (SEN). There is also a Sunday manager who holds also holds a nursing qualification. The owners, Mr and Mrs Parkin, are also fully involved in the management of the home. The Old Vicarage DS0000022065.V359749.R01.S.doc Version 5.2 Page 25 An Administrator is employed to help the management team with the day-today management and administrative tasks. While many aspects of the management of the home were entirely satisfactory, two aspects of administration were poor. The home has not notified the Commission of deaths, serious illnesses or incidents that have occurred in the home. They were advised that they must do this in order to meet the Care Homes Regulations. As reported in the Staffing section, recruitment processes were unsatisfactory and place people at risk. The people we talked to including people who live in the home and staff told us about the happy working atmosphere and their confidence in the management of the home. We received many positive comments about the home, including “It could not be better here.” People talked about their confidence in the owners, Mr and Mrs Parkin, and the manager, Sue Tisdall, to make sure all aspects of the home are running smoothly. We heard many examples of how people are consulted and involved in the daily routines in the home. Regular surveys are sent out on different aspects of the home. Recent surveys we saw covered meals and activities. A newsletter is sent out every month giving people news and information about the home. We were given some examples of how the home has listened to people and taken action to improve their daily lives. Some actions were simple but made a big difference, such as changing a door catch so that the person could open their bedroom door easily, or changing a door bolt to allow people to go out into the garden more easily. A large screen television and DVD player have been purchased as a result of consulting with people. The home told us “We have a very simple philosophy: the home belongs to the residents: we and the staff are here to provide the best possible service and support to enable out residents to live a care-free life.” We looked at the way the home handles some cash on behalf of those people who do not want to keep money in their rooms. The cash is held in separate envelopes along with a record of each transaction and a running balance. Where possible, receipts for purchases are also retained. The records and balances were checked and found to be correct. We looked at some of the records the home maintains on all aspects of health and safety. Responsibility for infection control, the control of substances hazardous to health (COSHH), manual handling, and health and safety have been passed to individual members of the staff team. Staff have received training on all relevant health and safety topics. Policies and procedures have been updated. The Old Vicarage DS0000022065.V359749.R01.S.doc Version 5.2 Page 26 We checked the fire log book and found this has been well maintained and showed that the home has taken preventative action to meet current requirements. We also checked accident reports and found these have been recorded correctly. The Old Vicarage DS0000022065.V359749.R01.S.doc Version 5.2 Page 27 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 3 8 4 9 3 10 3 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 x 18 3 4 X X X X X 2 4 STAFFING Standard No Score 27 3 28 4 29 1 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 x 4 x 3 x x 2 The Old Vicarage DS0000022065.V359749.R01.S.doc Version 5.2 Page 28 Are there any outstanding requirements from the last inspection? Yes 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 OP29 Regulation 19(5) sch 2 Requirement Timescale for action 07/04/08 2 OP25 13(4) New staff must not begin work in the home unless at least two satisfactory written references and a satisfactory criminal records bureau (CRB) check has been received. The home must ensure systems 01/07/08 are in place to prevent accidental burns and scalds. (Requirement have been made at previous inspections relating to radiator covers – progress has been made and the few remaining radiators were due to be covered in the near future) 3 OP38 37 The home must notify the Commission of any deaths, serious illnesses or incidents that occur in the home. 03/03/08 The Old Vicarage DS0000022065.V359749.R01.S.doc Version 5.2 Page 29 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations The Old Vicarage DS0000022065.V359749.R01.S.doc Version 5.2 Page 30 Commission for Social Care Inspection South West Colston 33 33 Colston Avenue Bristol BS1 4UA 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 DS0000022065.V359749.R01.S.doc Version 5.2 Page 31 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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