Inspection on 18/05/07 for The Old Vicarage Residential Home

This inspection was carried out on 18th May 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 Residential Home 01/03/10

The Old Vicarage Residential Home 07/09/09

The Old Vicarage Residential Home 09/07/08

Similar services:

Maple Lodge

Heathlands

Aston Court Nursing Home

Breme

Ravenhurst

Bank House

Inspirations

Ashcroft Hollow Nursing Home

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

CARE HOMES FOR OLDER PEOPLE The Old Vicarage Residential Home 2 Tibberton Road Malvern Worcestershire WR14 3AN Lead Inspector Wendy Barrett Key Unannounced Inspection 18th May 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 Residential Home DS0000068376.V332991.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 Residential Home DS0000068376.V332991.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service The Old Vicarage Residential Home Address 2 Tibberton Road Malvern Worcestershire WR14 3AN 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) 01684 569523 01684 569523 SJS Care Ltd Mrs Brenda Elizabeth Milner (also known as Knight) Care Home 17 Category(ies) of Mental Disorder, excluding learning disability or registration, with number dementia - over 65 years of age (2), Old age, of places not falling within any other category (17), Physical disability over 65 years of age (17) The Old Vicarage Residential Home DS0000068376.V332991.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The Home may also accommodate a maximum of 9 people over 65 years of age with dementia illnesses. Date of last inspection Brief Description of the Service: The Old Vicarage is situated a short distance from Malvern town and all the town’s amenities. A new Provider owner, S.J.S. Care Ltd., was registered with the Commission in November 2006. Dr. R.C. Sumanasuriya has been nominated as the ‘responsible individual’ who supervises the management of the care home on behalf of the Provider company. The home is a Victorian house on three levels that has been adapted to provide care for older people. There are thirteen single bedrooms, seven of which have en-suite facilities, and two shared bedrooms. In addition there is a communal lounge and a communal dining room. A stair lift is fitted to the main staircase to facilitate movement between the ground and first floor. A small number of steps do have to be negotiated, as the stair lift does not reach the first three or four steps from the ground floor. Grab rails are, however, provided. The house is surrounded by a well-established, accessible garden. The home is registered to accommodate 17 residents who have care needs arising from the ageing process or who are over 65 years of age and have care needs arising from physical disability. The service can accommodate up to nine residents over 65 years of age who have care needs arising from dementia and two residents over 65 years of age who have care needs arising from mental health problems. On 5th April 2007 the fees ranged from £350 to £440 per week. There are additional charges made for hairdressing, chiropody, optician, continence wear (cost shared), newspapers, activities and transport. The Old Vicarage Residential Home DS0000068376.V332991.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This report has been written with reference to information about the service and held by the Commission, survey responses from residents, relatives and visiting care professionals and details submitted in a pre-inspection questionnaire that was completed by the Care Manager at the home. An unannounced inspection visit was also undertaken. What the service does well: What has improved since the last inspection? There has been a recent change of Provider and the Care Manager has been due to retire in the near future. This has not, therefore, been a time for developments to the service but more for maintaining the current standard of care through the changes. Future inspections will expect to identify improvements instigated by the new operational staff. The Old Vicarage Residential Home DS0000068376.V332991.R01.S.doc Version 5.2 Page 6 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 Residential Home DS0000068376.V332991.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 Residential Home DS0000068376.V332991.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 and 3 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The new Provider has not yet updated information literature since the change of ownership in November 2006. This should be given priority attention so that residents and their representatives have accurate details of the current owner and the type of service being offered at the home. New residents are only accepted once the Care Manager has obtained enough details about the individual’s care needs and expectations to assess if the home will be suitable. EVIDENCE: A Statement of Purpose was displayed in the main entrance to the home. This was written by the previous owner of the home and should have been revised and updated by the new owner e.g. name and address of new Provider so that it accurately reflects the type of service now offered. Regulation 4 and The Old Vicarage Residential Home DS0000068376.V332991.R01.S.doc Version 5.2 Page 9 Schedule 1 of The Care Homes Regulations 2001 are relevant to this work and should be referenced. The new Provider was developing a Service User guide when this inspection took place. Regulation 5 of The Care Home Regulations 2001 is relevant to this work and should be referenced. A resident described her introduction to the home. She found it a comfortable experience. Records of the work done by staff to make the admission go well were inspected. Information had been obtained from the Primary Care Trust and an internal assessment report had been completed. The resident had been invited to participate by filling in a ‘getting to know you’ report and another section of the record had been completed by her daughter. This addressed the resident’s wishes in the event of serious illness or death. The Old Vicarage Residential Home DS0000068376.V332991.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 and 10 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents have up to date plans of care and these are resulting in considerable satisfaction for the residents, their relatives and involved health care professionals. There have been good training opportunities in the past to make sure staff have the knowledge they need to provide safe care, but it is not clear yet what plans there are to continue this programme. EVIDENCE: The staff write care plans, and keep them up to date so they all know how to look after each resident according to their needs and wishes e.g. dependency levels are regularly assessed so that any changes can be identified, a resident’s wish to visit old friends in the local community was being supported through a specific care plan. The Old Vicarage Residential Home DS0000068376.V332991.R01.S.doc Version 5.2 Page 11 Health care professionals have a lot of confidence in the way residents are cared for –‘a high standard of care’, ‘the level of care I observe is consistently good’. A resident commented ‘Doctor is always called when required’. In January 2007 Boots pharmacy inspected the way medication is handled at the home. This was satisfactory. The Commission was also satisfied when a similar inspection was undertaken in March 2006. Staff have been receiving the training they need to help them work safely with the residents e.g. manual handling, pressure area care, medication management. The Care Manager was unclear what plans there are for the following year. This lack of clarity should be addressed to be sure all staff keep up to date with their knowledge and skill. The Old Vicarage Residential Home DS0000068376.V332991.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 and 15 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents are encouraged to spend their days how they prefer and their relatives feel they are very happy with their life at the home. The staff arrange activities to try and suit everyone. The residents are satisfied with their meals but they would benefit if the menus were planned with more reference to the particular nutritional needs of older people. EVIDENCE: Survey responses from residents indicated that social opportunities only sometimes satisfied some residents. However, information in care records and from staff confirm that there is considerable effort to help everyone enjoy their days as they wish e.g. a Care assistant mentioned how a resident ‘gets a bit tearful sometimes and we have a chat about her family. I like talking to (another resident)– she’s got a special ‘glow’ – always grateful’. Third resident -‘he’s always hungry. I offer him whatever he likes e.g sandwich, chocolate, something light’. The Old Vicarage Residential Home DS0000068376.V332991.R01.S.doc Version 5.2 Page 13 Staff and relatives had put a photograph album together. The Staff were using this as a distraction when the resident became a little restless. The lady friend of a male resident was observed being welcomed into the home during the inspection visit. Staff explained that the couple regularly took shopping trips into town together. They were both given advice and support from the staff to be sure they were suitably dressed for their outing on the day. There are quarterly residents meetings to encourage good communication with staff about the running of the home. Residents are happy with their meals. A blackboard is used to advertise the menu for the day so residents know what food to expect. The cook explained how alternative choices are made available if required e.g. one resident always prefers a sandwich rather than a cooked dinner. Although there is some attention to finding out about each resident’s dietary needs and food preferences this should be more thoroughly monitored e.g. nutritional risk assessments should address any risk of malnutrition, catering staff should receive guidance about the particular dietary needs of older people and how to plan attractive, well balanced menus for them, when residents are known to have a poor appetite it would help staff monitor intake if charts were used rather than making entries in the general daily report. The Old Vicarage Residential Home DS0000068376.V332991.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 and 18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The service doesn’t generate complaints and residents feel safe with the staff. EVIDENCE: The Commission hasn’t received any complaints about the service since the new Provider was registered. There haven’t been any complaints raised at the home either. A resident commented ‘never felt the need to complain’ and no dissatisfactions were described in any of the survey forms returned to the Commission. Staff have received training in adult protection in October 2006 and abuse awareness and one of the staff explained that they are all given a booklet to help them with this part of their work. Residents feel confident in the staff who care for them –‘everyone is kind and friendly’. The home has implemented adult protection and whistle blowing policies and procedures. These have been updated within the last 12 months. The Old Vicarage Residential Home DS0000068376.V332991.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 and 26 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Residents live in a well maintained home and they are happy with their bedroom accommodation. The kitchen hasn’t been upgraded recently and should be prioritised in any future work programme. Staff are trained to work in a way that will keep everything clean and hygienic and they are supplied with the equipment they need to do this. EVIDENCE: The residents live in accommodation that has received regular maintenance during the previous year. It was clean and tidy when the inspection visit took place and residents feel happy with it - ‘I have a nice room with my own things’. The Old Vicarage Residential Home DS0000068376.V332991.R01.S.doc Version 5.2 Page 16 The kitchen is less satisfactory because it obviously hasn’t been upgraded for some time. Units looked rather worn, utensils well used and decoration rather tired. An Environmental Health Officer recommended refurbishment following an inspection in January 2007. There is good attention to maintaining a hygienic home. Staff understand how to work in a way that reduces the risk of cross infection - a training session relating to this was provided in May 2006. They are supplied with the equipment they need to work hygienically e.g. disposable gloves, good laundry facilities that enable them to keep dirty and clean laundry separated. The Old Vicarage Residential Home DS0000068376.V332991.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 and 30 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. There are enough staff to care for the residents needs and they have been receiving the training they need to work safely and professionally. Future training plans should be in place. New staff are carefully selected to be sure they will be safe to work with the residents. They should, however, be required to submit a full employment history so their background can be more easily checked. EVIDENCE: Residents and relatives have a lot of confidence in the staff and get on well with them –‘the staff are very attentive and extremely helpful’, ‘staff are excellent’, ‘all staff are helpful’. A care assistant described staffing arrangements and felt there were enough staff to care for the resident group. Staff also listed various training undertaken during the past year. This included their work on National Vocational Qualifications at level 2 or 3. A matrix confirmed a regular programme of training opportunities during the last year to meet health and safety requirements e.g. manual handling, fire safety, first aid. However, there did not yet appear to be any firm training plans for the following year. The provider may have to confirm these The Old Vicarage Residential Home DS0000068376.V332991.R01.S.doc Version 5.2 Page 18 arrangements as the Care Manager was due to retire from her post soon after the inspection visit and it is important the programme does not lapse. Existing staff need to have their knowledge regularly refreshed and new staff must have essential instruction before being asked to perform tasks such as manual handling, giving out medication. Two recruitment records were inspected. The records reflected a generally satisfactory method of selecting staff that included careful checking of the suitability of applicants to work with vulnerable adults e.g. obtaining criminal records bureau checks, written references. Details of past employment were rather brief on the application forms. It is now required that full employment histories are obtained and any gaps in employment are explored. This aspect of recruitment should, therefore, receive additional attention in the future. The Old Vicarage Residential Home DS0000068376.V332991.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 and 38 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The Care Manager is experienced and competent and organises the everyday management in a way that satisfies residents and their representatives. There is not yet a clear picture of the way the new Provider intends to monitor and maintain the quality of the overall service. EVIDENCE: The Provider company has recently been approved by the Commission as fit to run the service. The Old Vicarage Residential Home DS0000068376.V332991.R01.S.doc Version 5.2 Page 20 The Care Manager has been in post for a considerable period and her leadership has resulted in a lot of confidence in the care. She was due to retire soon after this current inspection and work was already underway to find a replacement manager. A communication book at the home listed contacts between staff and Provider representatives but this was not adequate in showing how the Provider was monitoring the service through regular contact with residents, staff and visitors or through audits of records maintained at the home. There must be an unannounced visit to the service at least once a month by the Provider’s representative and a report of each visit should be kept at the home and be available for inspection. It will be particularly important for staff to receive additional support and oversight while a new care manager is being recruited and introduced to the service. A resident was observed requesting some of his money out of the office safe so he could go shopping. Records were being kept of transactions and the resident obviously had ready access to his money. There has been a regular programme of servicing and maintenance to be sure the residents live in a safe environment. Staff have also been receiving the health and safety training they need e.g. manual handling The Old Vicarage Residential Home DS0000068376.V332991.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 2 x 3 x x x 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 2 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 x 18 3 2 x x x x x x 3 STAFFING Standard No Score 27 3 28 3 29 2 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 x 2 x 3 x x 3 The Old Vicarage Residential Home DS0000068376.V332991.R01.S.doc Version 5.2 Page 22 Are there any outstanding requirements from the last inspection? The Old Vicarage Residential Home DS0000068376.V332991.R01.S.doc Version 5.2 Page 23 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 OP33 Regulation 26 Requirement The Provider’s representative must visit and prepare a written report in accordance with this regulation so that the conduct of the home can be monitored. Timescale for action 30/07/07 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 2 3 4 5 Refer to Standard OP1 OP4 OP15 OP19 OP29 Good Practice Recommendations Information literature should be reviewed and updated so that it accurately reflects the current service and contains all the details required under regulation. Training programmes should be planned well in advance to be sure staff knowledge and skill is maintained and kept up to date. Residents may benefit from further staff training or guidance in managing the specific dietary requirements of older people. Refurbishment of the kitchen facilities should receive priority attention. A full employment history should be required of all applicants for employment at the home. The Old Vicarage Residential Home DS0000068376.V332991.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Worcester Local Office Commission for Social Care Inspection The Coach House John Comyn Drive Perdiswell Park, Droitwich Road Worcester WR3 7NW 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 Residential Home DS0000068376.V332991.R01.S.doc Version 5.2 Page 25 - 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!