Inspection on 31/07/08 for The Old Vicarage Residential Home

This inspection was carried out on 31st July 2008.

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

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 06/01/09

The Old Vicarage Residential Home 22/12/08

The Old Vicarage Residential Home 26/09/06

The Old Vicarage Residential Home 25/10/05

The Old Vicarage Residential Home 12/05/05

The Old Vicarage Residential Home 26/11/04

The Old Vicarage Residential Home 13/05/04

Extracts from inspection reports are licensed from CQC, this page was updated on 09/11/2008.

CARE HOMES FOR OLDER PEOPLE The Old Vicarage Residential Home 11 Silver Street Whitwick Coalville Leicestershire LE67 5EW Lead Inspector Lesley Allison-White Unannounced Inspection 31st July 2008 09:00 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 Residential Home DS0000059863.V369302.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 DS0000059863.V369302.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service The Old Vicarage Residential Home Address 11 Silver Street Whitwick Coalville Leicestershire LE67 5EW 01530 831802 F/P 01530 831802 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) The Old Vicarage Residential Home Ltd Mrs Renu Sood Care Home 19 Category(ies) of Dementia (19), Old age, not falling within any registration, with number other category (19), Physical disability (19) of places The Old Vicarage Residential Home DS0000059863.V369302.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. To specify the minimum age: No person under 18 years of age who falls within the categories OP, PD or DE may be admitted to the Old Vicarage Residential Home. 26th September 2006 Date of last inspection Brief Description of the Service: The Old Vicarage is a residential home for older people situated in the heart of the village of Whitwick. The home is a Grade II listed building of historic interest. It has 19 single bedrooms, most of which have en-suite facilities, two lounges, a small reading room, and a dining room. To the rear of the home is a large secluded garden. There is a car park. Fees range from £334.00 to £396.00 per week. The Statement of Purpose, Service Users Guide & Inspection Report is available at the entrance to the home (these provide information on how the home is organised and what services they provide). A current Employers Liability certificate of insurance is displayed in the hallway also. The Old Vicarage Residential Home DS0000059863.V369302.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. There were eighteen people living at the home on the day of inspection plus one person as a day care visitor. The inspection took six and a half hours to complete. Preparation included examining inspection records, looking at the service history and the annual quality assurance assessment (AQAA). The annual quality assurance assessment is in two parts. The first part is a self assessment and is how providers let us know how well their service is performing and achieving outcomes for the people using their service. The second part is a data collection form that asks providers to give us some detailed, factual information about their service. This aided the inspection process by providing background information. A discussion was held with four people who live at The Old Vicarage. One person had some memory problems. The primary method of inspection used was “case tracking”. This involved speaking with or observing the people who use the service provided, looking at three peoples care plans and making observations. Care plans are records about the care or support provided for an individual. All the required key standards were inspected during this visit. Requirements were made at this inspection. The Registered Provider and Registered Manager assisted during the inspection. What the service does well: What has improved since the last inspection? The Old Vicarage Residential Home DS0000059863.V369302.R01.S.doc Version 5.2 Page 6 Improvements that have taken place in the home include new bedroom carpets in some rooms, the creation of a new herb garden where individuals can take an active part growing herbs and vegetables. A new area has been created in the garden for the privacy. This will benefit the people who live at the home. A new stair lift has been purchased to help indviduals to get to their berooms upstairs. 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 DS0000059863.V369302.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 DS0000059863.V369302.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): S1, S3 and S6 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Assessments in the home are done prior to admission. EVIDENCE: Assessments in the home are done prior to admission although many of the people who spoke with the inspector asked their relatives to deal with the admission process. Some of the people who spoke with the inspector had some memory problems due to their condition. Mr X on choice of home ‘ my own General Practitioner (GP) chose the home and my nephew helped also.’ The personalised needs assessment ensures that people’s diverse needs are identified before they move into the home. The Statement of Purpose and Service User Guide needs to be reviewed to contain the information that an individual coming into the home should have. The Old Vicarage Residential Home DS0000059863.V369302.R01.S.doc Version 5.2 Page 9 This was discussed with the Registered Manager a requirement has been made. The Old Vicarage does not provide intermediate care. The Old Vicarage Residential Home DS0000059863.V369302.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. At The Old Vicarage Residential Home staff are successful in delivering appropriate care to individuals whose health and care needs are met. EVIDENCE: Three care plans were seen and each of them had updated photographs of the individual. This information is helpful for new staff to have. Two people were case tracked in detail, this included people with different care needs. The third person was recored by care staff as shouting a lot at night. The inspecor discussed this with the Registered Manager who explained that the individual is on medication for this and it can be given when required however, they tend to be sleepy during the days aferwards. The Registered Manager said that she would consider asking the night staff to provide night activities for this person to ensure that they did not disturb other people sleeping at the care home. The two peoples’ care records were satisfactory as they included relevant details needed for their care. The Old Vicarage Residential Home DS0000059863.V369302.R01.S.doc Version 5.2 Page 11 There was an incident involving admission to the hospital where no Regulation 37 or accident form was completed. On discussion of the incident with the Registered Manager an accident form was completed on the day of the inspection. The completion of forms was discussed with the Registered Manager who said that she would review this area of care in her home. As appropriate care had been given at the time no requriement was made. Carers assisted people living at the home to move safely. Individuals are encouraged to walk to the dining room. It is some distance from the main lounge to the dining room however, the staff are attentative and nearby should help be required. In this way people living at the home are encouraged to remain independent. Assessments in the care plans seen were up to date although there was evidence of duplication which could lead to confusion for staff as they were kept seperately from the individuals care plan. This included moving and handling information. Other assessments included past histories and the likes and dislikes of the individual. In this way the staff would be able to have a better understanding of the person they provided care for. In both care records there was evidence of care planning and follow up treaments when needed. People who spoke with the inspector felt their care needs were fully met and that they were treated with respect and their dignity maintained. ‘When I had an accident the staff contacted the owners and they were excellent and escorted me to hospital and stayed with me until they knew if I would need admission to hospital. I really appreciated that as my family could not attend at the time. As far as I am concerned the care is alright here the General Practitioners (GP’s) are good and the staff are kind’. ‘There are always two people on at night and I just use my call bell when I need help from them.’ Comments from Mr X ‘All the staff are very good.’ The medication of the two people case tracked was checked and fine. The Registered Manager said that there were no Controlled Drugs on the premises. Comments from another person living at The Old Vicarage said ‘I usually get offered two baths a week and it can vary.’ People who spoke with the inspector said that they were happy with the care that the received at the home. The Old Vicarage Residential Home DS0000059863.V369302.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. Activities within the home succeed in meeting the identified daily and social needs of the people living at this home and the outcome is positive for them. EVIDENCE: There is a notice board where the programme of activities for each week is displayed. Activity sessions run every day they include skittles, exercises, listening to music, dominoes, watching a movie and bingo. Individuals also said that they go out to lunch with their families and play quiz games. One person said that sometimes they just like to sit and talk or not talk. ‘ We are all so old now many of us are in our 90’s.’ Families continue to be invited to the meetings held at the home for the people who live there and their families. Individuals said that their friends and family are made welcome when they visit. Some people said that they had telephones in their bedroom and were able to keep in contact directly with their relatives. The Old Vicarage Residential Home DS0000059863.V369302.R01.S.doc Version 5.2 Page 13 One individual who spoke to the inspector said that they go out to the local church as part of the ‘old peoples fellowship’ to take part in the talks, services, tea and biscuits and bingo sessions held at the Methodist chapel, another person spoke about going to picnic areas, and pub lunches. Relatives are invited to attend if they wish. Church services are held in the home every month with different faiths represented. Lunchtime was observed. Four people stayed in their rooms for lunch, two people needed the assistance of staff in their bedrooms at lunchtime. The dining room was pleasant but the inspector thought that it looked slightly crowded. (Two people dine in their wheel chairs). The meals were cooked by the owner and served by the one senior care staff. (It is a slow process). The inspector tasted the liquidised food served to some of the people dining there. The potatoes lacked flavour (both liquidised and mashed). It is recommended that the owner tastes the food that he serves. A choice of two meals was served and a hot sweet of rice pudding was also served. The dining room contained a heated food trolley. Staff was seen taking the temperatures of some of the dishes served and recording them on a chart. After lunch people were seen and asked by staff to wait for their tablets before leaving the dining room. People were asked if they enjoyed their meals and mostly said that they did. One person commented ‘it the nicest rice pudding that I have ever had.’ The tuck trolley is also housed in the dining area. Items such as chocolate will become warmed by the room temperature and become less enjoyable. A cooler place may be preferred. The hallway contains information about the visiting library and advocacy services should anyone need them. The Old Vicarage Residential Home DS0000059863.V369302.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 Registered Provider has procedures for dealing with complaints and protection giving protection to the people who live at the home. EVIDENCE: The Commission of Social Care Inspection has not received any complaints about The Old Vicarage residential home since the last inspection. On the issue of the Protection of Vulnerable Adults (POVA) staff who spoke with the inspector were in the process of doing their National Vocational Qualification (NVQ) Level 2 in care and said that they would cover it more fully. They had some understanding of the issues. The staff members were able to describe their induction process and training received whist working at the Old Vicarage. They felt that they would be able ask senior staff for help to deal with any care situation. There are policies and procedures for dealing with complaints and protection although they need updating. People living at this home are protected in this way. Individuals who live at the Old Vicarage who spoke with the inspector felt happy to express their concerns or complaints and knew that the Registered Manager would address them. The Old Vicarage Residential Home DS0000059863.V369302.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. Individuals are provided with a comfortable environment but greater attention to hygiene in public areas is required. EVIDENCE: The inspector saw three bedrooms. Each of them looked clean, pleasant and homely. Improvements that have taken place in the home include new bedroom carpets in some rooms, the creation of a new herb garden where individuals can take an active part in the growing of herbs and vegetables. A new area has been created in the garden for the privacy of the people who live at the home. A new stair lift has been purchased to help individuals to get to their bedrooms upstairs. The Old Vicarage Residential Home DS0000059863.V369302.R01.S.doc Version 5.2 Page 16 On inspection two downstairs toilet areas were seen. None of them had liquid soap dispensers in them, one had a bath towel in it, no paper towels. Two bath gels were seen in one of the toilet areas. One toilet became soiled during the afternoon and had not been checked by staff. There were no hand gels in place either. This was discussed with the Registered Manager who sent staff to tidy both areas. The toilet doors need checking although they both lock they are very stiff and may be very difficult for a frail adult to open independently. The inspector saw another public area. It was a downstairs shower room. It was untidy as it housed peoples’ clothes on hangers when they were not currently needed. Again no paper towels for the drying of hands. The bins had to be opened by hand. The inspector is not aware of any recent infectious outbreaks at this care home however improvements in this area are essential for the continued well being of everyone who lives and works there. A requirement will be made for these general improvements to take place. When balancing these pieces of evidence against other more positive parts of this outcome group an overview of the environment may be seen as adequate. The Old Vicarage Residential Home DS0000059863.V369302.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. The Registered Provider has a recruitment procedure, which when fully implemented will protect all the people who live at the home. EVIDENCE: People living at the home said that felt well cared for by all the staff, no concerns. Staff who spoke to the inspector was new to care but felt supported by senior staff. On the day of inspection there was one senior care staff, two other care staff, the owner and the maintenance person. Later the Registered Manager and a change of shift also came on duty. There is evidence of training being provided for the staff that works at this home. Good recruitment practices have not been followed at all times by the Registered Manager as the home has been short of staff some shortcuts have been taken. This could potentially put the people living at the home at risk from people who do not meet the Criminal Records Bureau (CRB) checks. A requirement will be given for improvements in this area to be made. The Old Vicarage Residential Home DS0000059863.V369302.R01.S.doc Version 5.2 Page 18 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 Registered Provider should ensure that policies and procedures are applied. In this way the best interests of the people who live will be met at all times. EVIDENCE: One person’s money was checked and fine. The Registered Manager said that she would review where the money was stored to ensure security at all times. A Health and Safety inspection has taken place in between this inspection. (There were two areas of concern to do with monitoring of the hazard analysis critical control point. This relates to food safety. It was not being done or recorded). It has now been rectified. The Old Vicarage Residential Home DS0000059863.V369302.R01.S.doc Version 5.2 Page 19 Weekly fire alarm and smoke detector testing is carried out at the home and an external company is employed to check other areas relating to fire safety. On an inspection in May one of the doors was sticking when it should close automatically it stops half way. This door is part of a corridor link. The Registered Manager said that she would ensure that this gets repaired and fixed and will send the inspector proof of this having been done. The Registered Manager said that all other areas of Health and Safety had been met and people living at the home were kept safe. The Registered Manager had just attended a Health and Safety course on the day of inspection and said that she would review the uncovered radiators and windows without safety guards around the home and in people’s rooms to ensure that they do not provide a risk to the individual using the room at the time. In this way people’s interests will remain safeguarded. The Old Vicarage Residential Home DS0000059863.V369302.R01.S.doc Version 5.2 Page 20 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 N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 2 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 2 X X X X X X 2 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 3 X 3 X X 2 The Old Vicarage Residential Home DS0000059863.V369302.R01.S.doc Version 5.2 Page 21 Are there any outstanding requirements from the last inspection? No 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 OP1 Regulation 4 (1) (c) Requirement Timescale for action 31/10/08 2. OP26 13 (4) (a) (c) 3. OP29 19 4. OP38 23 (2) (i) 23 (4) (v) The Statement of Purpose and Service User Guide must be reviewed to contain the information that an individual coming into the home should have. Facilities for the washing and 31/10/08 drying of hands should be provided. Bins that can avoid being opened by hand should be considered to avoid the risk of cross infection from disease and contamination. A review of all staff records 31/10/08 must be done to ensure that they comply with the Care Standards Act 2000. Good recruitment practices must be followed at all times as this could potentially put the people living at the home at risk from people who do not meet the Criminal Records Bureau (CRB) checks. Doors within the building should 31/10/08 be checked to ensure that they comply with fire safety, privacy and ease of access and exit as required. The Registered Manager should supply the DS0000059863.V369302.R01.S.doc Version 5.2 The Old Vicarage Residential Home Page 22 inspector with this evidence when this has been done. RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard OP15 Good Practice Recommendations The person cooking the meals should taste the food served to ensure that it is nice. The Old Vicarage Residential Home DS0000059863.V369302.R01.S.doc Version 5.2 Page 23 Commission for Social Care Inspection Eastern Region Commission for Social Care Inspection Eastern Regional Contact Team CPC1, Capital Park Fulbourn Cambridge, CB21 5XE 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 DS0000059863.V369302.R01.S.doc Version 5.2 Page 24 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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