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Inspection on 08/02/06 for The Old Vicarage [Stockland]

Also see our care home review for The Old Vicarage [Stockland] for more information

This inspection was carried out on 8th February 2006.

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.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

What has improved since the last inspection?

There were no requirements made at the last inspection and only minor recommendations. However, there is now a lampshade in the assisted bathroom and two signatures are obtained for all residents` financial transactions.

What the care home could do better:

There were no immediate requirements made at the inspection. However, the pharmacy inspector did make one requirement relating to recording procedures. The home is also required to send to the Commission a copy of a report on the quality of care at the home.Several recommendations were made relating to medicines. The home should consider providing a further assisted bathroom and it would be useful to the home to gather more evidence of the health of staff prior to appointment.

CARE HOMES FOR OLDER PEOPLE The Old Vicarage Stockland Bridgwater Somerset TA5 2PZ Lead Inspector Sue Dewis Announced Inspection 8th February 2006 11:30 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 DS0000015986.V273908.R01.S.doc Version 5.1 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 DS0000015986.V273908.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service The Old Vicarage Address Stockland Bridgwater Somerset TA5 2PZ 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) 01278 652352 01278 652185 enquiries@restcare.co.uk Mr Sean James O`Brien Mrs Samantha Jane O`Brien Mrs Susan Mary Thomas Care Home 26 Category(ies) of Old age, not falling within any other category registration, with number (26) of places The Old Vicarage DS0000015986.V273908.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 1st November 2005 Brief Description of the Service: The Old Vicarage is a large three-storey property set in extensive grounds in the village of Stockland Bristol. The Registered Providers are Mr and Mrs O’Brien, and the Manager is Mrs Susan Thomas. The home is registered with the Commission for Social Care Inspection to provide accommodation and personal care to up to twenty-six people over the age of 65 years. The home provides accommodation to up to twenty people within the main building, and a further six service users can be accommodated in the bungalows within the grounds. The home works closely with local health services. The Old Vicarage DS0000015986.V273908.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place over approximately three hours in early January 2006. The lead inspector was joined for part of the inspection by the pharmacist inspector. The home had been notified that an inspection would take place within three months and had returned a pre-inspection questionnaire, information from which was used to write this report. Comment cards were received from 19 service users and 4 visitors. What the service does well: What has improved since the last inspection? What they could do better: There were no immediate requirements made at the inspection. However, the pharmacy inspector did make one requirement relating to recording procedures. The home is also required to send to the Commission a copy of a report on the quality of care at the home. The Old Vicarage DS0000015986.V273908.R01.S.doc Version 5.1 Page 6 Several recommendations were made relating to medicines. The home should consider providing a further assisted bathroom and it would be useful to the home to gather more evidence of the health of staff prior to appointment. 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 Old Vicarage DS0000015986.V273908.R01.S.doc Version 5.1 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 DS0000015986.V273908.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 3 Prospective residents are assured that their care needs can be met. EVIDENCE: One recently admitted resident was spoken with, they said they had not visited the home prior to their admission, but had had information from several sources that assured them the home was suitable for them. Pre-admission assessment information was seen on file. The Old Vicarage DS0000015986.V273908.R01.S.doc Version 5.1 Page 9 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 9 and 10 Care plans are well formulated and give clear information to enable staff to meet resident’s care needs. Residents’ privacy and dignity is promoted. Although medication is only administered by staff who have received safe handling of medication training some issues were found that had the potential to place service users at risk of harm. EVIDENCE: Three residents’ files were inspected. They had been reviewed each month and provided good basic care directions to staff. They also contained a social history and a variety of risk assessments including those for pressure areas and nutrition. Care staff record relevant information on individual care plans. Staff were seen offering personal care in a discreet manner and one resident told the inspector that staff were ‘always polite’. They also said that staff were ‘always ready to help if you ask them’. The Old Vicarage DS0000015986.V273908.R01.S.doc Version 5.1 Page 10 Secure storage is provided for medication within the home and those medicines found not to be secure were made secure during the inspection. The date and quantity received is recorded for regular monthly medication. However for medication received outside of this routine the date of receipt and the quantity received was not always recorded. It was found that for several service users there was no record of medicines administered made for two days. This was caused by the failure of the supplying doctor to supply Medication Administration Record (MAR) charts. The home had used two members of staff to check the administrations but had not recorded this. Some inconsistencies were found in the record of administration of eye drops to a service user after a dose change by the prescriber. All staff administering medication had received training on the safe handling of medicines and had been assessed as competent during this training. The homes medication policy was present but did not indicate when it was written or if it had been reviewed. When hand written entries are made on the MAR chart they are normally signed by two people but they are not normally dated. The Old Vicarage DS0000015986.V273908.R01.S.doc Version 5.1 Page 11 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12 and 14 Residents are offered good choices in many aspects of daily living. The home provides a good range of activities and entertainments to suit individual interests. Families and friends are welcomed in the home EVIDENCE: Residents told the inspector that they are able to choose how they spend their time. This may be watching TV, reading or joining in with some of the organised activities on offer. The home now produces a regular newsletter to inform residents about what is going on in the home. Residents said that they had many visitors who were always made welcome by the staff. A comment card from a visitor stated ‘This is a first class home, with helpful staff and a lovely home environment. The Old Vicarage DS0000015986.V273908.R01.S.doc Version 5.1 Page 12 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 inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18 The home has a satisfactory complaints procedure, which residents understand and are confident in. Residents are protected from abuse by the home’s policies and procedures and staff training. EVIDENCE: There is a simple complaints procedure displayed in the hallway. Residents told the inspector that they knew who they would talk to if they needed to make a complaint and felt sure that it would be acted upon. No complaints have been received by the Commission in relation to the home. The manager told the inspector that POVA (Protection of Vulnerable Adults) issues are discussed with staff regularly at staff meetings and are covered in induction for new staff. The owner is currently working on more formal training. The Old Vicarage DS0000015986.V273908.R01.S.doc Version 5.1 Page 13 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 21 and 26 The standard of the environment within the home is good, providing residents with a clean, safe, comfortable and homely place to live. EVIDENCE: The home was clean, comfortable and well maintained. There were no offensive odours around the home. The assisted bathroom now has a lamp shade fitted. There are two communal bathrooms in the home, with the ground floor bathroom having an assisted bath. The first floor bathroom has a sit in bath. The owners are currently considering their options as to how they can provide a second assisted bathroom. The Old Vicarage DS0000015986.V273908.R01.S.doc Version 5.1 Page 14 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 29 The deployment and numbers of staff available throughout the day are sufficient to meet the needs of the residents. The procedures for the recruitment of staff are robust and offer protection to residents. EVIDENCE: Three staff files were inspected All contained the required information, including satisfactory CRB (Criminal Records Bureau) checks, evidence of proof of identity and two written references. On the day of inspection there were five care staff one senior carer and several ancillary staff on duty. Though there is minimal information relating to staff health prior to starting work. The Old Vicarage DS0000015986.V273908.R01.S.doc Version 5.1 Page 15 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 33 and 35 The home has a range of methods in place to check the quality of the services and facilities provided. Residents’ finances are safeguarded by the homes’ procedures EVIDENCE: The home has achieved the Investors in People Award, and have several measures in place to review the quality of service provided. These include, questionnaires and resident meetings. However, no report on this review has been received by the Commission. Records of financial transactions on behalf of residents now contain two signatures. The Old Vicarage DS0000015986.V273908.R01.S.doc Version 5.1 Page 16 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 X X 3 X X X HEALTH AND PERSONAL CARE Standard No Score 7 3 8 X 9 2 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 X 14 3 15 X COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X 2 X X X X 3 STAFFING Standard No Score 27 X 28 X 29 2 30 X MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score X X 2 X 3 X X X The Old Vicarage DS0000015986.V273908.R01.S.doc Version 5.1 Page 17 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 OP9 Regulation 13(2) Timescale for action The registered person shall make 05/04/06 arrangements for the recording and safe administration of all medicines received into the care home. This refers to the need to record the date of receipt and the quantity received for all medication. It also refers to the need to record the administration of all medication to service users. You are required to supply to the Commission a report in respect of any review of the quality of care at the home, and make a copy of the report available to service users 05/04/06 Requirement 2. OP33 24(1) The Old Vicarage DS0000015986.V273908.R01.S.doc Version 5.1 Page 18 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 OP9 Good Practice Recommendations You are recommended to ensure that when an entry is hand written onto the Medicines Administration Record chart that this is signed and dated by the person making the entry and it is then checked and countersigned by a second person. You are recommended to ensure that the medicines policy be reviewed to reflect the current practice within the home You are recommended to ensure that the competence of all staff administering medication is reviewed regularly. You are recommended to consider providing a further assisted bathroom (carried over from last inspection) You are recommended to expand the information obtained from staff prior to appointment relating to their health 2. 3. 4. 5. OP9 OP9 OP21 OP29 The Old Vicarage DS0000015986.V273908.R01.S.doc Version 5.1 Page 19 Commission for Social Care Inspection Exeter Suites 1 & 7 Renslade House Bonhay Road Exeter EX4 3AY National Enquiry Line: 0845 015 0120 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 DS0000015986.V273908.R01.S.doc Version 5.1 Page 20 - 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. 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