Inspection on 07/10/05 for The Rectory

This inspection was carried out on 7th October 2005.

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 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 Rectory 27/08/09

The Rectory 07/09/07

The Rectory 14/11/06

The Rectory 09/03/06

The Rectory 21/02/05

The Rectory 26/04/04

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

CARE HOMES FOR OLDER PEOPLE The Rectory SRC Residential Care Home 2 Trinity Road Taunton Somerset TA1 3JH Lead Inspector Sally Murphy Unannounced 7 October 2005 th 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 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 Rectory SRC Residential Care Home D53 - D02 S3302 The Rectory V246726 071005 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service The Rectory SRC Residential Care Home Address 2 Trinity Road Taunton Somerset TA1 3JH 01823 324145 Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Maners Care Limited Mr Matthew James Parrish Personal Care Home Only 23 Category(ies) of DE(E) Dementia -over 65 registration, with number of places The Rectory SRC Residential Care Home D53 - D02 S3302 The Rectory V246726 071005 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: 1. Two named service users in category MD to be accommodated in the home, as agreed with the Responsible Individual. 2. Bedroom 9 must only be used to accommodate fully mobile service users. Admissions must be accompanied by an appropriate risk assessment. 3. The Registered Manager must obtain the NVQ 4 qualification in Care and Management by 31st December 2006. Date of last inspection 21st February 2005 Brief Description of the Service: The Rectory is a two storey detached property on the outskirts of Taunton town centre. Service user accommodation is provided over two floors. All service user rooms are single occupancy. A passenger lift, assisted bathroom and call system are provided. There is a garden at the rear of the property that is accessible to service users. The home is registered with the Commission for Social Care Inspection to provide personal care for up to twenty-three people who have a dementia. The Registered Manager is Mr Matthew Parrish and the Registered Provider is Maners Care Ltd. The Rectory has been approved by Somerset Social Services as a special rate care (SRC) home providing enhanced care for people suffering from dementia. The Rectory SRC Residential Care Home D53 - D02 S3302 The Rectory V246726 071005 Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was carried out as part of the planned annual programme of inspection. The inspection was unannounced and carried out by Sally Murphy and Paul Grey, Regulation Inspectors, over one day. The previous inspection was announced and took place on 21st February 2005. On the day of the inspection there were eighteen service users residing at the home. During the course of the inspection the Registered Manager, General Manager, Proprietor, service users, relatives and staff members were spoken with. Care practice was also observed, records examined and a tour of the premises was made. What the service does well: What has improved since the last inspection? Since the last inspection Matthew Parrish has been appointed as the Registered Manager for the home. He has now been in post for four months and provides effective leadership to the staff team. Sharon Trott, who had previously undertaken the role of Acting Manager, has become the General Manager for Maners Care Ltd and continues to have a key role within the home. There is an on-going program of re-decoration and refurbishment. The Rectory SRC Residential Care Home D53 - D02 S3302 The Rectory V246726 071005 Stage 4.doc Version 1.40 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 Rectory SRC Residential Care Home D53 - D02 S3302 The Rectory V246726 071005 Stage 4.doc Version 1.40 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 Standards Statutory Requirements Identified During the Inspection The Rectory SRC Residential Care Home D53 - D02 S3302 The Rectory V246726 071005 Stage 4.doc Version 1.40 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 standard(s) 1, 3, 4, & 5. (Standard 6 does not apply). The home ensures that prospective service users are provided with appropriate information regarding the home. Service users and their families are invited to visit the home and assess the services provided. An assessment of need is completed prior to any service user moving into ensure that the home will be able to fully meet their needs. EVIDENCE: The home has a Statement of Purpose and Service User Guide that provide details of the services and facilities provided at The Rectory. The Statement of Purpose is displayed in the hallway and a Residents Guide is available in each room. The Registered Manager ensures that an assessment of need is completed prior to any service user moving into the home. The Rectory SRC Residential Care Home D53 - D02 S3302 The Rectory V246726 071005 Stage 4.doc Version 1.40 Page 9 Prospective service users and their families are invited to visit the home. Respite care is provided. Placements are made via Somerset Social Services who have block purchased all beds at the home. The Rectory SRC Residential Care Home D53 - D02 S3302 The Rectory V246726 071005 Stage 4.doc Version 1.40 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 7, 8, 9 & 10. The home has developed an appropriate plan to meet service users’ needs. Care plans were comprehensive and are regularly reviewed. The home works closely with the Link Nurse from Somerset Partnership. Medications are appropriately maintained. Service users are treated with dignity and respect. EVIDENCE: Care plans are maintained for each service user. These include details of individual’s needs, daily routines and preferences. Care plans were thorough and included detailed directions to staff of the level and type of assistance to be provided to each person. A moving and handling assessment had been completed for each service user. Care plans had been regularly reviewed and updated as required. Waterlow and falls risk assessments had been completed. Pressure-relieving equipment is provided as required. Service users are weighed each month. The Link Nurse visits the home each week and is available to offer further advice as required. The home had taken appropriate actions to meet the needs of a service user who had displayed challenging behaviour. The Rectory SRC Residential Care Home D53 - D02 S3302 The Rectory V246726 071005 Stage 4.doc Version 1.40 Page 11 Staff have received medications training from the supplying pharmacy. The home plans for staff to receive further training on the Safe Handling of Medications. All medications are stored securely. Photographs have been provided on the Medication Administration Records for most service users. Medications requiring refrigeration are stored securely and the temperature monitored each day. Opening and discard dates had been recorded for creams. Medication Administration Records had been appropriately maintained. Staff were observed knocking on doors before entering. Service users are able to meet privately with visitors in their bedroom or one of the lounges. Interaction between staff and service users was friendly and respectful. The Rectory SRC Residential Care Home D53 - D02 S3302 The Rectory V246726 071005 Stage 4.doc Version 1.40 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12, 13, 14 & 15. The home has taken appropriate action to meet service users’ social needs. Service users are encouraged to exercise choice over their lives. Meals are of a good standard and offer a well-balanced diet. EVIDENCE: Daily routines are flexible to meet the needs of service users. Service users are able to participate in a range of activities, including: - flexercise, cold bake, walks, singing, shopping, picture making, bingo, manicures and listening to music. The weekly program of activities is displayed in the dining room. Visitors are welcomed. The home plans to develop a befriending service. Meals are provided by a catering company. A choice of meals is provided each day. Service users stated that they enjoyed the meals provided. Staff are aware of service users’ dietary needs and preferences. A food and fluid chart is maintained for one service user. Fresh cakes are baked at the home each day. The Rectory SRC Residential Care Home D53 - D02 S3302 The Rectory V246726 071005 Stage 4.doc Version 1.40 Page 13 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 standard(s) 16 & 18. The home has appropriate policies relating to complaints and the Protection of Vulnerable Adults. EVIDENCE: The home has a complaints procedure that includes details of external agencies that service users and their families may contact, including CSCI. The complaints procedure displayed in the hallway currently includes reference to nursing services and should be updated. A copy of the complaints procedure is also included within the Statement of Purpose. There have been no complaints received by the home or CSCI since the last inspection. The home has appropriate policies relating to the Protection of Vulnerable Adults. The Rectory SRC Residential Care Home D53 - D02 S3302 The Rectory V246726 071005 Stage 4.doc Version 1.40 Page 14 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 standard(s) 19, 20, 21, 22, 23, 24, 25 & 26. The home has been decorated and furnished to a high standard. There are sufficient communal areas and bathroom facilities to meet service users’ needs. Service user rooms are personalised to reflect their individual tastes. There is an on-going program of re-decoration throughout the home. The home must take further action to ensure that the issues identified for two service user bedrooms are addressed. The home follows good practice with regard to infection control. The home is maintained to a high standard of cleanliness. EVIDENCE: Service user accommodation is provided over two floors. There is a passenger lift, assisted bathroom and call system available to service users. Communal areas comprise of a lounge, observation lounge and dining room. New signage has been provided throughout the home. There is a secure garden at the rear of the property that is accessible to service users. The Rectory SRC Residential Care Home D53 - D02 S3302 The Rectory V246726 071005 Stage 4.doc Version 1.40 Page 15 Since the last inspection a number of service user rooms have been redecorated. New furniture and bedding has also been purchased. Service users are able to bring personal possessions with them into the home. Service user rooms seen had been personalised with pictures, furniture and photographs. Waterproof flooring has been provided in some service user rooms to meet individuals’ needs. The double glazed window in one service user’s room has failed and requires replacement. The plaster has cracked above the window in a further service users’ room. The Registered Provider plans to re-furbish the ground floor bathroom and office. The laundry is locked when not in use. New laundry equipment has been purchased. The home follows appropriate infection control procedures. The home was found to have a high standard of cleanliness. The Rectory SRC Residential Care Home D53 - D02 S3302 The Rectory V246726 071005 Stage 4.doc Version 1.40 Page 16 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 considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27, 28, 29 & 30. Staff are provided with appropriate training to undertake their role. There are sufficient staff on duty to meet service users’ needs. Staff are provided with regular supervision. The home operates a robust recruitment procedure. EVIDENCE: Duty rotas are maintained. There are generally four staff on duty throughout the day, and two waking staff at night. An Activities person is available each day 9 am - 2 pm. Additional domestic and catering staff are also employed. The Registered Manager and General Manager also work a number of shifts each week. The home ensures that staff are provided with opportunities to receive further training. A comprehensive training matrix is maintained. All staff receive regular updates in mandatory training. Eleven care staff have obtained the NVQ level 2 qualification in care. A further three staff plan to study for this. The Registered Manager will shortly begin studying for the NVQ level 4 qualification in Management and Care. Newly appointed staff receive a thorough Induction Program. Staff receive regular supervision, and appraisals are completed on an annual basis. Recruitment records were examined for the four most recently employed members of staff. Each was found to contain the documentation required under Schedule 2 of the Care Home Regulations 2001. The Rectory SRC Residential Care Home D53 - D02 S3302 The Rectory V246726 071005 Stage 4.doc Version 1.40 Page 17 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 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31, 32, 33, 34, 35, 36, 37 & 38. The home is well run. The Registered Manager provides effective leadership to the staff team. There are appropriate systems in place to obtain the views of service users. Records relating to service users are stored securely. Health and safety records have been appropriately maintained. EVIDENCE: The Registered Manager is Matthew Parrish. He has considerable experience of providing care to older people and plans to study for the NVQ level 4 qualification in Management and Care. The Registered Manager, Training Deputy Manager, and General Manager provide on-call management cover on a rota basis. The Rectory SRC Residential Care Home D53 - D02 S3302 The Rectory V246726 071005 Stage 4.doc Version 1.40 Page 18 There was a relaxed atmosphere within the home. Staff spoke highly of the Registered Manager, and stated that he was approachable. The home holds monthly meetings with service users, and plans to develop a support group. The home will keep money for service users who wish them to. Records are maintained of all transactions involving service users’ finances, and are supported by staff signatures and receipts. Records relating to service users are stored securely. The home displays appropriate Employers Liability Insurance. Fire safety equipment has been serviced and tested as required. Staff have been provided with regular fire safety training. Equipment servicing records have been appropriately maintained. The fire door for one service user room does not shut fully. The home must take appropriate action to ensure that the service user is protected in the event of a fire. The home operates a comprehensive system of quality audits to ensure that service users are provided with a safe and comfortable environment. Hazardous substances are stored securely and are not accessible to service users. Accidents are recorded and reported as required. The Rectory SRC Residential Care Home D53 - D02 S3302 The Rectory V246726 071005 Stage 4.doc Version 1.40 Page 19 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score 2 x 3 3 3 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 3 COMPLAINTS AND PROTECTION 3 3 3 3 3 3 2 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x 3 3 3 3 3 3 3 3 2 The Rectory SRC Residential Care Home D53 - D02 S3302 The Rectory V246726 071005 Stage 4.doc Version 1.40 Page 20 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 OP1 OP16 Regulation 4(1) Requirement The Statement of Purpose and Complaint Procedure currently contain reference to nursing services and the previous Manager; these must be updated to exclude this discontinued service. The double glazed window in one service users room has failed and requires replacment. The cracked plaster must be replaced in a further service users room. The fire door for one service users room does not shut fully. The home must take appropriate action to ensure that the service user is protected in the event of a fire. Timescale for action 14/11/05 2. OP25 23(2) 23/01/06 3. OP38 23(4) 14/11/05 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. The Rectory SRC Residential Care Home D53 - D02 S3302 The Rectory V246726 071005 Stage 4.doc Version 1.40 Page 21 Refer to Standard Good Practice Recommendations The Rectory SRC Residential Care Home D53 - D02 S3302 The Rectory V246726 071005 Stage 4.doc Version 1.40 Page 22 Commission for Social Care Inspection Riverside Chambers Castle Street Tangier Taunton TA1 4AL 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. 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