Inspection on 19/10/05 for The Vicarage

This inspection was carried out on 19th October 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Excellent. 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 Vicarage 26/04/07

The Vicarage 21/02/06

The Vicarage 21/03/05

The Vicarage 11/05/04

The Vicarage 28/01/04

Similar services:

2 Perhaver Park

7 Hyde Road

St George`s

5 Seafield Road

Credence House

Radfords

Trevaylor Manor

Honeybourne House

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

CARE HOME ADULTS 18-65 The Vicarage 59 Andover Road Tivoli Cheltenham Gloucestershire GL50 2TS Lead Inspector Kath Houson Announced Inspection 19th October 2005 13:00 The Vicarage DS0000037184.V260174.R01.S.doc Version 5.0 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 Vicarage DS0000037184.V260174.R01.S.doc Version 5.0 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 Adults 18-65. 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 Vicarage DS0000037184.V260174.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service The Vicarage Address 59 Andover Road Tivoli Cheltenham Gloucestershire GL50 2TS 01242 521918 01242 227646 thevicarage@gloucestershire.gov.uk 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) Gloucestershire County Council Mrs Judith Metcalf Care Home 5 Category(ies) of Learning disability (5), Learning disability over registration, with number 65 years of age (5) of places The Vicarage DS0000037184.V260174.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 21st March 2005 Brief Description of the Service: The Vicarage provides respite care for guests’ with learning difficulties. The facility is owned and operated by Gloucestershire Social Services. The home is a large detached two-storey house based in the local area of Tivoli and has easy access to Cheltenham town centre, the house is secluded and set within its own grounds with a pleasant garden at the rear of the building which additionally has wheelchair access for users. Sensitive adaptations have been made to accommodate individuals with physical disabilities. The premises has five very large bedrooms four of which are en-suite. There is an additional bathroom and shower room. There is also a large communal lounge dinning room, spacious kitchen. The large hallway is comfortably furnished into a quiet space where guests can sit and is close to the telephone for guests’ to have conversations in relative comfort with the added option to take private calls into their rooms. Guests were observed using this part of the house which looked welcoming. There is an intercom system available on request. All rooms have fitted furniture, colour TVs, portable CD, tape and radio player. The Vicarage DS0000037184.V260174.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The announced inspection took place one afternoon in October 2005. The registered manager was available throughout the inspection and able to assist and provide all relevant documentation on request. Twelve of the core standards were assessed and included an examination of documentation; three residents records were case tracked, a short and informal discussion was conducted with guests’ and staff team, a tour of the environment and a short succinct feedback was given to conclude the inspection visit. What the service does well: What has improved since the last inspection? The Vicarage continues to provide high quality care for guests’. The Vicarage DS0000037184.V260174.R01.S.doc Version 5.0 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 Vicarage DS0000037184.V260174.R01.S.doc Version 5.0 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection The Vicarage DS0000037184.V260174.R01.S.doc Version 5.0 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1&2 An updated version of the statement of purpose has been provided it outlines current information to ensure that guests’ make an informed choice about their place of residence. EVIDENCE: The manager had provided an updated version of the information booklet that detailed all aspects for the home. It’s sectioned and self-explanatory, with relevant contact details. The booklet additionally, has a staff structure that outlines the long-standing commitment of the staff members. Information is also available in a variety of formatted versions to include pictures, text, symbols and video, thus making this accessible to guests’ with communication difficulties. The guests’ are assessed for needs and suitability, following admission into the home and is documented in the service user care plan. The care staff also, conducts client home visits’ prior to admission into the home. The home has an admission procedure that is currently active, which allows the guests’ to sample the home before making an informed choice. The home is considered to be centre of excellence, and is sharing good practice with other establishments, thus to ensure high standards are uniform within homes in the community. The Vicarage DS0000037184.V260174.R01.S.doc Version 5.0 Page 9 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6; 7, and 9 Documentation and record keeping for the care of guests’ is recorded well, guests’ are aware of their individual needs and have a say in the development of their care plan. EVIDENCE: Guests’ files are documented in a good way, with daily-recorded information kept up to date. All files contain a current photograph of each guest, with descriptive accounts that will encourage freedom and choice. Care plans were designed with the consent of each guest, with the added factor that care needs are assessed during home visits prior to admission. Each guest has a communication sheet within each care plan to encourage open channels of non-verbal language for guests’ that may have difficulties with getting views across. A good working relationship exists between parents and staff team to ensure guests’ needs are met. Arrangements, for return visits of guests’ is organised thru additional needs assessment, to capture any change of client requirements. This was evident in care plans, information on future The Vicarage DS0000037184.V260174.R01.S.doc Version 5.0 Page 10 arrangements for guests’ have been included and well documented to ensure all members of staff are aware of any change in client information. Guests’ are encouraged to take risks, to promote a life of independence and was either working in a café, participating in arts and crafts, dancing, drama, socialising in a variety of venues. The guests are very active and are given the chance to participate in basic life skills and socialisation. Guests are given the opportunity to choose their key worker from the staff team who will monitor and support the guests’ during the respite period. The Vicarage DS0000037184.V260174.R01.S.doc Version 5.0 Page 11 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12; 16, and 17 The home enables guests’ to maintain appropriate and fulfilling lifestyles that reflect individual personality. Families of guests’ are encouraged to participate in their time at the home. EVIDENCE: The evidence obtained from care plans demonstrates that guests’ are encouraged to participate in culturally appropriate activities. For instance a female service user was involved in a ladies group in the community. Some of the guests’ attend college and participate in a wide variety of activities. The home additionally assist in developing employment skills this was evident when a guest stated that she worked in a café on a regular basis, this would enable the guest to become a equal member within their community. Observation made between care team and guests’ was one of positive approach in which the mannerism of the care team towards the guests’ was a relationship built on mutual respect. The body language can be described as warm caring, and friendly. The staff talk with the guests’ in a respectful way The Vicarage DS0000037184.V260174.R01.S.doc Version 5.0 Page 12 that encourage a good communication channel between guests’ and staff team; who regularly seek permission from guests’ to enter bedrooms when necessary such as when cleaning or bed making. Although this standard around a healthy diet was not examined, a full explanation was given from the manger of dietary needs of the guests’ were recorded in care plans with alternative choices made available. In addition, guests’ confirmed mealtime’s activities during an informal discussion in which the guests’ said that the food was good and enjoyed breakfast in bed over the weekend. Guests’ each have their meals cooked according to individual tastes of likes and dislikes and that there are no set menus. The Vicarage DS0000037184.V260174.R01.S.doc Version 5.0 Page 13 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 20 Guests’ are encouraged to continue with prescribed or homely medication during respite period within the home. Robust administration and record keeping of medication is of benefit to service users. EVIDENCE: Manger discussed that a good links exist between Primary Care Trust and the home, with ongoing working partnerships with general practice surgeries, in which contact will be made only when health problems arise with guests’. Guests are additionally, encouraged to self-administer their medication in which one guest continued to self medicate as a positive part of their independence, and personal healthcare to form a daily routine during their stay at the home. All care plans relating to medication has been signed with the guest’s consent to administer prescribed medicine. All staff members are trained to administer, dispense medication prescribed for the guests’ during their stay. Staff team who are fully trained and competent to administer insulin for example, as part of their extended role, if any difficulties should occur, District Nurses will be required to assist. There has been no incidence of drug errors, that is of reassurance to guests’ and their representatives, in which families are requested to sign for homely medication that are in prescribed containers. The Vicarage DS0000037184.V260174.R01.S.doc Version 5.0 Page 14 The home exercise clinical governance in which the correct medication is given to the correct guests’ at the time stated care plan. The Vicarage DS0000037184.V260174.R01.S.doc Version 5.0 Page 15 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 22 and 23 Guests take the opportunity to share positive comments after every stay in the home and every 4th tea visit. EVIDENCE: The registered manager has ensured that there is a system in place for guests to share their views. Feedback forms provide clear and effective means where complaints can be voiced. The Vicarage has had no complaints for the last 10 years that is evident to the high standard that is maintained consistently for a long period of time. The home receives on a regular basis a number of complimentary comments from guests’ and their advocates. Correspondence is often sent via Gloucester Social Services which outlines the excellent care guests’ have received, cards letters are sent on a continual basis which is good for both potential guests’ and staff members to ensure that that high standards are maintained and consistent. There is a complaints procedure that will become active if any negative responses are received. The Vicarage DS0000037184.V260174.R01.S.doc Version 5.0 Page 16 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 24;25,26,27,28,29, and 30 The home continues to maintain high environmental standards that meet the needs of the guests’ during their stay. EVIDENCE: The respect for the guests’ privacy is significant combined with the autonomy and independence is supported by the home. On entering the home the notice wall, has a board that displays pictures of both guests’ and members of staff, this would suggest that the guests’ and staff members are equal and has taken the element of discrimination on board. The home additionally has a communication tool for guests who are unable to communicate verbally; this tool consists of pictures, symbols and video format. Specialist equipment exists to ensure the guests can exercise their independence to its full potential. The guests’ have the option to have a bedroom key; with locks to ensure privacy in addition, each bedroom has a lockable safe in which staff members do not own a key. The fixtures and fittings are of high standard and quality, and contribute to the homely décor. Each room has home entertainment equipment with living space, which far exceeds the NMS. The home has a clean organised laundry room in which guests have the opportunity to do their The Vicarage DS0000037184.V260174.R01.S.doc Version 5.0 Page 17 own laundry. The home additionally, has specialist equipment to maximise independence of guests with mobility difficulties thus to ensure that the stay is one of comfort and relaxation. The home owns a custom-made people carrier vehicle, for the guests. It’s well designed to accommodate guests’ with physical disabilities. The grounds are well maintained with a large security light, encouraging guests’ to utilise the outdoor space thus further enjoying other aspects, which the house has to offer and falls in the health and safety remit. The home also demonstrate it has a day and night fire procedure displayed on the wall in the entrance hall, additionally; the fire certificates are put on the entrance hall wall to promote an element of reassurance, where the most recent credentials can also be seen this is considered good practice. The building is well maintained with a maintenance and cleaning program insitu. Home is clean and free from any offensive smells. Daily cleaning of fridge, cupboards for instance are regularly documented. There are plans to have a lift installed that would result in a bathroom and shower room will be moved to a different part of the house. The Vicarage DS0000037184.V260174.R01.S.doc Version 5.0 Page 18 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 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 The home consists of a small robust longstanding committed staff team with a wealth of experience. EVIDENCE: The home has a strong team of qualified carers who are skilled to meet the needs of guests’. Each staff member would be a key worker for each guest during the respite period. There consist of an induction package, which each staff member is given own personal copy along with any new policies and procedures. A training matrix displays all training and updates for staff. There has been no sickness rate for this year. There, also have been no new appointments since 2004; the manager never had to deal with disciplinary action within the home. This is a clear indication that the staff enjoy their place of work, the manager is able to retain her staff team via the “care for people approach”. A member of staff is active within the community and enjoys working in the home very much. The issue around the requirement for waking staff has been explained and will be applied according to the needs of the guests’. The manager states, that on the first night of guest’s stay she would do a waking night shift. The skill mix and experience of the staff team adopt a clear supportive role for the needs of the guests’. The Vicarage DS0000037184.V260174.R01.S.doc Version 5.0 Page 19 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. 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 are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 37 and 42 The home fulfils it stated purpose and objectives to meet the needs of the guests during their respite period. The manager and team listen very carefully to the voice of the guest and act on any information given. The home continues to operate to exceptionally high standards that would be of benefit to guests. EVIDENCE: The manger fosters an atmosphere of respect for guests’ family, representatives, advocates, friends and resident members of staff. Policies and procedures are in place and suitable for the size and function of the home. The long viability of the Vicarage is based on the positive response from guests ’that have made an informed choice for respite care. Furthermore, the responsible person has displayed warm commitment to the home and guests over a long period of time to enable members of staff to grow with training and support. Home had recently undergone a health and safety checks to ensure the premises is safe environment. The vicarage has already completed fire safety precautions with new fire regulations in readiness in 2006. All rooms have been risk assessment, to promote safety and protection. Operations document details all policies and procedures to ensure staff and guests aware of safe working practice. The Vicarage DS0000037184.V260174.R01.S.doc Version 5.0 Page 20 The Vicarage DS0000037184.V260174.R01.S.doc Version 5.0 Page 21 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 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 CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score X 4 X 4 4 Standard No 22 23 Score 4 4 ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score 4 4 X 4 4 Standard No 24 25 26 27 28 29 30 STAFFING Score 4 4 4 4 4 4 4 LIFESTYLES Standard No Score 11 X 12 4 13 X 14 X 15 X 16 4 17 Standard No 31 32 33 34 35 36 Score X X 4 X X X CONDUCT AND MANAGEMENT OF THE HOME 4 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 The Vicarage Score X X 4 X Standard No 37 38 39 40 41 42 43 Score 4 X X X X 4 X DS0000037184.V260174.R01.S.doc Version 5.0 Page 22 NO Are there any outstanding requirements from the last inspection? 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. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations The Vicarage DS0000037184.V260174.R01.S.doc Version 5.0 Page 23 Commission for Social Care Inspection Gloucester Office Unit 1210 Lansdowne Court Gloucester Business Park Brockworth Gloucester, GL3 4AB 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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