CARE HOMES FOR OLDER PEOPLE
Valerie`s Rest Home 20 Ravenswood Avenue Crowthorne Berkshire RG11 6AY Lead Inspector
Yvonne Souden Unannounced Inspection 27th September 2005 11:20 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 Valerie`s Rest Home DS0000060562.V249607.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 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. Valerie`s Rest Home DS0000060562.V249607.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION
Name of service Valerie`s Rest Home Address 20 Ravenswood Avenue Crowthorne Berkshire RG11 6AY 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) 02087866393 S E S Care Homes Ltd Mrs Annette Chuter Care Home 17 Category(ies) of Old age, not falling within any other category registration, with number (17) of places Valerie`s Rest Home DS0000060562.V249607.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION
Conditions of registration: Date of last inspection 20th April 2005 Brief Description of the Service: Valerie’s Care Home is a large detached Victorian house set within a private residential road within the village of Crowthorne, and is within 5 minutes walk from local shops, post office, railway station and bus stop. The home has thirteen single bedrooms (five have en-suite) and two double bedrooms. The rooms are arranged over two floors, and a passenger lift is available. The building is not suitable for service users who are wheelchair dependant due to some premises restriction. There is a large Victorian conservatory that leads from the main dining area and is used as a lounge. The rear garden has been landscaped and seating is provided. Valerie`s Rest Home DS0000060562.V249607.R01.S.doc Version 5.0 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This was an unannounced inspection on a Monday and on arrival the Inspector observed sufficient staff on shift to meet the needs of the service users, and observed residents to be comfortable in a clean and tidy environment as they enjoyed morning coffee. The Inspector had one-to-one and group discussions with residents, staff and management and viewed the files of three residents and other documentation in place. What the service does well: What has improved since the last inspection? 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.
Valerie`s Rest Home DS0000060562.V249607.R01.S.doc Version 5.0 Page 6 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 Valerie`s Rest Home DS0000060562.V249607.R01.S.doc Version 5.0 Page 7 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): 1&3 The home ensures information is available to enable prospective service users to make an informed choice about where to live, and prospective service users needs are assessed prior to admission. EVIDENCE: The home has a Statement of Purpose that sets out the homes aims and objectives and philosophy of care, and the manager is currently working on improving the format of the Service Users Guide. Service user files identify that the home obtains information about their health and social care needs prior to their admission. Service users spoke of their life history and health and social care needs and these were clearly detailed within their assessments that had been completed by the home and by health and social care professionals. Valerie`s Rest Home DS0000060562.V249607.R01.S.doc Version 5.0 Page 8 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, 8, 9 and 10 The health care needs of service users are met and are detailed within their individual plan of care. Service users are protected by the homes policies and procedures for dealing with medicines and are treated with respect. EVIDENCE: The registered manager and staff have recently attended care planning training that has enabled them to improve the format used to detail the needs of the service user, and of how those needs are to be met. The care plans are in a crystal clear format and associated risk is detailed within individual risk assessments that include a moving and handling assessment. Records and discussions with service users identify that their health care needs are met. A chiropodist visited the home on the day of the inspection and pressure care equipment was in use. The home has implemented a new medication system and records of medication in stock matched records kept. The home has policies and procedures on the administration of medicines, and staff have received medication training. Observation of care practice and staff interaction with service users identify that the service users are treated with respect and that their privacy is assured. Screens are provided within the two double rooms.
Valerie`s Rest Home DS0000060562.V249607.R01.S.doc Version 5.0 Page 9 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): 13, 14 and 15 Service users maintain contact with family/friends and the local community, and are helped to exercise choice and control over their lives, however this is jeopardised from the choices they are afforded at meal times. EVIDENCE: Regular residents meetings takes place that enables the service users to have a say on how the home is run. The minutes of a resident meeting identified that service users views are listen to, but the minutes also identified that three service users would say something if they did not like what was offered at mealtimes and three service users said that they would just put up with it. The residents meeting had taken place three months prior to the inspection and no improvement was evident to ensure service users are given an alternative choice at mealtimes. Service users were complimentary of the meals served, and a menu plan identifies a nutritionally balanced diet. Service users have personalised their rooms to their choosing, however an inventory of their belongings is not maintained by the home. Records of activities and discussions with service users identify that service users have contact with the community, and a service user spoke of visiting family and friends and of having family and friends visit within the home. Service users are satisfied with activities arranged within the home but commented that outside activities have reduced in recent months.
Valerie`s Rest Home DS0000060562.V249607.R01.S.doc Version 5.0 Page 10 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 Service users and their relatives and friends are confident that complaints will be listened to, taken seriously and acted upon. EVIDENCE: The home has a complaint procedure and has placed a detailed user-friendly shortened version onto the service users notice board. The home has a complaint/compliments logbook to ensure all formal and informal complaints are logged. One compliment and no complaints have been recorded within the homes complaint/compliment logbook since the last inspection, and CSCI have received no complaints about the service provided within the home. Valerie`s Rest Home DS0000060562.V249607.R01.S.doc Version 5.0 Page 11 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): 26 The home is clean, pleasant and hygienic with systems in place to ensure infection control. EVIDENCE: Infection control policy procedures are in place and staff have received training within food and hygiene and infection control. The homes laundry is small but appears to meet the laundering needs of the service users and has sluicing and hand washing facilities. The home has a clinical waste contract and was observed to be clean, fresh, comfortable and homely with no offensive odours. Valerie`s Rest Home DS0000060562.V249607.R01.S.doc Version 5.0 Page 12 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): 30 Staff are supported within their training needs to be competent within their role. EVIDENCE: Records and discussions with staff identify a long-standing staff team who are committed to the needs of the service users and have training that enables them to meet those needs. The most recent staff member of 18 months confirmed the type of induction that she had received to ensure safe working practice, knowledge of the principles of care and the needs of the service users. The home works closely with a local college where support is given to staff that meets their training needs and aids them in achieving a National Vocational Qualification in care. Records, certificates and discussions with staff identify that staff receive mandatory training and that this is regularly reviewed and updated as required. Valerie`s Rest Home DS0000060562.V249607.R01.S.doc Version 5.0 Page 13 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 Quality assurance systems in place ensure the home is run in the best interest of the service user and service users financial interests are safeguarded. EVIDENCE: The home does not manage the finances of the service users, information on who to contact for financial guidance is made available. A service user confirmed that a family member manages their finances satisfactorily. The registered manager is in the process of achieving an NVQ in care/management and as part of the training has been developing systems on improving the quality assurance system in place, and on ensuring the views of the service users and their representatives are sought. CSCI receives a monthly report from the responsible individual that monitors the standards maintained within the home.
Valerie`s Rest Home DS0000060562.V249607.R01.S.doc Version 5.0 Page 14 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
With CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 3 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 X 13 3 14 2 15 2 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 x 18 x X X X X X X X 3 STAFFING Standard No Score 27 X 28 X 29 X 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score X X 3 X 3 X X X Valerie`s Rest Home DS0000060562.V249607.R01.S.doc Version 5.0 Page 15 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. 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. 1 Refer to Standard 12.3 Good Practice Recommendations The home should advertise local community events on the service users notice board to ensure the service users are informed and enable service user to attend community events and entertainment. An inventory of the service users personal belongings should be maintained. The home should review its menu planning and incorporate an alternative choice to that of the main meal, and ensure a record of choice is maintained. 2 3 14 12.2 15 Valerie`s Rest Home DS0000060562.V249607.R01.S.doc Version 5.0 Page 16 Commission for Social Care Inspection Berkshire Office 2nd Floor 1015 Arlington Business Park Theale, Berks RG7 4SA National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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