CARE HOME ADULTS 18-65
Vane Hill 15 - 72 Vane Hill Road Torquay Devon TQ1 2BZ Devon TQ1 2BZ Lead Inspector
Judy Hill Unannounced 12 September 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 Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationary 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. Vane Hill D54-D07 S18445 Vane Hill V246817 120905 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION
Name of service Vane Hill Address 15 - 72 Vane Hill Road, Torquay, Devon, TQ1 2BZ 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) 01803 298727 01803 299024 Mr Nunzio Notaro Mr Steven William Sydney Todd Care Home 32 Category(ies) of Past or present alcohol dependence (32), Past or registration, with number present alcohol dependence over 65 years of of places age (32) Vane Hill D54-D07 S18445 Vane Hill V246817 120905 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION
Conditions of registration: 1. No Service Users to be admitted under the age of 40 Date of last inspection 27th April 2005 Brief Description of the Service: Vane Hill Care Home is registered to provide accommodation and care for up to 32 people who are over forty years of age and who are or have been alcohol dependent. The majority of the residents have Kosacoffs Syndrome, which is a form of dementia linked to excessive drinking, and need long term care. As this is a specialist service, some restrictions are in place which limit the service users rights and choices. Vane Hill is made up of two detached houses which are situated at the top of a Vane Hill overlooking Torquay Harbour. One of the houses provides accommodation for eighteen residents who require high or medium levels of supervision, the other accommodates fourteen residents who are more independent. The registered manager and two deputy managers live on the premises and additional staffing is provided on a twenty-four hour basis. Vane Hill D54-D07 S18445 Vane Hill V246817 120905 Stage 4.doc Version 1.30 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This was the second inspection carried out in the year April 2005 to March 2006. The inspection was unannounced and was carried out by one inspector from 1pm to 3.50pm on Monday 12th September 2005. The information contained in this report was gained in conversation with the manager, staff and residents of Vane Hill, from documentary evidence, including Service Users’ Guides and information packs, the statement of Purpose, needs and risk assessments, care plans, menu plans, staff training records, policies and procedures and from direct and indirect observation. What the service does well: What has improved since the last inspection?
The Service Users’ Guide has been redrafted and personalised copies have been given to each of the residents as part of an information pack so that each resident has the information they need about the service provided. The needs and risk assessment and care planning processes have been improved and are now detailed and comprehensive. This ensures that the resident’s needs can
Vane Hill D54-D07 S18445 Vane Hill V246817 120905 Stage 4.doc Version 1.30 Page 6 be identified and met and that risk management strategies can used to reduce risk without overprotecting the residents. A file has been developed which contains information on all the medicines used by the residents. This is kept accessible to the staff and residents so they can access information about the drugs used. 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. Vane Hill D54-D07 S18445 Vane Hill V246817 120905 Stage 4.doc Version 1.30 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 Standards Statutory Requirements Identified During the Inspection Vane Hill D54-D07 S18445 Vane Hill V246817 120905 Stage 4.doc Version 1.30 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 standard(s) 1, 2, 3, 4 & 5 Prospective and current residents are given the information they need about the home and the service provided. EVIDENCE: The Statement of Purpose was seen to contain all of the required and recommended information. The information pack given to residents on admission was inspected and found to include a Service Users’ Guide, a statement of terms and conditions/contract between the service user and the service provider which includes their individual fees and extra charges, a copy of the complaints procedure, guidance on avoiding accidents, a policy on data protection and information on advocacy services. Detailed assessments of the residents individual needs and risk assessments were seen at the home and the manager said that he visits prospective residents and their representatives prior to admission to enable him to confirm that the home will be able to meet the resident’s individual needs. The Statement of Purpose identifies that following admission there is a trial period of one month, it is recommended that this is extended to a minimum of three months. Vane Hill D54-D07 S18445 Vane Hill V246817 120905 Stage 4.doc Version 1.30 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 standard(s) 6, 7, 9 & 10 The residents are involved in the development of comprehensive needs and risk assessments and in their individual care planning and reviews, so they can be confident that the service will identify and meet their needs. EVIDENCE: Samples of resident’s needs and risks assessments and care plans were seen which showed that these processes have been upgraded and improved to since the last inspection. Very comprehensive needs and risk assessments are now being carried out and detailed care plans, which are subject to regular reviews, are being produced. Written evidence was seen that the residents are involved in their assessments and in drawing up and reviewing their care plans. The manager explained that because the home specialises in providing long term care for people Kosacoff’s Syndrome and most of the residents have severe short term memory loss, some restrictions are in place which place limit the residents rights to make decisions. These include limits on alcohol consumption, the control of resident’s spending money and, although the doors are not locked, restrictions on some of the residents going out without an escort. The manager demonstrated that he is aware of the Data Protection Act and the inclusion of leaflets on data protection in the residents information packs demonstrates that the residents are made aware that the information kept about them will be handled appropriately.
Vane Hill D54-D07 S18445 Vane Hill V246817 120905 Stage 4.doc Version 1.30 Page 10 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 standard(s) 12, 13, 15, 16 & 17 The residents can lead active lives within their home environment and go on regular group outings if they choose to do so. Good support is given to help the residents to mend broken family ties and to maintain existing relationships. The residents would benefit from being offered a choice of healthy options at mealtimes. EVIDENCE: Although none of the residents has permanent employment, the manager said that some of the residents do some gardening for a neighbouring property and demonstrated that some of the residents have carried out maintenance work at the home and that some assist with general household duties, including cooking and cleaning. Two of the residents go to care services with Project 2000 where they attend a computer workshop and sport skills. Certificates demonstrated that several residents have taken part in training sessions within their home in subjects including Health and Safety, Food Hygiene, Infection Control, Handling and Lifting, First Aid and Resuscitation. Some of the residents go out fairly regularly and several of them said that they had recently been on a short camping holiday. Some of the residents also go on long guided walks and may have a picnic, bar-b-q or cream tea while they are out.
Vane Hill D54-D07 S18445 Vane Hill V246817 120905 Stage 4.doc Version 1.30 Page 11 The manager said that three of the residents are able to go out without an escort but that the other residents needed to be escorted because may forget where they live. Continued contact with families is encouraged and the manager demonstrated during the last inspection that he had been very proactive in attempting to help the residents who had lost contact with or fallen out with their families to be reconciled. One of the residents said that he was going to stay with his sister for a week and the manager confirmed that he had worked with the resident’s family to make this visit possible. The daily menu plans are written up on boards in the dining rooms. Although the residents are occasionally offered a choice of set meals such choice is not offered routinely. Menu plans are kept to form a record of food provided but these do not show alternatives to the set meals. It was observed from the menu plans that some of the meals provided may not provide a good nutritional balance and advise from a professional dietician with knowledge of the needs of people with Kosacoff’s dementia would help to ensure that the residents are offered a more healthy, varied and balanced diet. Vane Hill D54-D07 S18445 Vane Hill V246817 120905 Stage 4.doc Version 1.30 Page 12 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 standard(s) 0 EVIDENCE: None of the above standards was fully inspected on this occasion but a recommendation made in the last report was follow up and the manager has obtained information sheets on all of the prescribed medicines used in the home. These are kept in a file in the lounge so that the staff and service users have access to them. Vane Hill D54-D07 S18445 Vane Hill V246817 120905 Stage 4.doc Version 1.30 Page 13 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 standard(s) 0 EVIDENCE: Neither of the above standards were inspected on this occasion but both had been assessed as met at the last inspection. Vane Hill D54-D07 S18445 Vane Hill V246817 120905 Stage 4.doc Version 1.30 Page 14 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 standard(s) 30 The residents benefit from living in clean and hygienic homes. EVIDENCE: The laundry facilities, which are in an outbuilding, were inspected and found to be clean and hygienic. The residents clothing is discretely marked to ensure that it can be returned to the rightful owner. The washing machines are able to reach high temperatures to reduce the risk of the spread of infection. Hand washing facilities are in areas where infected materials may be handled. The manager said that all of the staff and some of the residents had received certificated training in infection control. Although a full inspection of the premises was not carried out on this occasion, the parts of the home that were seen were clean and free from offensive odours. Vane Hill D54-D07 S18445 Vane Hill V246817 120905 Stage 4.doc Version 1.30 Page 15 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 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 0 EVIDENCE: None of the above standards were inspected on this occasion. Vane Hill D54-D07 S18445 Vane Hill V246817 120905 Stage 4.doc Version 1.30 Page 16 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 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 42 The residents benefit from living in a home in which their health, safety and welfare is promoted and protected. EVIDENCE: Written evidence was seen that the home has policies and procedures on all safe working practices, that the staff have received appropriate training as part of their induction and foundation training programmes and that regular refresher courses are provided. Some of the residents have also attended training sessions and hold certificates on moving and handling, fire safety, first aid and infection control. Appropriate arrangements are being made for the safe storage of domestic chemicals and the disposal of hazardous waste. The water temperatures are controlled and monitored to reduce the risk of scalding. Evidence was seen of periodic tests to the electrical systems and appliances. The manager said that the gas boilers were serviced regularly but no certificate was seen to confirm this. Window restraints have been fitted to the first floor windows to reduce the possibility of falls. A record is kept of all accidents, injuries and incidents.
Vane Hill D54-D07 S18445 Vane Hill V246817 120905 Stage 4.doc Version 1.30 Page 17 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 4 3 3 2 3 Standard No 22 23
ENVIRONMENT Score x x INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10
LIFESTYLES Score 3 3 x 3 3
Score Standard No 24 25 26 27 28 29 30
STAFFING Score x x x x x x 3 Standard No 11 12 13 14 15 16 17 x 3 3 x 4 3 2 Standard No 31 32 33 34 35 36 Score x x x x x x CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21
Vane Hill Score x x x x Standard No 37 38 39 40 41 42 43 Score x x x x x 3 x D54-D07 S18445 Vane Hill V246817 120905 Stage 4.doc Version 1.30 Page 18 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. 1. Standard 17 Regulation Requirement Timescale for action 12/10/05 12, 13, 16 The residents must be offered a & 17 choice of nutritious, varied and balanced meals and records must be kept of the food provided for each resident. 2. 3. 4. 5. 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. 2. Refer to Standard 4 Good Practice Recommendations Extend the trial period follow admission to a minimum of three months. Vane Hill D54-D07 S18445 Vane Hill V246817 120905 Stage 4.doc Version 1.30 Page 19 Commission for Social Care Inspection Unit D1 Linhay Business Park Ashburton TQ13 7UP National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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