Inspection on 27/04/05 for Vanehill Specialist Care Homes

This inspection was carried out on 27th April 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 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

Vanehill Specialist Care Homes 26/09/06

Vanehill Specialist Care Homes 12/09/05

Vanehill Specialist Care Homes 27/10/04

Vanehill Specialist Care Homes 06/04/04

Similar services:

Clouds House

Closereach

Westcliffe House

Hilldales

Longreach

Chandos House

Cherry Orchards Camphill Community Ltd

Broadreach

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

CARE HOME ADULTS 18-65 Vane Hill 15 - 72 Vane Hill Road Torquay Devon TQ1 2BZ Devon TQ1 2BZ Lead Inspector Judy Hill Announced 27 April 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 V214229 270405 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 V214229 270405 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 & 28th October 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. The home provides both long term and rehabilitative 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 V214229 270405 Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was the first inspection carried out in the year April 2005 to March 2006. The inspection was announced and was carried out from 9.30am to 5.30pm on Wednesday 27th April 2005. Two inspectors carried out the inspection, the second inspector, a qualified pharmacist, inspected the storage and administration of medicines. 31 of the 32 residents were seen and 25 of them were spoken with. The manager and one of the deputy managers were spoken with and both they and four members of staff were seen working with the residents. Completed Comment Cards were received from 5 relatives/visitors and 4 residents. An inspection of the premises was carried out and samples of records, including needs and risk assessments, care plans and records of staff training were seen. Additional sources of information included a pre-inspection questionnaire that had been completed by the manager, the Statement of Purpose and Service User’s Guide. What the service does well: What has improved since the last inspection? The quality assurance/quality monitoring system has been further developed. Disposable towels have been provided in the communal toilets. Fresh fruit is now made available for the residents. The systems of handling and administering the residents’ medication have been improved. Vane Hill D54-D07 S18445 Vane Hill V214229 270405 Stage 4.doc Version 1.30 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. Vane Hill D54-D07 S18445 Vane Hill V214229 270405 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 V214229 270405 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 Prospective residents are not provided with enough information to enable them to make an informed choice about where to live. The resident’s individual needs assessments are not sufficiently comprehensive and do not provide justification for some of the restrictions that are placed on their individual rights. EVIDENCE: The Statement of Purpose was assessed as satisfactory at the last inspection and has not been amended. Copies of the Service Users’ Guides were seen in their rooms but some of the information that needs to be included to meet this standard is missing. The missing information includes individual statements of the terms and conditions of the service provided and written contracts so the residents are not made fully aware of their rights and responsibilities. A sample of the resident’s individual needs assessments were inspected and evidence of the residents’ participation in the process was seen. Some of the information that needs to be recorded, such as the identification of individual risk to provide justification for any restrictions imposed by the home and agreed with the service users, was not included. Vane Hill D54-D07 S18445 Vane Hill V214229 270405 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 The care planning systems are not sufficiently detailed to enable the individual residents needs and choices to be identified and met. There is not enough evidence to justify some of the restrictions placed on the resident’s individual rights. EVIDENCE: The care plans seen were not sufficiently detailed. They do not identify how the resident’s individual health, personal and social care needs will be met. They do not include risk management strategies or justification for any restrictions that have been placed on the resident’s choice and freedom. Conversations with the residents and manager and an observation of how the home is run identified that resident’s right to make decisions about some areas of their lives are restricted. Although these restrictions may be justified, there are no records to demonstrate that they have been agreed with the individual service users as part of the assessment process, and no records were seen in the residents’ care plans. Vane Hill D54-D07 S18445 Vane Hill V214229 270405 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) 15 Excellent support is given to help the residents to mend broken family relationships and to maintain existing relationships. EVIDENCE: Comment cards from relatives and conversations with the residents and manager demonstrated that family involvement is encouraged and that manager has been very proactive in seeking to reconcile broken family ties. Vane Hill D54-D07 S18445 Vane Hill V214229 270405 Stage 4.doc Version 1.30 Page 11 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) 18, 19 & 20 The manager and staff have been very successful in helping the residents to stop drinking, which has improved their health and enabled them to take a pride in their appearance. The improvements implemented during the inspection should ensure that the resident’s medication is administered safely. EVIDENCE: All of the residents seen were clean and well presented. Several of the residents spoke openly about their physical condition before coming to Vane Hill and how much better they felt now that they had given up drinking. The second inspector, who is a qualified pharmacist, audited the storage and administration of the resident’s medicines. The majority of audits undertaken demonstrated that medicines were stored appropriately and administered as prescribed. Medication systems had been installed but there were not robust enough. Staff were not aware that certain medications required refrigeration after first opening and failed to follow correct procedures during medicine administration. The Medication Administration Record (MAR) chart was signed by one staff and medicine administered by another member of staff. Staff were unclear of the dosage to be administered of certain medicines to service users. The written policy did not have details of supplying pharmacy, out of Vane Hill D54-D07 S18445 Vane Hill V214229 270405 Stage 4.doc Version 1.30 Page 12 hour’s pharmacy, GP’s, ordering of prescriptions, homely remedies and reporting to CSCI in the event of serious medication error. However, the home was eager to improve their current systems for medicine management and immediately implemented and rectified their systems for the handling of some medicines and the procedure for administration and recording of medicines by staff. Vane Hill D54-D07 S18445 Vane Hill V214229 270405 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) 22 & 23 The support provided successfully protects the residents from self-neglect and self harm. EVIDENCE: The complaints procedure was seen to be included in the Service User’s Guides and each of the residents has a copy of this. The Comment Cards completed by four of the residents all indicated that they would know who to speak to if they were unhappy with the service provided. The Comment Cards completed by five relatives/visitors all confirmed that they were aware of the home’s complaints procedure. The Registered Manager has a Certificate of qualification to provide Protection of Vulnerable Adults Training and this was seen along with staff records of training provided. The homes statement of Aims and Objectives includes as a principle aim, the need to protect the residents from self-neglect and self-harm and this is being achieved. Vane Hill D54-D07 S18445 Vane Hill V214229 270405 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) 24, 25, 27 & 28 The service users live in a homely, comfortable and safe environment. EVIDENCE: Vane Hill Care Home is made up of two separate detached houses and a physical inspection of both houses was carried out. Both houses were seen to be well maintained, the standard of decoration was seen to be satisfactory and the rooms were seen to be adequately furnished. There are fourteen single bed-sitting rooms and nine double rooms. Most of the residents who were asked said that they were happy to share. One said that he would prefer his own room and it was agreed with the manager that this would be arranged when a suitable room became available. There are adequate toilet and bathroom facilities and these were seen to be clean and functional. Both homes were seen to have spacious lounges and dining rooms. Vane Hill D54-D07 S18445 Vane Hill V214229 270405 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) 32, 33, 35 & 36 The staff are well trained and the staffing levels are high enough to meet the needs of the residents. EVIDENCE: Records of staff training were seen and discussed with the manager. These provide evidence that staff training is given a high priority. Although there is very little specialist training available locally on caring for people with Kosacoff’s syndrome, the manager demonstrated that he has developed a good understanding of the condition and that he is able to share his knowledge with the staff. The staff are instructed to read the homes policies and procedures and to sign and date a record to demonstrate that they have read and understand them. Most of the staff have, or are working towards completing NVQ’s in Care at Levels 2 or 3. Records were seen of staff appraisals, which the manager carries out with each member of staff every two months. Most of the residents needs are supervisory, rather than ‘hands on’ and the staffing levels were judged to be satisfactory. Vane Hill D54-D07 S18445 Vane Hill V214229 270405 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) 37 & 39 The manager is well qualified and has the qualities needed to provide a well run home. Insufficient attention is being given to ensuring that residents are able to influence how the service provided. EVIDENCE: Records of the manager, and staffs, qualifications were seen and conversation with the manager demonstrated his commitment to continually updating his skills through training. A quality assurance/quality monitoring system is in place and completed questionnaires were seen. Discussion took place with the manager about how this could be further developed and used to improve service delivery. Vane Hill D54-D07 S18445 Vane Hill V214229 270405 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 2 2 x x x Standard No 22 23 ENVIRONMENT Score 3 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 2 2 x x x Score Standard No 24 25 26 27 28 29 30 STAFFING Score 3 3 x 3 3 x x Standard No 11 12 13 14 15 16 17 x x x x 4 x x Standard No 31 32 33 34 35 36 Score x 3 3 x 3 3 CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Vane Hill Score 3 3 2 x Standard No 37 38 39 40 41 42 43 Score 3 x 3 x x x x D54-D07 S18445 Vane Hill V214229 270405 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 1 Regulation 5 Requirement Timescale for action 27/7/05 2. 2 14 & 15 3. 6 15 4. 7 12 & Schedule 3.3.(q) Redraft the Service Users Guides to include all of the information listed in Standard 1 and Regulation 5. Revise the residents individual 27/7/05 needs assessments with them and include information on all of the sections listed in Standard 2. Include written justification for any restrictions placed on and agreed by individual residents in individual risk assessments. Draw up more detailed care 27/7/05 plans and make them available to the residents. Ensure that the staff use the service users individual care plans to ensure that the service users individually assessed needs are met. A record must be kept of any 27/7/05 limitations agreed with the service users as to the individual service users freedom of choice, liberty of movement and power to make decisions. 5. Vane Hill D54-D07 S18445 Vane Hill V214229 270405 Stage 4.doc Version 1.30 Page 19 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 20 Good Practice Recommendations It is strongly recommended that the home obtain patient information leaflets preferably kept in one file for the provision of up to date information on medicines. Vane Hill D54-D07 S18445 Vane Hill V214229 270405 Stage 4.doc Version 1.30 Page 20 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 © 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 Vane Hill D54-D07 S18445 Vane Hill V214229 270405 Stage 4.doc Version 1.30 Page 21 - 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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