Please wait

Please note that the information on this website is now out of date. It is planned that we will update and relaunch, but for now is of historical interest only and we suggest you visit cqc.org.uk

Inspection on 08/08/05 for Vaughan Lee House

Also see our care home review for Vaughan Lee House for more information

This inspection was carried out on 8th August 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.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

The home has an inclusive atmosphere and the residents appeared relaxed and at ease. Several of those who commented said they felt well cared for. There was a friendly atmosphere and rapport between residents and the staff team. Continuity of support is provided by a stable staff team (agency staff are very rarely called upon). The home provides a range of interesting and stimulating activities on a daily basis whilst respecting individual`s needs and preferences. As the following comments from residents illustrates, `There`s always lots to do....I`m never bored`. The people living at Vaughan Lee are encouraged and supported to get out and about in the community, both independently or with support as needed.

What has improved since the last inspection?

The previously unguarded radiators have now been safely covered. Topical creams are now clearly labelled for individuals use. The medicines trolley is now safely secured to the wall when not in use. Soiled or contaminated linen is now more readily identified by the introduction of Red laundry bags. This ensures it is kept separate from the regular laundry items.

What the care home could do better:

The current sluicing facilities are only easily accessible from one end of the home. At the time of this inspection the management team were already considering the installation of a secondary sluicing facility. This would eliminate the need to carry soiled items or waste from one part of the home to the other. The complaints policy is readily accessible in the home. This could be further improved for residents and their families by the inclusion of contact details for Advocacy services.

CARE HOMES FOR OLDER PEOPLE Vaughan Lee House Orchard Vale Ilminster TA19 0EX Lead Inspector Pat Edwards-Jackson Announced 8 August 2005 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. Vaughan Lee House D53 - D02 S16070 Vaughan Lee House V232625 080805 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Vaughan Lee House Address Orchard Vale, Ilminster, TA19 0EX 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) 01460 52077 Ilminster and District (OPW) Housing Society Ltd Mrs Rosalind Anne Woolmington Personal Care Home only 26 Category(ies) of Old age (26) registration, with number of places Vaughan Lee House D53 - D02 S16070 Vaughan Lee House V232625 080805 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: None Date of last inspection 4th February, 2005 Brief Description of the Service: Vaughan Lee House is a care home providing care and support for up to 26 older people. The home is located in a residential area of Ilminster. Local services including shops, pubs and public transport are nearby. The home is owned and managed by a local charitable organisation. The home was purpose built in 1970 with the specific aim of providing support for local people. Consequently the majority of resident service users are from Ilminster and the surrounding villages. Locally based staff are also attracted to working in the home. Consequently the home has strong links with the local community, including volunteers, which benefits the residents. All accomodation is on the ground floor and bedrooms are for single occupancy. The home offers a limited amount of day care for non-residents each week. Vaughan Lee House D53 - D02 S16070 Vaughan Lee House V232625 080805 Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. At the time of this announced inspection the new manager Yvonne Foulsham was in charge of the home. Ms Foulsham commenced in her current post at the home in July 2005 and this was her first experience of an inspection at the home. It was also the inspector’s first visit to the home. The manager was supported by a staff team comprising 2 care assistants; 1 assistant head of home; 4 domestics; 2 kitchen staff; 1 laundry staff member and the homes administrator. 24 older people were residing in the home. One resident was in hospital and the home had one vacancy. The community nurses and a chiropodist visited the home during the inspection. The people living at the home described themselves as ‘residents’ and this term has been used throughout the report rather than ‘service user’. What the service does well: What has improved since the last inspection? The previously unguarded radiators have now been safely covered. Topical creams are now clearly labelled for individuals use. The medicines trolley is now safely secured to the wall when not in use. Soiled or contaminated linen Vaughan Lee House D53 - D02 S16070 Vaughan Lee House V232625 080805 Stage 4.doc Version 1.40 Page 6 is now more readily identified by the introduction of Red laundry bags. This ensures it is kept separate from the regular laundry items. 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. Vaughan Lee House D53 - D02 S16070 Vaughan Lee House V232625 080805 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 Vaughan Lee House D53 - D02 S16070 Vaughan Lee House V232625 080805 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;2;3;4;5;6(not applicable here) Prospective residents and their families and supporters have the opportunity to visit the home prior to admission. Assessments are undertaken prior to admission and the scale of charges is made clear. Trial periods are provided. Each person has a contract for the service they receive. EVIDENCE: Discussions took place with the majority of residents and the staff, including the homes administrator who deals with financial and contractual issues at the home. A sample, of resident files was seen including contracts for their care at the home. The current scale of fees is £349 – 458, regardless of the funding source. One of the residents spoken with had moved to the home a few months ago. She had previously lived at another home. She described how when her needs increased she had looked for another home, with the help of a relative. She had visited Vaughan Lee prior to admission and said she was ‘enjoying’ living at the home. She had also managed to remain on the list of her original GP who had known her for many years. This was important to her. Other residents spoke about visiting the home prior to admission and also being able Vaughan Lee House D53 - D02 S16070 Vaughan Lee House V232625 080805 Stage 4.doc Version 1.40 Page 9 to compare it with other homes in the area. The sample of care and support plans seen contained evidence that a trial period formed part of a new residents introduction to the home. Vaughan Lee House D53 - D02 S16070 Vaughan Lee House V232625 080805 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;11 The care and support plans clearly set out individual needs and how they would be met. Health care needs are met with the support of the multidisciplinary team who visit the home as needed. Arrangements are made for out patient or inpatient care as needed. The medication system and storage arrangements are safe. There is mutual respect between residents and staff alike. The staff team respect the needs of those whose condition deteriorate and are able to support residents who wish to remain at the home until the end of their lives. EVIDENCE: A sample of resident’s care and support plans were seen, these clearly set out the health and social care needs. The home currently has a vacant room – the occupant had died not long after moving in. Staff and residents alike spoke respectfully about this person. The community nurses and the chiropodist visited to see a small number of residents, during the course of the inspection. The CSCI had also received positive feedback about the home, from the community nursing service and a number of residents, prior to the inspection. Vaughan Lee House D53 - D02 S16070 Vaughan Lee House V232625 080805 Stage 4.doc Version 1.40 Page 11 One person had a fall during the inspection, staff intervened swiftly and sensitively to re-assure her and ensure she was not injured. Two other residents in the vicinity at the time took action to ring a call bell for assistance (whilst the inspector remained with the resident). Following the incident the residents commented on the swiftness of staff action saying this had ‘been a good demonstration of how quickly help comes if you need it’. Vaughan Lee House D53 - D02 S16070 Vaughan Lee House V232625 080805 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 people living at the home enjoy a range of lifestyles and interests (both in the home and outside) according to their needs. Regular contact with friends and families is supported and occurs on a regular basis. Exercising choice and control in daily living is encouraged and supported by the home. A well balanced diet is provided and mealtimes are a social occasion taken in pleasant surroundings. EVIDENCE: From the discussions with residents during the inspection it was apparent that the home currently caters for a wide range of older people, in age, life experience and interests. For example one of the younger residents spoke about a full social life inside and outside the home. She goes out independently visiting friends and family on a regular basis, and taking holidays abroad. She also attends clubs and activities in the community but said she also enjoys the company of the other people living at the home. One resident spoke about her failing eyesight which meant she was no longer able to do some of the things she had previously enjoyed e.g. keeping up with current affairs in the newspaper. The possibility of seeking further advice from the RNIB was discussed and with her permission the manager was asked to follow-up her request. One of the few male residents has a small greenhouse in the grounds, which he tends with the help of the gardener/handyman. One resident returned from an independent shopping trip in time for lunch and was Vaughan Lee House D53 - D02 S16070 Vaughan Lee House V232625 080805 Stage 4.doc Version 1.40 Page 13 enthusiastically greeted by the staff with the offer of ‘a cuppa’. A number of relatives also visited the home; one person came to accompany a resident to hospital whilst another took a resident out for the day. During the morning a small group of residents were seen to enjoy a game of tabletop skittles. They commented on social life in the home saying they enjoyed ‘something like this every day’. They spoke about card games and quizzes, ‘sometimes the questions are difficult, but it’s good to keep the brain active’. All were fully aware of their increasing frailty but were equally determined to keep active, mentally if not physically. Some residents also spoke about the ‘gentle exercise sessions’, which also take place on a regular basis. In addition to the organised activities small groups of residents were observed chatting and socialising both inside and out in the garden throughout the day. Residents also spoke fondly about the pet cat, which was seen during the course of the day. A small number of residents appeared to enjoy spending time in their rooms engaged in hobbies e.g. one person was involved in knitting items for an overseas children’s charity and proudly showed off examples of her earlier work which were on display in her room. It was extremely pleasing to see so much spontaneous activity and enthusiasm throughout the home. Lunchtime was observed during the inspection, it looked and smelled appetizing – residents spoken with after the meal reported they had enjoyed it and that the food at the home was good. One person commented ‘meals are very good. You can have a cooked breakfast every day except the two days when we have a roast dinner (mid week and Sundays). We always have fruit juice for breakfast’. A menu board listing the day’s meal was on display in the entrance hall. Vaughan Lee House D53 - D02 S16070 Vaughan Lee House V232625 080805 Stage 4.doc Version 1.40 Page 14 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;17;18 The home has system for dealing with complaints and information about this is publicly displayed in the home. The guidance information does not inform residents and their families about additional support, which may be available to them. The homes whistle-blowing policy document has improved since the previous inspection but would benefit from further development. Systems are in place to protect residents (service users) from abuse. EVIDENCE: The complaints information was seen and discussed with the manager and information regarding advocacy services will be included as discussed with her. The Whistle-blowing Policy was seen and this would benefit from further development (to make it more informative) as discussed with the manager. Policies relating to Complaints; Smoking in the home; the use of Illegal substances were all prominently displayed in the communal entrance hall to the home. Discussions with residents throughout the course of the inspection confirmed that they felt able to comment on the service and to complain if they were unhappy. Feedback (CSCI comment cards) from seven residents prior to the inspection also confirmed this. Discussion with the homes administrator confirmed that systems are in place to ensure residents are protected e.g. financial arrangements. The home does not act on behalf of any resident in respect of their financial arrangements. Lockable facilities are provided for residents to keep money and valuables. Vaughan Lee House D53 - D02 S16070 Vaughan Lee House V232625 080805 Stage 4.doc Version 1.40 Page 15 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 is well maintained and systems were in place to ensure the safety of those living and working here. Lavatories and bathing facilities are provided throughout the home. The accommodation could be improved further by the addition of en-suite facilities. A range of equipment is available to aid the mobility and independence of those living in the home. Individual bedrooms are furnished and equipped to meet individual needs. The home is clean with no persistent odours. EVIDENCE: Equipment throughout the home is kept well maintained and serviced. This was evidenced in the pre-inspection information provided by the home and during the inspection a sample of equipment was ‘spot checked’ to confirm this. Comments received from a small number of residents indicated they would appreciate en-suite facilities e.g. two of those spoken with had visited other homes and the main difference they had noted was the lack of en-suites at Vaughan Lee. Another person commented that individual bedrooms were ‘a bit Vaughan Lee House D53 - D02 S16070 Vaughan Lee House V232625 080805 Stage 4.doc Version 1.40 Page 16 cramped’. Clearly it is difficult for some people to maintain a balance between the numbers of personal items, which a bedroom can accommodate if available floor space is to remain free. All of the bedrooms seen during the inspection were comfortably furnished and well decorated. There was a great variety in décor, which very much reflected the interests and needs of their individual occupants. The administrator was also able to confirm that bedrooms are always re-decorated for new occupants. The home also strives to ensure the prospective resident can choose the décor and that they are encouraged to bring their own belongings. However if they prefer not to then the home would ensure the room was appropriately furnished. The home currently has one sluicing facility, which meets the needs of the entire home. This means that waste products and soiled materials sometimes need to be carried from one part of the home to another. Following a discussion with the manager it was clear that plans are in place to improve the situation and a space has been identified to install a second facility. Vaughan Lee House D53 - D02 S16070 Vaughan Lee House V232625 080805 Stage 4.doc Version 1.40 Page 17 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 The staff team have the skills to meet the needs of the people living at the home. Systems are in place and staff are trained and supervised to ensure the people living here are in safe hands. The recruitment policy and practices protect the people living here. EVIDENCE: A sample of staff recruitment files was scrutinised. Each contained all the necessary documentation e.g. references, identifying documents, evidence of induction training. 1:1 conversations with staff confirmed that they felt well supported by their colleagues and the management team. Some staff spoke about the training they had undertaken since working at the home. Attaining formal NVQ qualifications is supported by the home and in-house assessors are available within the staff team. Records of recent staff training demonstrate that 11 staff received Moving & Handling training during May and June this year. 25 members of staff attended Fire training in July this year. A Fire drill also took place in June. All of the staff spoken with commented on the team spirit and how the team covered sickness and holiday absences. The use of agency staff was regarded as a rarity. The majority of staff lives in Ilminster or the surrounding villages. Vaughan Lee House D53 - D02 S16070 Vaughan Lee House V232625 080805 Stage 4.doc Version 1.40 Page 18 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 recently appointed manager is committed to becoming registered with the CSCI. The home is run in the best interests of the people living here. The administrator ensures that residents are protected by the homes accounting and financial procedures. Staff are supervised. Systems and practices within the home ensure that the health and safety of residents and staff are promoted. EVIDENCE: Discussion with the manager confirmed that she has applied for registration with the CSCI. She is currently undertaking the Registered Managers Award. The manager is currently reviewing the supervision system, which has been predominantly informal until now. Staff spoken with 1:1 during the inspection commented that the manager was both approachable and swift to act if Vaughan Lee House D53 - D02 S16070 Vaughan Lee House V232625 080805 Stage 4.doc Version 1.40 Page 19 problems were identified. Another person commented on changes the manager had made which they felt were ‘for the better’. The staff were fully aware of the mandatory training they need to keep updated and that they had the opportunities and support to undertake training as needed. The manager was able to confirm that night staff are included in training sessions. Discussion with the homes administrator confirmed that she ensures the financial procedures within the home are sound. She has responsibility for organising staff wages; resident’s accounts; the company accounts. She also supports the service management committee. The management committee visit the home on a monthly basis and speak with residents and staff alike. The administrator was able to confirm that the service is adequately funded and the most recent annual Statement of Accounts (31 December 2004) was seen. The homes management committee has recently recruited relatives of residents onto the committee. This increases the user representation for this service. Vaughan Lee House D53 - D02 S16070 Vaughan Lee House V232625 080805 Stage 4.doc Version 1.40 Page 20 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 3 3 3 3 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 4 13 3 14 3 15 3 COMPLAINTS AND PROTECTION 3 3 3 3 3 3 3 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 3 3 3 3 3 3 3 3 3 3 Vaughan Lee House D53 - D02 S16070 Vaughan Lee House V232625 080805 Stage 4.doc Version 1.40 Page 21 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 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 OP16 Good Practice Recommendations That the complaints policy be amended to include contact details for advocacy services. Vaughan Lee House D53 - D02 S16070 Vaughan Lee House V232625 080805 Stage 4.doc Version 1.40 Page 22 Commission for Social Care Inspection Riverside Chambers Castle Street 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. Extracts may not be used or reproduced without the express permission of CSCI Vaughan Lee House D53 - D02 S16070 Vaughan Lee House V232625 080805 Stage 4.doc Version 1.40 Page 23 - 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. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!