Inspection on 31/07/07 for Vecta House

This inspection was carried out on 31st July 2007.

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

Similar services:

21 High Street

Vale House

Chestnut Walk

The Old Vicarage

Cherwood House Care Centre

Ashley House

Ascot Nursing Home

Fountain View

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

CARE HOMES FOR OLDER PEOPLE Vecta House 24 Atkinson Drive Newport Isle Of Wight PO30 2LJ Lead Inspector Mark Sims Key Unannounced Inspection 31st July 2007 09:30 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 Vecta House DS0000069283.V341380.R01.S.doc Version 5.2 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. Vecta House DS0000069283.V341380.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Vecta House Address 24 Atkinson Drive Newport Isle Of Wight PO30 2LJ 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) 01983 525521 01983 522453 vecta@barchester.com Barchester Healthcare Homes Ltd Mr Ian Leitch Care Home 40 Category(ies) of Dementia - over 65 years of age (40), Mental registration, with number Disorder, excluding learning disability or of places dementia - over 65 years of age (5) Vecta House DS0000069283.V341380.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection N/A Brief Description of the Service: Vecta House is located within a residential area of Newport, the County Town of the Isle of Wight and therefore has good transport links to the rest of the Island. The premise is purpose built, with all accommodation and communal facilities situated on the ground floor. Currently building work is in progress to increase the overall capacity of the home to 54 places, the new memory lane extension and additional facilities for the service users due for completion later in the year. The fee’s charged for accommodation at Vecta House range from £635.32 to £950.00 per week. Vecta House DS0000069283.V341380.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was the first ‘Key Inspection’ of Vecta House, a ‘Key Inspection’ being part of the inspection programme, which measures the service against core National Minimum Standards. The fieldwork visit, the actual visit to the site of the home, was conducted over four and a half hours, where in addition to any paperwork that required reviewing the inspector met with service users, their relatives and staff; and undertook a tour of the premises to gauge its fitness for purpose, several issues outstanding from the last inspection were also considered during the fieldwork. The inspection process involves far more pre fieldwork visit activity, with the inspectors gathering information from a variety of professional sources, the Commission’s database, pre-inspection information provided by the service and linking with previous inspectors to have visited the home. What the service does well: Choice of Home: The service provides a good level of pre-admission information to service users and their families and makes people visiting the home, prior to arranging a permanent or temporary placement, welcome. Health and Social Care: The records maintained, indicate that people are supported to access appropriate health and social care agencies/professionals, feedback from professional sources was positive and supportive of the service provided. Daily Life and Social Contacts: The service employs an activities coordinator and is actively working towards creating a ‘memory lane’ theme within the home, which encourages people to pick up an use day-to-day items, such as hats & clothing, machinery & tools and cleaning items, etc. The environment is also well set out and encourages a large degree of independence for service users within a safe environment, people able to access the gardens and various aspects of the premise without hindrance or unnecessary restriction. Complaints and Protection: The service provides access to a complaints process, which has been drafted in accordance with the regulations and adult protection training and guidance is made available to staff. Vecta House DS0000069283.V341380.R01.S.doc Version 5.2 Page 6 Environment: The environment is generally well presented and is currently undergoing a huge redecoration and refurbishment process, as part of the service being increased in size. Staffing: The ratio of staff to residents is being maintained at a good level, this including both care and ancillary staff, with numerous employees seen around the home during the visit. Interactions with service users were observed to be good generally and the visitor, staff relations seemed courteous, polite and friendly. Management: The service appears to be well managed, with the manager and his deputy having introduced a number of systems and tools into the home for the purposes of monitoring the care delivered. As part of a large organisation the manager is well supported in the delivery of his role and meets regularly with his direct line manager and managerial peers. What has improved since the last inspection? The following information has been lifted from the Annual Quality Assurance Assessment (AQQA). Choice of Home: We have updated and improved the Service Users Guide. We have updated and improved the format and content of our brochure and website; www.barchester.com. Health and Social Care: A new care planning documentation system was introduced about eighteen months ago. In the last twelve months, the staff team have properly learned to operate this system, and I would say it is now running smoothly, and naturally. We have developed our response to any first aid need, by deciding to support each Registered Nurses training with a one day first aid course. Acknowledging that although we have many fully trained first aiders on our team, it is always the nurse-in-charge that people look to in the event of an incident requiring first aid response. We therefore decided to ensure that each nurses skills were up to speed. We are currently 65 through that training. The General Manager has undertaken further training to underpin our already person-centred approach to the care of our residents; Leadership in PersonCentred Dementia Care, a five day training course facilitated by the Directors of the Dementia Care Matters publication and training organisation. Vecta House DS0000069283.V341380.R01.S.doc Version 5.2 Page 7 Daily Life and Social Contacts: All prospective service users and their representatives are offered access to an advocacy service that offers support and advice to older people. We have created the new post of Hospitality Manager, whos role has been to ensure the correct ambience in dining rooms, and anywhere a person may choose to dine, which has included music at mealtimes and a general relaxation of the atmosphere around mealtimes. There are choices of wine, or sherry available as an aperitif before lunch. We have invested and developed the artwork adorning the walls. Environment: We have purchased new table linen, cutlery and crockery. We have created the new post of Hospitality Manager, whos role has been to ensure the correct ambience in dining rooms, and anywhere a person may choose to dine We have invested and developed the artwork adorning the walls. Much of the Memory Lane developments have been installed during the last year. Six divan beds have been replaced with electronic profiling, or li-lo beds within the last year. This is part of an on-going programme of updating our stock for all who do not choose a divan bed. Current stock of beds renewed within the last three years - 26. Two air conditioning units were installed, one in each of the clinic rooms, this provides a very welcome cool spot within the home, and ensures we can maintain a satisfactory environment in which to store medications. A further air-conditioning unit has been installed in the laundry; improving the environment for those who work in there. A new oven and range have been installed in the kitchen. Staffing: Improved files management system introduced by the administration team. Management: Our detailed Fire Drill Procedure has developed further this year with the support of the latest Fire Safety training. The introduction of our Critical Incident Analysis system has contributed to a significant development in our abilities to anticipate the potential for difficulties between service users. Vecta House DS0000069283.V341380.R01.S.doc Version 5.2 Page 8 The introduction of the philosophy and physical manifestations of the Memory Lane Programme have enhanced the environment and the range of congruent opportunities for our service users. What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Vecta House DS0000069283.V341380.R01.S.doc Version 5.2 Page 9 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 Vecta House DS0000069283.V341380.R01.S.doc Version 5.2 Page 10 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. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Standards 3 and 6: Prospective residents and their representatives have access to sufficient information when choosing the home and can expect to have their needs appropriately assessed. EVIDENCE: Admission - Assessment: The evidence indicates that patients are having their needs assessed prior to admission and that they are provided with sufficient information prior to deciding to move into the home. The evidence used to make this judgement includes: o The Barchester Website, which provides information about the company and specific information about the home’s and services provided, a local search is possible. Vecta House DS0000069283.V341380.R01.S.doc Version 5.2 Page 11 o A details and comprehensive pre-admission information brochure is made available to prospective clients and/or their relatives, a copy of this document has been seen by the inspector. The company have introduced a detailed a comprehensive pre-admission assessment tool, which is completed by the manager or his deputy prior to an offer of accommodation being made. Six service user files were reviewed during the fieldwork visit, three of those six being new patients to the service and all contained a completed copy of the home’s assessment document. o Standard 6: The home does not provide and intermediate care facility. Vecta House DS0000069283.V341380.R01.S.doc Version 5.2 Page 12 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. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Standards 7, 8, 9 and 10: The health and personal care that people receive is based on their individual needs. The principles of respect, dignity and privacy are put into practice. EVIDENCE: Service User Plans: The evidence indicates that the service users are fully involved in planning and reviewing the care and support they receive. The evidence used to make this judgement includes: o Six service user plans (care plans) were reviewed and found to be informative and reasonably well maintained documents, which contained the following details: 1. Admission Information 2. Admission Assessment 3. Total Care Assessment Vecta House DS0000069283.V341380.R01.S.doc Version 5.2 Page 13 4. Moving and Handling Assessment 5. Care Plans based on the Activities of Daily Living 6. Risk Assessments 7. Nutritional Assessments 8. Life Histories 9. Running Records 10. Health Records/Contacts 11. Homely Medicines Agreements 12. Discharge Summaries 13. Pre-admission Assessments. The process is a corporate design and all of the plans are uniform, gathering and/or requesting similar information be collated and helping staff use this information in a structured and consistent manner. o The AQAA make clear that this is a relatively new care planning package, which has been adapted from previous plans and was re-introduced about eighteen months ago. The manager states that he feels the staff are now coming to terms with the changes and improvements made, however, the deputy manager is routinely monitoring the plans to ensure the staff are updating and reviewing the records accordingly. o The manager has also undertaken training around ‘Leadership in PersonCentred Dementia Care, a five day training course facilitated by the Directors of the Dementia Care Matters publication and training organisation. It is the manager’s intention to cascade the knowledge and experience gained via this training to the rest of the care team. Health Care: The evidence indicates that the health care needs of the service users are being well met. The evidence used to make this judgement includes: o Direct feedback from both health and social care professionals involved with the service; who view the staff to be co-operative and knowledgeable and who felt that referrals were both timely and appropriate. The service users plans, which contained details of health appointments to be attended by residents, as well as information relating to visits undertaken by various allied health and medical professionals. Information taken from the AQAA, which indicates that: DS0000069283.V341380.R01.S.doc Version 5.2 Page 14 o o Vecta House ‘We have developed our response to any first aid need, by deciding to support each Registered Nurses training with a one day first aid course. Acknowledging that although we have many fully trained first aiders on our team, it is always the nurse-in-charge that people look to in the event of an incident requiring first aid response. We therefore decided to ensure that each nurses skills were up to speed. We are currently 65 through that training’. o Information taken from the ‘Statement of Purpose’, which commits the home to the provision of: ‘The Home does provide 24 hour a day nursing care for residents in the Home. Where possible, staffing levels allowing, residents may have a choice in the gender of those providing their personal care. The right of access to outside agencies of your choice e.g. doctor, optician, chiropodist etc and where necessary to be assisted with this. Medication: The evidence indicates that the service users are being appropriately supported with their medications. The evidence used to make this judgement includes: o As mentioned above the care planning files of the service user were found to contain details of their and their general practitioners agreement to them participating within the services homely remedies policy/procedure. The dataset makes clear that policies and procedures are available to guide staff when handling service users medication and observations evidenced that each ‘medication administration record’ (MAR) contained a copy of the company’s medication policies and procedures. Storage facilities were seen during the inspection and considered satisfactory and a review of the mar sheets and medication stocks revealed no issues for concern. o o Privacy and Respect: The evidence indicates that people’s rights to privacy and respect were generally well promoted within the home. The evidence used to make this judgement includes: o The company’s ‘statement of purpose’ indicates that: Vecta House DS0000069283.V341380.R01.S.doc Version 5.2 Page 15 ‘When being admitted to a care home, it is important that you make every effort to retain your privacy, dignity and independence. In many respects, a care home is similar to a hotel; for instance, you can keep your room locked at all times, if you would like this facility please inform a member of staff. Staff should knock and only enter with your permission. If this does not happen, then you should report such instances to the General Manager. You can decide who visits you and whom you meet in the home and if you wish to meet family members in private then you may do so in your room or in an area of the home set-aside for this purpose if it is available. If you do not wish to see a visitor then you should make your wishes known to the General Manager. Your room is your own private space and will only be entered with your permission. We provide facilities for you to make telephone calls in private. You can discuss with your named nurse how your personal care needs will be met – for instance, you can bathe alone but staff are available to help you in and out of the bath. This will be planned in conjunction with a risk assessment on how to ensure that these arrangements are made having due regard to your risk of falling or accidental injury. o Information taken from the home’s own internal audit, which produced a 23 response rate and indicates that eleven people feel the home promotes respect excellently, ten people opted to rate this as good and 1 person average. The tour of the premise, which established that all bedrooms are single occupancy and fitted with specialised locks, which can be secured externally but not internally, meaning the person occupying the room cannot lock themselves inside their bedroom. The majority of the bedroom doors had some form of identification or recognisable symbol that was personal to the occupant and which is designed to aid orientation and awareness of which is the persons’ bedroom. o The dataset establishes that policies, on the promotion of privacy and dignity, are made available to staff, the AQAA indicates that awareness sessions on the existence of these policies are operational. o Vecta House DS0000069283.V341380.R01.S.doc Version 5.2 Page 16 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. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Standards 12, 13, 14 and 15: People who use services are able to make choices about their life style activities, whilst social, educational, cultural and recreational activities meet individual’s expectations. EVIDENCE: Activities and Entertainments: The evidence indicates that the activities and entertainments provided meet the needs of the people residing at the home. The evidence used to make this judgement includes: o The employment of an activities co-ordinator and two assistance one part-time and the other volunteer, whose responsibilities include the organising and arrangement of both group and individual sessions for the entertainment and stimulation of the service users. Records of the activities undertaken are maintained by the co-ordinators. o During the tour of the premise the manager discussed how the activities team and the some of the service users have worked on the DS0000069283.V341380.R01.S.doc Version 5.2 Page 17 Vecta House development of a courtyard garden, which has made it through to the semi-finals of an inter-company competition, notices about this success were noted, displayed around the home. o o The service also provides minibus transport for the service users, which takes people to a variety of locations and events. The ‘statement of purpose’ also makes clear that service users should receive access to the following: ‘If you wish to attend religious services outside the home on a regular or periodic basis then we will arrange for someone from the church of your choice to help make such arrangements. Please refer to Welcome Booklet for details. An Activities Organiser is employed on a full time basis. A full range of activities is available, guided by resident preferences. These activities will contribute to the overall personal needs, health needs and preferences of service users to ensure the individual’s inclusion in the community. These are outlined in the ‘Welcome Pack’, a copy of which is attached’. Visiting and Family Contacts: The evidence indicates that people are able to maintain appropriate contact with their families and friends. The evidence used to make this judgement includes: o Information taken from the company’s ‘statement of purpose’, which reads: ‘The Home encourages regular contact between residents, their family, friends and representatives. They are encouraged to participate in all events, to join in the social activities at the Home and to assist in the organisation of regular social activities. The Home has an Activities Organiser and relatives and friends are encouraged to participate in the organisation of activities, which are provided for the benefit of residents, their families and friends. Relatives and friends wishing to organise or assist in organising events should contact the Social Activities Organiser or the General Manager.’ o Information taken from the home’s internal audit, which revealed that six visitors rated the visiting arrangements as excellent, five as good, two as adequate and one person felt the arrangements were poor. Vecta House DS0000069283.V341380.R01.S.doc Version 5.2 Page 18 o Observations allowed the inspector to note families arriving and departing the home and a review of the signing in book, established that large numbers of visitors are welcomed into the home daily. Choice and Control: The evidence indicates that people are encouraged to make decisions for themselves, although this is constrained at time by their physical and mental frailties. The evidence used to make this judgement includes: o Risk assessment documentation, which is used to assess a person’s ability to exit the home independently and supports the reasons behind the code-locked and alarmed doors. Most service users, according to their risk assessments and supported by observations made during the fieldwork visit, would be unable to function safely outside of the home, unless accompanied and therefore the environment has been created to promote as much independence as possible, providing people with access to both internal and external areas of the home, which are secure. People were observed walking about the premise, which provides a continuous loop for service users so they can walk around unimpeded and safe, as well as the gardens, which are designed to meet up with various access points into the home and the loop mentioned above. o o The environment also provides people with access to any one of four lounges, plus two dining areas whilst walking about the property. The ‘statement of purpose’ clearly sets that the company’s aims and objectives are: ‘The Residents are encouraged to express a choice. Their preferences and personal tastes are respected; they will be encouraged to continue life according to their life style prior to admission to the Home. Our aim is to maintain the individuality of our residents as if he/she were in his/her own home and able to do so for him/herself. As far as possible daily routine, interests, likes, dislikes, personal possessions, clothing are maintained, and respected’. o Observations did generally support the fact that people were able to undertake self-directed activities, with people noted walking around the home, moving from lounge to lounge, sat in the garden and going back and forth from their bedroom, etc. Vecta House DS0000069283.V341380.R01.S.doc Version 5.2 Page 19 Meals and Menus: The evidence indicates that people enjoy a varied diet and are provided with a range of meal options and that their nutritional wellbeing is monitored. The evidence used to make this judgement includes: o Whilst the inspector did not observe a mealtime during this visit, he was shown evidence of the work being undertaken by the Barchester Group into nutrition within the elderly, including the use of ‘nutmeg’, a computerised system, which calculates the nutritional value of the meals people select and their overall dietary benefits. The manager also discussed the input of the company’s hospitality manager and the benefits of a newly appointed local hospitality coordinator, whose roles are to improve and monitor the environment within which people dine and the meals presented to them. o The care planning system, which contained both a detailed assessment of a person’s dietary habits using the malnutrition universal screening tool (MUST) and a plan to monitor where applicable. The home’s internal auditing system, which when last conducted indicated that people were less than happy with the meals provided and found the dining area less that appealing. The actions taken by the home / company to address these issues are encouraging, the employment of a local hospitality co-ordinator, the introduction and trial of the ‘nutmeg’ system, support visits undertaken by the hospitality co-ordination team and review of the menu’s. o Vecta House DS0000069283.V341380.R01.S.doc Version 5.2 Page 20 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. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Standards 16 and 18: People who use the service are able to express their concerns and have access to a robust, effective complaints procedure, are protected from abuse, and have their rights protected. EVIDENCE: Complaints and Concerns: The evidence indicates that service users and/or their relatives are able to raise issues with the home and/or the staff if they need. The evidence used to make this judgement includes: o The dataset, which contains details of the home’s complaints activity over the last twelve months: 1. 2. 3. 4. 5. No of complaints: 3. No of complaints substantiated: 2. No of complaints partially substantiated: 0. Percentage of complaints responded to within 28 days: 100 No of complaints pending an outcome: 0. Vecta House DS0000069283.V341380.R01.S.doc Version 5.2 Page 21 o The dataset also establishes the existence of the home’s complaints and concerns procedure, which was last updated in September 2005 and which is on display within the main entrance hallway of the home. Further details of the home’s / company’s complaints process can be found within the ‘statement of purpose’, which states: ‘If you have a complaint about any aspect of the service or care please speak to the Nurse in charge. If the Nurse in charge is not able to resolve the problem please speak or write to the General Manager. All complaints will be investigated and we undertake to inform you of the outcome within 28 days or such shorter period as is reasonable. If there is no resolution to the matter or you do not feel comfortable discussing the matter with the home manager then you can contact the Regional Operations Director Richard Hawes on 07799 692 190 who will investigate your complaint or concerns further and inform you of the outcome. We will always do our best to resolve your complaint as soon as possible and then tell you what we have actually done to sort out your problem. The complaints policy can be read to you if your vision is impaired and arrangements can be made, in special circumstances, for an audio version to be made available. A copy is attached. If you remain dissatisfied, then you may also complain to our Support Office or to the Commission for Social Care Inspection’. o Protection: The evidence indicates that people are appropriately protected from abuse and/or harm. The evidence used to make this judgement includes: o On arriving at the home the manager was involved in drafting a presentation, for his staff team, on the new ‘safeguarding adults’ policies and procedures introduced by the Local Authority. The manager explained that he had been to a study day and was now preparing to cascade this information to his staff via a series of study/educational sessions. o The dataset also establishes that staff have received, within the last twelve months, updated protection training and that access to policies and procedures on the safeguarding of vulnerable people is made available: Vecta House DS0000069283.V341380.R01.S.doc Version 5.2 Page 22 1. Safeguarding adults and the prevention of abuse last reviewed and updated in September 2005. 2. Disclosure of abuse and bad practice last updated and reviewed in September 2005. o Information taken from the home’s internal audit, which indicates that 1 person feels the safety within the home is excellent, 10 feel it is good, two indicated it was average and one person felt the measures taken to promote safety for people was poor. Vecta House DS0000069283.V341380.R01.S.doc Version 5.2 Page 23 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. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Standards 19 and 26: The physical design and layout of the home enables people who use the service to live in a safe, well-maintained and comfortable environment, which encourages independence. EVIDENCE: Environment: The evidence indicates that the environment is well maintained and meeting the needs of the service users. The evidence used to make this judgement includes: o Historically, reports on the home have always indicated that the environment has been well maintained and the home decorated and furnished to a good standard. DS0000069283.V341380.R01.S.doc Version 5.2 Page 24 Vecta House At this time the property is undergoing a huge development and subsequently a huge refurbishment, with all of the corridors and communal areas of the home being redecorated, re-carpeted and refurbished. During the fieldwork visit the internal aspects of the home, were noted not to have been affected by the development work, with the builders managing to keep any and all disruption to a minimum, the rear gardens, those most commonly used by the service users have also not been affected and people continue to use these facilities unhindered. The internal redecoration work is largely being completed at night to minimise disruption, although the manager stated that the carpets had to be fitted during the day, as the work involved considerable banging, which a night would have been more upsetting to people. The work undertaken so far appears to be of good quality and will freshen up and revitalise the premise. o The ‘statement of purpose’ is used to advice people of the home’s accommodation, with both a current copy and a revised copy, ready for distribution on completion of the new unit/extension: The revised document states: ‘The accommodation comprises of 54 single rooms, of which 51 have en-suite toilet and washing facilities, and 14 rooms with en-suite shower facilities, each have at least 10 square metres of usable space. There are 6 assisted bathrooms. All the bedrooms are wheelchair accessible, as are all the community areas. Day Space is provided in Lounges and Dining Rooms. There are 9 in total and this includes a semi detached room where guests can receive visitors and family groups in private, and by prior arrangement’. o The company has an estates department and the home has an estate’s or maintenance operative deployed at the home full-time, as well as a part-time gardener. Both individuals were seen around the home during the fieldwork visit, the newly recruited gardener involved in tidying and re-establishing the gardens, which whilst reasonable, lacked some of the colour normally associated with the home’s grounds. The records maintained by the estates operative were reviewed and found to be appropriately updated and in order. Cleanliness and Hygiene: The evidence indicates that the home is clean and tidy throughout. Vecta House DS0000069283.V341380.R01.S.doc Version 5.2 Page 25 The evidence used to make this judgement includes: o The tour of the premise considered both the decorative condition of the home and the cleanliness of the property, which was extremely good, especially considering the amount of building work and redecoration, etc underway around the property. The home also employs a domestic staff team, who under the management of the hospitality co-ordinator (local), ensure the premise is routinely cleaned and tidied, significant machinery for the purposes of cleaning the home were observed during the fieldwork visit. The dataset establishes that the staff have access to infection control guidelines, if required and that as with other documents these were last reviewed in the September 2005. However, the policy on the control of substances hazardous to health (COSHH) was reviewed and updated in March 2006. o Training is also provided to staff around infection control and health and safety (COSHH), etc, which is provided via the company’s intranet site and a CD-Rom package, according to the AQAA and discussions during the visit. o o Vecta House DS0000069283.V341380.R01.S.doc Version 5.2 Page 26 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. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Standards 27, 28, 29 and 30: Staff in the home are trained, skilled and provided in sufficient numbers to support the people who use the service, in line with their terms and conditions, and to support the smooth running of the service. EVIDENCE: Staffing Resources: The evidence indicates that sufficient staff are employed to meet the needs of the service users. The evidence used to make this judgement includes: o o The ‘statement of purpose’ document, which sets out the managerial and staffing arrangements for the home and people’s experiences and skills. A review of the home’s duty roster established that, the home operates a monthly roster and that staff are deployed in two teams one working either end/side of the home. Staff work across the twenty-four hour period covering the following shifts: AM. Vecta House 07:30 hrs to 13:45 hrs, one qualified nurse. DS0000069283.V341380.R01.S.doc Version 5.2 Page 27 07:30 hrs to 13:30 hrs, seven care assistants. PM. 13:30 hrs to 19:45 hrs, one qualified nurse. 13:30 hrs to 19:30 hrs, five care assistants. Twilight. Night. 15:00 hrs to 21:00, hrs one care assistant. 19:30 hrs to 07:45 hrs, one qualified nurse. 19:30 hrs to 07:30 hrs, three care assistants. The shifts quoted above are per unit with additional long-days available to staff should they wish the qualified nurses working 07:30 hrs to 19:45 hrs and the care assistant’s 07:30 hrs to 19:30 hrs, respectively. o Information taken from the home’s internal audit, which establishes that four people find the welcome excellent, six people find it good, three adequate and one person found it to be poor. The audit also revealed that three people found the care and support to be excellent, six people indicated it was good, four adequate and one person felt the care was poor. Observations made during the visit indicated that the teams worked well together, people noted sharing roles, completing tasks without undue difficulty and seemingly available to meet the needs of the service users, or address questions raised without undue delay or hold up. o o Training & Development: The evidence indicates that the training opportunities for the staff are good. The evidence used to make this judgement includes: o As previously mentioned the manager was working on a training package, to be presented to his staff team, when the inspector arrived at the home. The dataset, which contains a statement in relation to the provision of an induction training package, which meets National Minimum Standards and that 100 of the catering staff and 21 of the care staff possess a food hygiene certificate. The manager has also made a declaration via the dataset that the home has ‘a staff development programme that meets the National Minimum Standards for the service’. o Vecta House DS0000069283.V341380.R01.S.doc Version 5.2 Page 28 o The AQAA, which has been used to document the in house courses provided and identify how the skills of the staff team are used to promote learning: 1. ‘General Manager - Yesterday, Today, Tomorrow, - POVA, Fire Safety, Communication Skills. 2. Staff Nurse #1 - Tissue Viability, recommended dressing techniques, (this is supported by our GP surgery). 3. Staff Nurse #2 - Palliative Care in Dementia, (undertaking a cooperative project with Lyn Dawkins, from Earl Mountbatten Hospice). 4. Staff Nurse #3 - Aromatherapy / Reflexology. 5. Site Engineer - Health and Safety at Work’. o The AQAA also discusses the use of the CD-Rom trainer/computer system, which includes Basic Food Hygiene, Health and Safety and Customer Care, as discussed earlier and seen during a visit to the home. The manager also discussed ‘Barchester’s’ staff audit, which is updated and reviewed regularly and used to monitor and manage staff documentation/record, etc, the database recording all training and development completed,\plus identifying any revision or updates due. Information taken from the dataset and confirmed during the visit, indicates` that currently the home employs 21 care staff and 13 nursing staff. 15 of 21 care staff have completed a National Vocational Qualification (NVQ) at level 2 or equivalent, giving the home a percentage of 71.5 of its care staff possessing an NVQ at level 2. o o o The dataset also indicates that 1 care team member is presently completing an NVQ level 2, which, should the carers pass the course, could raise the home’s percentage rate to 76 . Recruitment and Selection: The evidence indicates that the recruitment and selection process is now being appropriately operated. The evidence used to make this judgement includes: o The files of the last three people employed at the home were reviewed and found to contain the following information: 1. An application form 2. Two written references 3. Dates of employment Vecta House DS0000069283.V341380.R01.S.doc Version 5.2 Page 29 4. Protection Of Vulnerable Adults (POVA) clearance 5. Criminal Records Bureau (CRB) check outcome 6. Induction details 7. Photo Identification 8. Contract 9. Interview questions and responses 10. Medical/Health declaration o The dataset establishes that a recruitment and selection strategy/procedure exists to support the management staff when employing new staff and that the home has a very low turnover of staff, two staff recently celebrating ten years of continuous service. Details of the staff employed and their skills and qualifications are contained within the ‘statement of purpose’, as previously mentioned/identified. Information taken from the home’s internal audit, which establishes that four people find the welcome excellent, six people find it good, three adequate and one person found it to be poor. The audit also revealed that three people found the care and support to be excellent, six people indicated it was good, four adequate and one person felt the care was poor. o o o Vecta House DS0000069283.V341380.R01.S.doc Version 5.2 Page 30 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. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Standards: 37, 39 and 42: The management and administration of the home is based on openness and respect, and has effective quality assurance systems developed by a qualified, competent manager. EVIDENCE: Management: The evidence indicates that the home is currently being managed to a satisfactory standard. The evidence used to make this judgement includes: o All of the information contained within this report supports the fact that this service is being well run and operates in the best interest of the service users. DS0000069283.V341380.R01.S.doc Version 5.2 Page 31 Vecta House o o o The well structured and maintained records/systems observed in place during the fieldwork visit. The views of the staff, who find the management and direction of the home satisfactory. The continued improvements being made to the service both structurally, as mentioned within the report and also intrinsically with the low turnover of staff and the huge reduction in safeguarding referrals and incidents reported to the Commission. Quality Audit and Assurance: The evidence indicates that service users and/or their relatives are afforded the opportunity to comment on the service provided at the home. The evidence used to make this judgement includes: o The ‘statement of purpose’, which contains the following declaration: ‘The home is run for the benefit of residents and the views and observations of residents are important in ensuring that wherever possible, residents participate in the way it is organised. We expect to inform you in good time of any changes, which may affect you, and periodically we will be inviting you to comment and participate in a resident’s survey. We will also arrange residents meetings to which residents and their supporters are encouraged to attend. During these meetings there will be an opportunity to make comments and suggestions. At any time however, we welcome comments and observations on how we can change and improve the services we offer and you are welcome to make such observations to the Home’s General Manager’. o Quality audit outcomes, which have been used throughout this report to evidence people’s views of the service and which demonstrate that both a functional and operational quality assurance system is in place and that the outcome’s are used by the management to inform practice and monitor the service. The AQAA provides evidence of the fact that the home’s policies and procedures are regularly reviewed and updated, the last reviews taking place between August 2005 and April 2007. The service user plans contained evidence, by way of a review date, of when the records were last updated and reviewed and there is clear o o Vecta House DS0000069283.V341380.R01.S.doc Version 5.2 Page 32 evidence of the deputy manager’s involvement in auditing the plans to ensure staff are reviewing the plans effectively. o The AQAA also makes clear that staff receive supervision six times a year and that details of the sessions are kept on the individual staff members file, none were seen on the files inspected, however, these were all new employees, as mentioned above. Service users finances: The evidence indicates that the arrangements within the home promote independent when managing finances. The evidence used to make this judgement includes: o The home does not get involved with the residents’ finances. Fees are usually paid through direct debit from the residents and/or their relatives’ bank or the Local Authority funding. Health and Safety: The evidence indicates that the health and safety of the service users and staff is being reasonably well managed. o The AQAA and dataset information establishes that full health and safety policies/guidance documents are made available to the staff and that equipment is regularly maintained and serviced, gas, electrical installations, portable electrical appliances, hoists, baths, etc. Health and safety training is clearly made available to staff, with the AQAA evidencing that staff have completed moving and handling, infection control and health and safety training. Maintenance issues are also being appropriately identified and recorded by the care staff and responded to within a reasonable time period by the estates personnel, as evidence during the tour of the premise and review of records. The manager, also has copies of the extensive risk assessments, which have been generated, as a direct response to the building / development work ongoing at the home, which has been agreed by the contractors. o o o Vecta House DS0000069283.V341380.R01.S.doc Version 5.2 Page 33 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 Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X 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 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X X X X X 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 3 X 3 X 3 X X 3 Vecta House DS0000069283.V341380.R01.S.doc Version 5.2 Page 34 Are there any outstanding requirements from the last inspection? N/A STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Vecta House DS0000069283.V341380.R01.S.doc Version 5.2 Page 35 Commission for Social Care Inspection Hampshire Office 4th Floor Overline House Blechynden Terrace Southampton SO15 1GW National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 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 Vecta House DS0000069283.V341380.R01.S.doc Version 5.2 Page 36 - 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. 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