Inspection on 01/03/06 for Venn House

This inspection was carried out on 1st March 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. 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 found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Venn House 02/10/08

Venn House 01/10/07

Venn House 04/04/07

Venn House 02/08/06

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

CARE HOMES FOR OLDER PEOPLE Venn House Lamerton Tavistock Devon PL19 8RX Lead Inspector Helen Tworkowski Unannounced Inspection 1st March 2006 9:10 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 Venn House DS0000065984.V285398.R01.S.doc Version 5.1 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. Venn House DS0000065984.V285398.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Venn House Address Lamerton Tavistock Devon PL19 8RX 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) 01822 612322 0870 1270388 Venn Care Ltd Miss Geraldine Joan Maureen Hodge Care Home 25 Category(ies) of Old age, not falling within any other category registration, with number (25) of places Venn House DS0000065984.V285398.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. To accommodate one named individual in the category of DE(E) for an initial period of 3 months, until 13/04/06. 23 and 24 August 05 (Under previous ownership) Date of last inspection Brief Description of the Service: Venn House is a Grade 2 listed house set in its own grounds on the edge of the village of Lamerton. The property consists of the main house that accommodates 16 people and a converted coach house, a short distance away that accommodates 9 people. The home is registered for people who fall into the category OP, who are elderly. The main house is of great character, with slate floors and gothic windows, however there are some steps between some rooms on the ground floor. The majority of rooms are en suite or have a bathroom close by. The Coach House Annexe is a short walk from the main house. It has it’s own lounge and dining room with a small kitchen for snacks and drinks. Like the main house there are bedrooms on the ground and first floor. Meals are brought over from the main house to the Coach house and taken in the dining room. There are some bath adaptations in some bathrooms and there is a stair lift in the main house. Venn House is not suited and not registered for people who have a significant level of disability, however where a service user develops a disability, efforts are made to accommodate needs. The grounds and gardens are extensive. Many rooms look out over the gardens or surrounding countryside. The home is staffed 24 hours per day and has waking night staff. Venn House DS0000065984.V285398.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection was the first that has taken since Venn House has been taken over by Venn Care Ltd, and Ms Geraldine Hodge became the Registered Manager. The inspection included a tour of the lounges and dining rooms, and some of the bedrooms. Staff and Service Users were spoken with, and a District Nurse who was visiting gave feedback. Service User and staff records were looked at during this visit. What the service does well: What has improved since the last inspection? What they could do better: The checks that should be done, to ensure that staff are suitable for working in the Care Home, are still not being completed. This involves references and checks in relation to the criminal records. There were also concerns that improvements could be made in relation to consulting service users, not only in relation to the changes to the service they receive but also in relation to the quality of service received. Venn House DS0000065984.V285398.R01.S.doc Version 5.1 Page 6 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. Venn House DS0000065984.V285398.R01.S.doc Version 5.1 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 Outcomes Statutory Requirements Identified During the Inspection Venn House DS0000065984.V285398.R01.S.doc Version 5.1 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 the following standard(s): 3 and 4 Service Users can be assured that their needs are known and that can be met at Venn House, before they move. EVIDENCE: Three files were looked at during this inspection, and each contained an assessment that had been completed prior to a move to Venn House. This information was detailed and indicated that the assessment had involved speaking with the individual and others who were providing support. Assessments are important as without knowing what a person’s needs are, then they cannot be met. Each person had been written to, to confirm that his or her needs could be met at Venn House. Where there were specific issues these had also been addressed in the letter. Venn House DS0000065984.V285398.R01.S.doc Version 5.1 Page 9 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8 Service Users can be assured that their care needs will be met. EVIDENCE: Three Service User Plans were looked at during this inspection. These documents define how needs are to be met, and should specify in detail the actions staff are to take to meet needs. The three plans seen at this Inspection did contained detailed information. Staff on duty confirmed that there was an expectation that they read and are up to date with these documents. One Service Users who had diabetes had a diabetes care plan on file, giving details of how their diabetes is to be managed. Service User Plans, in the main house, are stored in the “tower room” on the second floor, these documents should be in day-to-day use. Staff on duty explained that there is an expectation that they will regularly read these documents, however the tower room is not easily accessible. It is therefore recommended that the storage of these documents is reviewed, so that they are kept securely, given that they are confidential, but readily accessible to staff who must use them. Venn House DS0000065984.V285398.R01.S.doc Version 5.1 Page 10 One Service User has a pressure pad alarm near the door to alert staff to the fact that they are leaving the bedroom. This is appropriate given the needs of the individual. However there is no record of this device being used in the Plan, or the conditions under which it is to be used. All Service User Plans should be agreed with the individual or their representative and signed. Where restrictive devices are used, such as pressure pad alarms, there must be a record of consultation, agreement and conditions of use. Two Service Users spoken with said that they had were very satisfied with the care and support received, that the staff were very considerate. The Inspector spoke with a District Nurse who was visiting, and she confirmed that staff ask for and take advice in relation to health care needs. There is no indication of poor care – such as pressure areas. It was also noted that whenever she visited there was a wonderful smell of cooking in the home. Venn House DS0000065984.V285398.R01.S.doc Version 5.1 Page 11 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13 and 14 Service Users are provided with support to be able to lead their lives in the manner that they choose. EVIDENCE: Service User spoken with said they were very satisfied with the support they received at Venn House. Many Service Users choose to follow their own interests and hobbies, such as reading, listening to talking books, completing crosswords, or walking in the grounds of the house. Some Service Users enjoy a drink, and are able to do this. Some of the Service Users in the Coach House eat lunch in the Main House, which is a short distance away. Service Users are able to receive visitors or to visit their family when they choose. The Inspector spent some time in discussion with one Service User regarding a change in the contractual arrangements. Whilst this had been discussed with family, there had been no consultation with the individual concerned, as this was thought to be their wish. This had caused the individual some concerns. Consideration must be given as to how such changes are to be managed, so that the Service Users is appropriately consulted about changes that affect their lives. Venn House DS0000065984.V285398.R01.S.doc Version 5.1 Page 12 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 18 Robust recruitment systems, which should help in protecting service users from abuse, are not in place. EVIDENCE: Staff personnel files indicated that not all recruitment checks had been made for all new staff such checks help ensure Service Users are protected from abuse. The inspector asked one of the staff on duty about dealing with suspected abuse, and they were clear about their responsibility and what to do. The Inspector asked about training, and was told that this was covered as part of the Nation Vocational Qualification, however it was not possible to establish if there was any specific training for staff. All staff should have training in relation to the protection of vulnerable adults, appropriate to their role. Venn House DS0000065984.V285398.R01.S.doc Version 5.1 Page 13 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 22 and 26 Venn House is clean, comfortable and in good decorative order. EVIDENCE: Only communal areas, some of the bathrooms and few of the bedrooms were seen during this inspection. These areas were all clean and comfortable. The grounds were well maintained and there were benches where Service Uses could sit. It has been noted at previous inspections that the call bell system is not readily accessible in some areas. Mr Widders, the owner, confirmed that they were looking at replacing this system. Concerns were raised at a previous inspection that regular checks were not being made in relation to ensuring that hot water was not over 43 degrees centigrade. There is now a record of regular checks and where temperatures of concern, action is taken. Venn House DS0000065984.V285398.R01.S.doc Version 5.1 Page 14 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 29 and 30 Recruitment systems are not sufficiently robust, and could potentially place Service Users at risk. EVIDENCE: Before staff work in a care home a series of checks must be made to ensure that they are fit, competent and of good character. This is one way that Service Users are protected from abuse. The Commission upheld a complaint in February 06 that the Registered Provider at Venn House had failed to take references on staff prior to employment. Checks on staff files for people who had recently started work at the home indicated that Criminal Records Bureau check had not been initiated for new staff. Staff should not be working without supervision providing personal care unless a satisfactory CRB check has been received. One person had no application form, or information about his or her experience or previous work that would show that they were a suitable person to work at Venn House. Staff files were kept in filing cabinet, however this appeared not to be locked. Confidential information should be kept locked and only open to those who have a responsibility to see it. There were records of an induction for new members of staff, and this included an induction in relation to fire procedures. There are three staff on duty on each shift plus the manager during the week. There are also three waking night staff on duty at night. As the staff work on two sites: the main house and the coach house staff are allocated to work in one of these areas or are expected to work between the two houses. Staff on Venn House DS0000065984.V285398.R01.S.doc Version 5.1 Page 15 duty confirmed that this was sufficient, and Service User were happy with the care they received. Venn House DS0000065984.V285398.R01.S.doc Version 5.1 Page 16 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 33,35,38 Venn House is generally well run and safe, thought the needs of the Service users need to be taken into account including via a Quality Assurance System. EVIDENCE: The Registered Manager Geraldine Hodge was not present at this inspection. Mr Widders and the staff on duty were not able to confirm if there was a quality assurance system, that took into account the views of Service Users, had been set up. Mr Widders said that no money is kept or managed by staff at Venn House on behalf of Service Users. The Fire Log was checked during this inspection and it was found that all necessary checks had been made, and staff had received regular fire training. As has already been noted regular checks are being made on the hot water to ensure that Service Users are not scalded when taking a bath or shower. Venn House DS0000065984.V285398.R01.S.doc Version 5.1 Page 17 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 3 X X HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 X 10 X 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 2 15 X COMPLAINTS AND PROTECTION Standard No Score 16 X 17 X 18 2 3 X X X X X X 3 STAFFING Standard No Score 27 X 28 X 29 1 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score X X 1 X 3 X X 3 Venn House DS0000065984.V285398.R01.S.doc Version 5.1 Page 18 YES 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 OP7 Regulation 15, 13 Requirement Restrictive devices, including pressure pads, must only be used after consultation with the Service Users, their representatives and any professionals involved in care. A record of this discussion and under what circumstances the device is to be used must be recorded. Service Users must be consulted as far as possible regarding changes to the service. All care staff should have training in relation to the protection of vulnerable adults. The Registered Provider must review the all bell system, and ensure that it is readily accessible and appropriate for the people accommodated. The Registered Provider must ensure that there is a robust recruitment process: including taking two written references prior to a person starting work in the home. The Registered Provider must ensure that there is a quality DS0000065984.V285398.R01.S.doc Timescale for action 01/06/06 2 3 4 OP14 OP18 OP22 12 18 23 01/05/06 01/08/06 01/10/06 5 OP29 19 01/05/06 6 OP33 24 01/08/06 Venn House Version 5.1 Page 19 assurance system, that takes into account the views of Service Users, is set up. 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 OP7 Good Practice Recommendations The location and storage of Service User Plans should be reviewed so that they are readily accessible for use by staff. Venn House DS0000065984.V285398.R01.S.doc Version 5.1 Page 20 Commission for Social Care Inspection Ashburton Office 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 Venn House DS0000065984.V285398.R01.S.doc Version 5.1 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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