Inspecting for better lives Key inspection report
Care homes for older people
Name: Address: Ventress Hall Care Home 22-28 Trinity Road Darlington Durham DL3 7AZ The quality rating for this care home is:
two star good service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Jane Basset
Date: 0 6 0 1 2 0 0 9 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area.
Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. the things that people have said are important to them: They reflect This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection.
This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop 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 Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Older People Page 2 of 25 Reader Information
Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.csci.org.uk Internet address Care Homes for Older People Page 3 of 25 Information about the care home
Name of care home: Address: Ventress Hall Care Home 22-28 Trinity Road Darlington Durham DL3 7AZ 01325488399 01325480011 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Maureen McMain Type of registration: Number of places registered: Southern Cross OPCO Ltd care home 45 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 old age, not falling within any other category physical disability Additional conditions: The maximum number of service users who can be accommodated is: 45 The registered person may provide the following category of service only: Care Home with Nursing, Code N To service users of the following gender: Either Whose primary care needs on admission to the Home are within the following categories: Old Age, not falling within any other category, Code OP, maximum number of places 45 Physical Disability - Code PC, maximum number of places 45 Date of last inspection Brief description of the care home Ventress Hall is a care home with nursing for up to 45 older people. It was registered by its current owners, Southern Cross OPCO Ltd., in August 2007. Ventress Hall was purpose built in 1989. It is conveniently located, close to Darlington town centre and other amenities. The home is a three-storey building with passenger lifts between floors. There is a central courtyard garden with seating, pleasant floral displays and a Care Homes for Older People
Page 4 of 25 Over 65 45 0 0 45 Brief description of the care home water feature. From information provided by the home, fees range from #418 to #600 per week. Care Homes for Older People Page 5 of 25 Summary
This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: The quality rating for this service is 2 star. This means the people who use this service experience good quality outcomes. This inspection was an unannounced key inspection. As a key inspection, all of the key standards were looked at or discussed. This was to check that the home meets the standards that the Commission for Social Care Inspection say are the most important for the people who use service, and that it does what the Care Standards regulations say it must. We have reviewed our practice when making requirements, to improve national consistency. Some requirements from previous inspection reports may have been deleted or carried forward into this report as recommendations - but only when it is considered that people who use services are not being put at significant risk of harm. Care Homes for Older People
Page 6 of 25 In future, if a requirement is repeated, it is likely that enforcement action will be taken. This inspection was carried out by one inspector. The inspection lasted a total of six hours. During this time the inspector looked at a range of documentation including, service user and staff files. The inspector spoke to four service users, two family members, three staff members, and the manager. The manager of the service completed an Annual Quality Assurance Assessment (AQAA). Five service users, and four staff returned surveys to CSCI. At the time of the inspection the home was providing services to 44 service users. The home was last inspected on 25/03/08. Fees at the home range from 506.50 to 610.30 pounds per week. What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 240 7535. Care Homes for Older People Page 8 of 25 Details of our 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) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 9 of 25 Choice of home
These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home has procedures that should ensure that prospective service users have their needs assessed. Evidence: During the visit the inspector examined the files of two service users recently admitted to the home. Each was found to contain evidence of information gathered by the home prior to that persons admission. During discussion with the manager she was able to describe the process that is followed to obtain information about a prospective service users needs including, an assessment from the care manager if that person is funded by a local authority. Service users or their representatives are encouraged to visit the home prior to moving in. One service user who spoke to the inspector confirmed this. Evidence was seen that indicated service users are issued with terms and conditions / contract of accommodation and services as required at the previous inspection. Care Homes for Older People Page 10 of 25 Care Homes for Older People Page 11 of 25 Health and personal care
These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The health and personal care that people receive is based on their individual need. The principles of respect, dignity and privacy are put into practice. Evidence: During the visit the inspector examined the files of five service users. Two of these were for people receiving long term nursing care, one for a person receiving long term personal care, and two for people receiving intermediate care. Each file contained records of assessment including activities of daily living, moving and handling, falls risk, continence, nutrition, weight and risk of pressure damage. Assessments and care plans of those people receiving long term care were seen to be reviewed at least monthly, those receiving intermediate care were reviewed weekly. Other information recorded included social and family history. The files contained records of daily activities and a weekly key worker diary / review. Files were seen to contain plans of care in relation to physical health care needs. Four of the files examined contained good information, the fifth contained briefer details. All files seen contained information that indicated service users have access to GPs
Care Homes for Older People Page 12 of 25 Evidence: and other health professionals as needed. People who are accommodated in the transition / rehabilitation unit have access to a physiotherapist and occupational therapist on a daily basis. Staff who spoke to the inspector were able to demonstrate a good knowledge of individuals needs and how these are met. Staff spoke of promoting individuals privacy, dignity and Independence. Service users who spent time with the inspector confirmed they were happy with how the care is given. One person said staff are brilliant, another said people receive consistent good care. The inspector observed good interactions between staff and service users. Family members who spoke to the inspector also expressed satisfaction with the care their relative receives. Information contained in surveys returned to CSCI indicated people were satisfied with the care they receive. One person commented on the caring staff. Information in the AQAA returned to CSCI indicated the home has a policy and procedure in relation to safe handling of medication. A sample audit of medication records and systems found no major concerns. A sample audit of Medication Administration Records (MAR) examined were seen to be completed with no gaps in entries. The inspector was told medication is administered by either qualified nursing staff or senior care staff who have completed safe handling of medication training. The manager told the inspector that it is her intention to commence annual competency checks. Care Homes for Older People Page 13 of 25 Daily life and social activities
These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The food at the home is of a good quality, well presented and meets the dietary needs of the people who use the service. people who use the service are able to make choices about their lifestyles. Evidence: Service users who spent time with the inspector all expressed satisfaction with the support they receive from the staff and their lifestyles within the home. People said they were given choice in daily activities and could spend their time how they wished. The home employs an activities coordinator. Records seen indicated the service users are offered a variety of one to one and group activities. People spoke of trips out, entertainers, games and a recent visit by Zoo Lab. The activities coordinator produces a monthly newsletter detailing the activities that have taken place and those planned. Service users and family members who spent time with the inspector told her that visitors were always made welcome, staff are friendly and approachable. The majority of people who spoke to the inspector and those who returned surveys to CSCI said the meals were of a good standard and there was a good variety and choice. However one person did say the meals were hit and miss and another commented on the variable quality.
Care Homes for Older People Page 14 of 25 Evidence: Information contained in surveys returned to CSCI indicated people were satisfied with their lifestyles within the home. The inspector observed part of the lunchtime meal. Menus were seen to be available on each table. The meal was well presented and served in pleasant surroundings. Staff were observed to give assistance as required. Care Homes for Older People Page 15 of 25 Complaints and protection
These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who use the service are able to express their concerns and have access to a complaints procedure, are protected from abuse and have their rights protected. Evidence: The home has a policy and procedure in relation to handling complaints. This was seen to be available. Service users and family members who spoke to the inspector confirmed they were aware of how to raise any issues. All service users who spent time with the inspector said they felt safe and comfortable and had no concerns. Information contained in the AQAA indicated the home has receive eight concerns or complaints in the last twelve months. The inspector was shown documentation recording issues raised and outcomes. Information contained in training records seen by the inspector indicated the majority of staff had received training in relation to prevention of abuse and no secrets. Staff who spoke to the inspector were able to demonstrate through response to questions the action they would take if they became aware of a concern. All demonstrated a commitment to protecting service users from abuse. The home has a policy in relation to prevention of abuse. Care Homes for Older People Page 16 of 25 Environment
These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The physical design and layout of the home enables people who use the service to live in a safe, generally well maintained and comfortable environment. Evidence: During the visit the inspector walked around the building. It was seen that the home provides a clean, odour free and homely environment. Work had commenced in a ground floor bathroom to convert it to a wet room. Other bathrooms seen by the inspector would benefit from refurbishment to enhance the comfort of service users. The carpet on the ground floor corridor was seen to be old and faded and would benefit from replacement. Service users who spoke to the inspector expressed a general satisfaction with the environment. Some of the bedrooms have recently been redecorated, however wallpaper in one bedroom was seen to be torn. Information contained in the AQAA returned to CSCI indicate a new fire alarm system and call bell system have been fitted. Information relating to the kitchen and laundry were examined during the inspection of Stanton Hall. Care Homes for Older People Page 17 of 25 Care Homes for Older People Page 18 of 25 Staffing
These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are satisfied with the care they receive. The home has a recruitment procedure that promotes the safety and wellbeing of service users. Evidence: On the day of the inspection the home was accommodating 44 service users. Twenty nine of these people were receiving nursing care, five personal care and ten intermediate care. On the day of the visit the inspector found there were two qualified nurses, (one supplied from an agency), two senior care assistants and five care assistants on duty. Service users and family members who spoke to the inspector told her there were usually sufficient staff on duty to meet their currant care needs. Service users who spoke to the inspector told her they were satisfied with the care they receive. One person stated the staff are brilliant, another said you can not fault the care and a third person said if you want anything it is there. Staff who spoke to the inspector told her there were sufficient staff to meet service users needs. Information in the AQAA indicated the home has a policy and procedure in relation to recruitment. The inspector examined the files for two staff, one of whom was a qualified nurse, who were recently recruited. These were found to contain evidence of application, two
Care Homes for Older People Page 19 of 25 Evidence: written references and PoVA first / CRB (Criminal Record Bureau ) check and PIN (Professional identification number) obtained prior to employment. The dates of employment recorded on one of the application forms gave years only. The inspector examined a further four files for staff who had been employed for a number of months or years. Files seen by the inspector contained evidence that staff have received training including moving and handling, fire safety and prevention of abuse. Staff who spoke to the inspector confirmed this. Information in the AQAA indicated 55 of care staff had successfully completed NVQ at level 2 or above and a further 3 staff were undertaking the training. The manager told the inspector the home has recently used agency nursing staff on a number of occasions and had received a covering letter from each agency stating employment checks are carried out. The inspector was not able to evidence that confirmation had been obtained for each individual supplied by the agency. Care Homes for Older People Page 20 of 25 Management and administration
These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The management and administration of the home is based on openness and respect, has quality assurance systems that should promote the safety and wellbeing of service users. Evidence: The manager has submitted an application to register to CSCI and this is being processed. Staff who spoke to the inspector told her communication is good, they have regular supervision and meetings. The inspector saw evidence of monthly Regulation 26 visits and reports. The manager carries out monthly audits of care plans, medication, pressure area damage and accidents. Southern Cross carry out an annual audit of service user satisfaction. The manager told the inspector this was last completed in April 2008. The manager also issues surveys to each service user who has been accommodated in the intermediate care unit on their discharge.
Care Homes for Older People Page 21 of 25 Evidence: Records seen indicated that accidents to service users are recorded appropriately and analysis takes place. Staff told the inspector they had regular formal supervision and annual appraisals. Service users and family members who spoke to the inspector all said they were satisfied with the care and support they receive. All said that the manager and staff were approachable and any issues raised are acted upon. Information contained in surveys returned to CSCI indicated people were satisfied with the care they receive. One person stated the staff are caring. Southern Cross have recently introduced a new computerized system to record service users personal monies held by the home. The account is audited on a regular basis by financial staff employed by Southern Cross. Information contained in the AQAA returned to CSCI indicated the home has a range of policies and procedures that should promote the safety and wellbeing of service users, and these were reviewed in January 2006. Other information indicates the home and equipment are maintained as required. Other records seen indicated fire alarms are tested weekly and there are regular fire drills. Hot water temperatures are recorded on a monthly basis. Care Homes for Older People Page 22 of 25 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements
These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards
No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 23 of 25 Requirements and recommendations from this inspection:
Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours.
No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set.
No. Standard Regulation Requirement Timescale for action 1 29 19 Evidence must be obtained 20/02/2009 that individual agency staff employed by the home have had satisfactory recruitment checks. To promote the safety and wellbeing of service users. Recommendations
These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations 1 9 Annual competency checks should take place for all staff who administer medication to promote safe handling for the safety and wellbeing of service users. The program of refurbishment should continue and include all bathrooms, the corridor carpet and decor to the bedroom with torn wallpaper to promote the safety and comfort of service users. Employment history in application forms should include full details of dates of previous employment to promote the safety and wellbeing of service users. Hot water temperatures of baths and showers should be checked and recorded on a more regular basis to promote the safety and wellbeing of service users. 2 19 3 29 4 38 Care Homes for Older People Page 24 of 25 Helpline: 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 We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. Care Homes for Older People Page 25 of 25 - 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!