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Inspection on 01/07/05 for Vera James House

Also see our care home review for Vera James House for more information

This inspection was carried out on 1st July 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

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

What the care home does well

The home offers a high level of personalised care, and is able to meet the needs of the service users living in the home. A variety of activities are available to service users, including Art and crafts, regular entertainers, board and card games and cookery, and this helps keep service users engaged. Staff is also keen to take service users into the local community, visiting shops and local restaurants where possible. The home has a stable staff group, which provides consistent support to the service users, and a variety of training is provided to the staff.

What has improved since the last inspection?

Since the last inspection, management changes have led to an overall improvement in staff relations, and better morale within the group, although some difficulties have been experienced with changes to terms and conditions. These were managed well by the organisation. There have been small changes to the layout of the building, and better staff facilities are now available.

What the care home could do better:

The service needs to ensure that records required in the regulations are available for inspection, which has been a long term requirement in this home. They must also ensure that the relevant assessment and review documentation is available within the files for future inspections.

CARE HOMES FOR OLDER PEOPLE Vera James House Chapel Street Ely Cambridgeshire CB6 1TA Lead Inspector Alan Buttery Unannounced 1st July 2005 @ 10:00 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Vera James House I53 I03 s15109 VERA JAMES HOUSE v234277 270605 STAGE 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Vera James House Address Vera James House, Chapel Street, Ely, Cambridgeshire, CB6 1TA. 01353 661113 Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Cambridge Housing Society to be appointed Care Home 39 Category(ies) of Dementia - over 65 years of age (10), Old age, registration, with number not falling within any other category (39) of places Vera James House I53 I03 s15109 VERA JAMES HOUSE v234277 270605 STAGE 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: None Date of last inspection 25th October 2004 Brief Description of the Service: Following some internal changes in the last year, Vera James House now provides a service for a maximum of thirty nine people over the age of 65, including a separate unit for up to eight older people with dementia. They also provide a respite care facility. All rooms provide en-suite facilities and are appropriately furnished and decorated. The property is situated within a larger complex belonging to the Cambridgeshire Housing Society which includes sheltered housing. Vera James House I53 I03 s15109 VERA JAMES HOUSE v234277 270605 STAGE 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection was the first of the current year, and was unannounced. The manager and staff members were available to discuss the inspection, and the home in general, and care plans, service user records and staff information was made available. During the inspection, which lasted about three hours, the inspector spoke with a few service users, but arrangements have been made to attend a service user event later in the year, and this will be incorporated as part of the second annual inspection report. Comments cards were left with the home, which have been distributed to relatives and service users, and to date 21 have been returned from relatives, although none have been received yet from service users. They are largely positive, although one or two refer to staffing shortages, which will be looked at further at the next inspection. Feedback from these comments will be made to the home in due course, but very positive comments on the standard of care were received. What the service does well: The home offers a high level of personalised care, and is able to meet the needs of the service users living in the home. A variety of activities are available to service users, including Art and crafts, regular entertainers, board and card games and cookery, and this helps keep service users engaged. Staff is also keen to take service users into the local community, visiting shops and local restaurants where possible. The home has a stable staff group, which provides consistent support to the service users, and a variety of training is provided to the staff. Vera James House I53 I03 s15109 VERA JAMES HOUSE v234277 270605 STAGE 4.doc Version 1.30 Page 6 What has improved since the last inspection? 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. Vera James House I53 I03 s15109 VERA JAMES HOUSE v234277 270605 STAGE 4.doc Version 1.30 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Standards Statutory Requirements Identified During the Inspection Vera James House I53 I03 s15109 VERA JAMES HOUSE v234277 270605 STAGE 4.doc Version 1.30 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 3 and 6 Although verbal confirmation of the pre admission process was available, the written evidence of the process was not available, and must be kept on the individual service user files. EVIDENCE: As part of the inspection, the pre assessment information on a new admission to the home was examined, together with the information on the files of service users who moved into the home in January and March this year. Although a policy for pre admission assessments is in place, and the manager confirmed that they had been done, there was no evidence on the files to support this. However the file of a service user who has been in the home for some time did include evidence of the pre admission process being followed. The home must therefore ensure that all relevant information is available on file. The home does not offer any intermediate care, and this standard was not therefore assessed. Vera James House I53 I03 s15109 VERA JAMES HOUSE v234277 270605 STAGE 4.doc Version 1.30 Page 9 Vera James House I53 I03 s15109 VERA JAMES HOUSE v234277 270605 STAGE 4.doc Version 1.30 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 7 and 8 Care plans are in place to ensure staff are able to meet service user need, but must be reviewed monthly to ensure changes in need are identified. EVIDENCE: Four service users files were examined during the course of this inspection, and all contained detailed care plans and risk assessments, which have been revised in recent months. There was evidence on the files of health needs being recorded and met, although the recording of weights suggested there might be problems with the reliability or accuracy of the scales, and this should have been picked up. The care plans showed evidence of reviews taking place, but on three of the four files, the last review was three months previously, and these must take place on a monthly basis. There was evidence on the files that service users are involved in the car planning process, and a record of visits from health professionals, and in addition, the home is involved with the PCT in a project to prevent unnecessary hospital admissions, and maintain service users in the home, with support as required from local health professionals. Vera James House I53 I03 s15109 VERA JAMES HOUSE v234277 270605 STAGE 4.doc Version 1.30 Page 11 Vera James House I53 I03 s15109 VERA JAMES HOUSE v234277 270605 STAGE 4.doc Version 1.30 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12 and 13 Vera James House offers a variety of activities to service users, who are supported in making choices, and still taking part in community activities where possible. EVIDENCE: The home employ an activity worker to help staff in arranging activities and trips out, as well as staff accompanying service users into the town when they wish to. The activities available were discussed with staff, and will be considered further at the next inspection. Visitors are welcome at any time, and comment cards were left for family and friends to complete and return to the CSCI. At he time of writing the report, fifteen have already been returned, offering generally positive comments. Visitors feel generally welcome, although one comment card suggested that visitors should be checked better on entering the home. Vera James House I53 I03 s15109 VERA JAMES HOUSE v234277 270605 STAGE 4.doc Version 1.30 Page 13 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 16 and 18 Policies and procedures are in place to ensure concerns are listened to, and all staff are aware of adult protection procedures, ensuring any suspected abuse is properly dealt with. EVIDENCE: The home both a complaints policy and an adult protection policy, and these were discussed with the senior staff member who helped during the inspection. One complaint has been received by the CSCI, and this was dealt with appropriately by the home, in accordance with their policy. A log of other complaints received is kept by the home, and this was looked at, although no other significant complaints have been received. All staff have now received training in adult protection issues, and the senior carer was familiar with the procedure to be followed in the event of any incidents. Vera James House I53 I03 s15109 VERA JAMES HOUSE v234277 270605 STAGE 4.doc Version 1.30 Page 14 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 19 and 26 The home continues to offer a clean and pleasant environment for service users, and recent changes have improved facilities for staff. EVIDENCE: Vera James House is purpose built, and recent changes have increased the capacity of the home to 39 service users. The home offers a comfortable and safe environment, which was seen to be clean, and free from unpleasant odours on the day of the inspection. Service users now have individual safes in their rooms in which medication and valuables can be stored. Service users can also access safe and well maintained gardens, with seating and areas of shade. The home employs a gardener/handy man who attends to everyday maintenance, and the providers maintenance department deal with other Issues. Staff spoken to said that the response from the maintenance department is good in the event of problems in the home Vera James House I53 I03 s15109 VERA JAMES HOUSE v234277 270605 STAGE 4.doc Version 1.30 Page 15 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27 and 30 The home has a well trained staff team, competent in managing the varied needs of service users living in the home. EVIDENCE: Since the last inspection, a review of staffing in the home has taken place, together with a more general review of pay and conditions, which although causing some unsettling times for staff appears to be well handled by the provider, with visits to the home to explain the changes made by the responsible person and a representative from their HR department. As a result of the staffing review, levels have increased slightly, although there have been three occasions recently where the staff spoken with felt they were short staffed (where a staff member had called in sick at the last minute, and the home had been unable to find a replacement) The home provides a good range of training for the staff, and the staff spoken with advised that training in all mandatory areas had been provided in the last year, together with additional more specific training such as dementia training. Vera James House I53 I03 s15109 VERA JAMES HOUSE v234277 270605 STAGE 4.doc Version 1.30 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 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 33 and 38 The new manager in the home has improved the morale and attitude of staff, and she ensures all health and safety matters are attended to, for the protection of service users and staff. EVIDENCE: The acting manager of the home has introduced a number of changes and is well regarded by her staff team, who made very positive comments to the inspector when discussing the management of the home. In addition they felt that the regular visits to the home by the responsible individual are also a positive feature. The home has the appropriate policies in place to protect the health and safety of service users and staff, and regular checks of the workplace are made. Vera James House I53 I03 s15109 VERA JAMES HOUSE v234277 270605 STAGE 4.doc Version 1.30 Page 17 A number of health and safety records were seen including details of the fire alarm tests, the accident book, the homes risk assessments and alarm records, all were satisfactory. Vera James House I53 I03 s15109 VERA JAMES HOUSE v234277 270605 STAGE 4.doc Version 1.30 Page 18 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score x x 2 x x N/A 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 x 15 x COMPLAINTS AND PROTECTION 3 x x x x x x 3 STAFFING Standard No Score 27 3 28 x 29 x 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x 3 x x 3 x x x x 3 Vera James House I53 I03 s15109 VERA JAMES HOUSE v234277 270605 STAGE 4.doc Version 1.30 Page 19 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 OP37 Regulation 17(2) Requirement Staff records must be available in the home for inspection THIS IS A REQUIREMENT CARRIED FORWARD FROM THE LAST INSPCTION Pre admission assessments must be available for inspection at all times. Care plans must be reviewed in accordance with this regulation Timescale for action 31/8/05 2. 3. OP3 OP7 14(1)(a) 15(2)(b) 30/9/05 30/9/05 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 Good Practice Recommendations Vera James House I53 I03 s15109 VERA JAMES HOUSE v234277 270605 STAGE 4.doc Version 1.30 Page 20 Commission for Social Care Inspection CPC1, Capital Park Fulbourn Cambridge CB1 5XE 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 Vera James House I53 I03 s15109 VERA JAMES HOUSE v234277 270605 STAGE 4.doc Version 1.30 Page 21 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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