Inspection on 08/08/06 for Vera James House

This inspection was carried out on 8th August 2006.

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

Vera James House 03/02/06

Vera James House 01/07/05

Vera James House 25/10/04

Vera James House 28/05/04

Similar services:

Claremont House

Oak Ridge

Sun Court Nursing Home

Ashville House

Bilney Hall

Hill Barn

Mabbs Hall Nursing Home

Henrietta House

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

CARE HOMES FOR OLDER PEOPLE Vera James House Chapel Street Ely Cambridgeshire CB6 1TA Lead Inspector Janie Buchanan Key Unannounced Inspection 08 August 2006 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 Vera James House DS0000015109.V306777.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. Vera James House DS0000015109.V306777.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Vera James House Address Chapel Street Ely Cambridgeshire CB6 1TA 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) 01353 661113 01353 661829 verajames@cambridgehs.org.uk Cambridge Housing Society Ltd Mrs Susan Jill Gooch 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 DS0000015109.V306777.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 3rd February 2006 Brief Description of the Service: Vera James House 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. Weekly charges vary between £425.95 and £522.97, depending on residents’ needs. About 25 of residents are privately funded and 75 funded by the local primary care trust. A copy of the home’s most recent inspection report form the Commission for Social Care Inspection is available in the entranceway to the home. Vera James House DS0000015109.V306777.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 home’s key inspection for the year 2006/7. It was unannounced. The inspector spoke with four residents, four members of staff, two visiting relatives and the manager. A brief tour of the home was undertaken and a range of documents was viewed. In addition to this, the inspector received a seven comment cards requesting feedback about the home, completed by residents and their relatives. Two requirements and one recommendation have been made as a result of this inspection. What the service does well: What has improved since the last inspection? What they could do better: Residents must be actively consulted about, and involved in, reviewing their care plans. Staff must spend individual time with residents to enable them to participate and communicate their views to the development of their care plan. Staffing levels must be reviewed, particularly in relation to the home’s dementia care unit, to ensure that residents on this unit are properly supervised and supported. The lay out of the home is a little confusing and more could be done with the use of orientation aids to help residents and visitors find their way about. Vera James House DS0000015109.V306777.R01.S.doc Version 5.2 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. Vera James House DS0000015109.V306777.R01.S.doc Version 5.2 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 Vera James House DS0000015109.V306777.R01.S.doc Version 5.2 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): 1,2,3,5 Outcomes in this group of standards are good. Comprehensive information is available about the home to help residents decide if it is where they want to live. All new residents receive a thorough assessment of their care needs before admission. EVIDENCE: There is a Statement of Purpose and Service User Guide that give good information about the home and the services it offers. This information is also available in audiotape so it is accessible to residents with a sight impairment. Prospective residents are encouraged to visit the home to assess its facilities and those residents spoken to confirmed that they, or their relatives, had visited the home prior to moving in. New residents are only admitted on the basis of a full assessment and the residents’ files checked contained good pre-admission information about their individual needs. All residents are issued with a licence agreement which clearly states the terms and conditions of their stay. Vera James House DS0000015109.V306777.R01.S.doc Version 5.2 Page 9 Vera James House DS0000015109.V306777.R01.S.doc Version 5.2 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 the following standard(s): 7,8,9,10 Outcomes in this group of standards are adequate. Each resident has a care plan to guide staff in how to meet their needs, however more must be done to actively involve residents in reviewing their plan. EVIDENCE: Each resident has a care plan and those viewed were generally detailed and up to date. There was evidence of health care treatment and intervention, and a record of general health care information including weight and nutrition monitoring. However, the practice of involving residents in the development and review of the plans was poor. One resident told the inspector that the only time she had seen her care plan was when she first moved in, nearly two years ago. Although her plan had been reviewed monthly by the care staff since, she had not been consulted once. This resident felt her needs had changed quite considerably since she was admitted but that staff had not noticed, and consequently had assumed she was more able than she actually was. Medication records were up to date for each resident and medicines received, administered and disposed of were recorded. However, hand written additions to MAR sheets were not signed or dated, there were a few discrepancies as to Vera James House DS0000015109.V306777.R01.S.doc Version 5.2 Page 11 the dates some tablets had been administered and staff had not recorded the date on which they had opened a bottle of eye drops. All residents spoken to confirmed that staff treated them respectfully, although one stated that: ‘ you do sometimes feel a little rushed as staff hurry from job to job’. Vera James House DS0000015109.V306777.R01.S.doc Version 5.2 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 the following standard(s): 12,13,14,15 Outcomes in this group of standards are good. Residents have access to a range of activities to suit their interests and are supported to maintain contact with friends and family. EVIDENCE: Residents have the opportunity to take part in a variety of activities both within the home and in the community, and these were well advertised around the home. On the day of inspection itself 16 residents were attending a nearby church service. A number of trips are planned to Anglesey Abbey, Bury St Edmunds and shopping at the Grafton Centre. One resident told the inspector that he enjoyed the weekly exercise classes and that he still nearly touches his toes as a result. Another resident said she had enjoyed the ‘Racing Day’ that had taken place the day before the inspection. Residents are actively encouraged to keep in contact with family and friends, and visitors are welcome at any time. Staff help one resident receive a phone call from her daughter in America every day. Routines in the home appeared flexible and residents spoken to confirmed that they choose how to spend their day. The food on the day of inspection was of good quality, well presented and met the dietary needs of the residents. There is always a choice of menu offered. Vera James House DS0000015109.V306777.R01.S.doc Version 5.2 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 the following standard(s): 16, 18 Outcomes in this group of standards are good. Residents have access to an effective complaints procedure. EVIDENCE: There is a well-devolved complaints procedure that is on display around the home. Residents who completed the questionnaire stated that they knew who to speak to if they were unhappy, and knew how to make a complaint. The home’s record of complaints was viewed and recent complaints in relation to missing laundry, one resident disturbing another, and lack of staff attendance at a resident’s funeral had been dealt with effectively and sensitively. However, one resident told the inspector that she had complained about poor television reception in her bedroom and that this had taken over 6 weeks to sort. This resident stated she was ‘really fed up’ by the whole affair, as she relies on her TV for her daily entertainment. Training for staff in protecting vulnerable adults is regularly arranged by the home and one of the assistant manager’s has recently completed the advanced 3-day key practitioner course. Vera James House DS0000015109.V306777.R01.S.doc Version 5.2 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 the following standard(s): 19,20,22,26 Outcomes in this group of standards are good. Residents live in a safe and well-maintained environment. EVIDENCE: The home has a well-maintained environment, which provides aids and equipment to meet the care needs of residents. Each of the three living units has access to a pleasant garden, allowing residents access to light and fresh air. However, the garden in the dementia unit is used as a smoking area for staff. There was no evidence if residents had been consulted about this matter, and agreed for their garden to be used by staff in such a way. The layout of the home consists of long, similar looking corridors between the units. This makes navigation very difficult and the inspector frequently lost her way. More could be done to provide better signage and orientation aids to help residents, and their visitors, find their way around the home. Vera James House DS0000015109.V306777.R01.S.doc Version 5.2 Page 15 Vera James House DS0000015109.V306777.R01.S.doc Version 5.2 Page 16 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): 27,28,29,30 Outcomes in this group of standards are good. Staff receive regular and meaningful training in meeting the needs of residents. However staffing levels should be reviewed to ensure that residents’ needs are fully met. EVIDENCE: There are seven care staff on between 7.30am and 2.30pm and six on between 2.30pm and 9.30pm for 39 residents. However, on some afternoons this drops to five staff between 2.30 and 4.30pm. At night three waking staff are on duty at the home. It was of concern that sometimes there was only one member of staff on duty in the home’s dementia care unit. This does not provide adequate supervision given the needs of this client group. The manager must review staffing levels on this unit. Training for staff is good and files viewed showed that they undertake training in a variety of subjects including dementia care, protecting vulnerable adults, falls prevention, diabetes, bereavement and equality and diversity. Over half the staff hold and NVQ level 2 or 3 in care. The home’s recruitment procedures are good and staff interviewed confirmed that they had received an application form and job description; had been thoroughly interviewed and had had two references and a CRB taken up before starting work. Vera James House DS0000015109.V306777.R01.S.doc Version 5.2 Page 17 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): 31,33,36,38 Outcomes in this group of standards are good .The manager takes residents’ feedback seriously and makes changes where possible. EVIDENCE: The new manager has the required qualifications and experience and is competent to run the home. Staff find her approachable and, as one stated: ‘a good all rounder’, although two staff interviewed felt she could be ‘a little stricter’ with poorly performing staff. There are regular staff meetings and all staff receive regular supervision of their working practices. The home closely monitors the quality of its service and there are systems in place for checking residents’ satisfaction with the service. There are regular residents’ meetings and evidence that residents’ suggestions were acted upon. For example at a recent meeting residents suggested that wine be served with Sunday lunch: this has now been implemented. A questionnaire was recently sent to all residents, their families and a variety of health care professionals Vera James House DS0000015109.V306777.R01.S.doc Version 5.2 Page 18 asking for comments about the quality of care, the friendliness of staff and the cleanliness of the home. 25 responses were received most of which rated the home as ‘excellent’ or ‘good’. A number of records in relation to health and safety (gas, passenger lift service, hoist servicing, fire and emergency lighting) were checked and found to be in good order. Staff receive training in first aid, fire safety, and moving and handling. Vera James House DS0000015109.V306777.R01.S.doc Version 5.2 Page 19 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 3 3 3 x 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 2 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 3 x 3 x x x 3 STAFFING Standard No Score 27 2 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 x 3 x x 3 x 3 Vera James House DS0000015109.V306777.R01.S.doc Version 5.2 Page 20 Are there any outstanding requirements from the last inspection? no 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 Requirement Residents must, wherever possible, be consulted about and actively involved in the review of their care plan. Staffing levels in the dementia care unit must be reviewed to ensure residents’ needs are met Timescale for action 01/11/06 2. OP27 18(a) 01/10/06 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 OP19 Good Practice Recommendations Better signage and orientation aids should be provided around the home. Vera James House DS0000015109.V306777.R01.S.doc Version 5.2 Page 21 Commission for Social Care Inspection Cambridgeshire & Peterborough Area Office 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 DS0000015109.V306777.R01.S.doc Version 5.2 Page 22 - 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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