CARE HOMES FOR OLDER PEOPLE
Vermont House 16 Anchorage Road Sutton Coldfield West Midlands B74 2PR Lead Inspector
Mrs Amanda Hennessy Key Unannounced Inspection 14th August 2007 11:00 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 Vermont House DS0000016919.V344099.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. Vermont House DS0000016919.V344099.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION
Name of service Vermont House Address 16 Anchorage Road Sutton Coldfield West Midlands B74 2PR 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) 0121 354 5060 0121 354 5060 vermonthouse@freenetname.co.uk Vermont Trust Mrs Sithembiso Wilcox Care Home 10 Category(ies) of Old age, not falling within any other category registration, with number (10) of places Vermont House DS0000016919.V344099.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION
Conditions of registration: 1. The registered manager, Sithembiso Wilcox, to provide the Commission with evidence of successful completion of the Registered Managers` Award by September 2006. 29th September 2006 Date of last inspection Brief Description of the Service: Vermont House is a detached home situated in a residential area of Sutton Coldfield, close to bus and train routes to both Birmingham and Lichfield. It is a large property that is in keeping with the neighbourhood and can accommodate up to 10 elderly people. The home is owned and run by Vermont Trust Ltd and is exclusively for older people who are Christian Scientists. This faith is probably best known for its reliance on prayer alone for the healing of sickness and disease rather than medical treatment. The aim of the home is to provide long term personal care to Christian Science men and women, almost exclusively over 65 years of age, who rely solely upon the Bible-based method of spiritual healing, Christian Science. On the ground floor there is a lounge, dining room, sun lounge, good-sized kitchen and two residents bedrooms. On the first floor there are a further eight bedrooms for residents, which are accessible via either a shaft lift or stairs. The second floor of the property is solely for staff use. All of the bedrooms have en-suite facilities. There are toilets & bathrooms on all floors. To the front of the property there is an area of hard standing with room for cars to park, and at the rear of the property there are large private and wellmaintained gardens accessible via a ramped pathway. The current weekly fee is at the home range between £470. Hairdressing, toiletries, newspapers is not included in the fee but is available for an additional charge. Vermont House DS0000016919.V344099.R01.S.doc Version 5.2 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This was an inspection undertaken without any prior notice by one Inspector. The inspection was carried out between 11.00 and 16.30. The inspection included a tour of the building, talking to residents, staff and the Manager, a review of records including information forwarded by the Manager before the inspection and survey comment cards that were completed by service users and their relatives. Care records were reviewed as part of the “case tracking” of two residents. All of the fourteen requirements of the previous inspection have been addressed, or removed as they are no longer applicable; No new requirements were made as a result of this inspection. What the service does well:
Vermont House is clean, welcoming, well maintained and comfortable for Christian Scientists. A relative commented: “Vermont House is kept clean and tidy, provides excellent meals and friendly and caring staff”. The home has an experienced manager who provides effective and competent leadership for her staff. There is a stable staff team who provide continuity of care for the homes residents and all care staff have a care qualification. All prospective residents have a comprehensive assessment of their needs and are able to visit the home and have a meal at Vermont House prior to their agreement to come to live at the home. Residents choices and views are respected. There are no apparent rigid rules or routines in the home. Residents are free to come and so and worship according to their faith. Staff have a good understanding of the needs and choices of Christian Scientists. A resident said: “ Staff give me quiet time in my room and I put my do not disturb sign up which gives me time to read”. A relative said “ the home looks after both the physical and spiritual needs of my mother very well”. Vermont House DS0000016919.V344099.R01.S.doc Version 5.2 Page 6 There are no restrictions on visitors to the home within reasonable hours and visitors say that they are always made welcome. Residents say that the homes staff are very good, comments received included: ‘We are just like a family, the staff are very good.’ What has improved since the last inspection? What they could do better:
The home needs to ensure that the recruitment and selection is robust and safeguards residents on a consistent basis.
Vermont House DS0000016919.V344099.R01.S.doc Version 5.2 Page 7 Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Vermont House DS0000016919.V344099.R01.S.doc Version 5.2 Page 8 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 Vermont House DS0000016919.V344099.R01.S.doc Version 5.2 Page 9 Choice of Home
The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 1,2,3,4. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home meets the needs of Christian Scientists and has all required information available for both prospective and existing “guests”. EVIDENCE: The home’s Statement of Purpose and Service Users’ Guide are together in one document and have been reviewed since the previous inspection and provide required information about the home. Residents records seen contained terms and conditions of residency which included required information about the home including fees that are payable and what the fees include and do not include. All residents needs are assessed prior to their admission by the Care Manager.
Vermont House DS0000016919.V344099.R01.S.doc Version 5.2 Page 10 People who live at Vermont House told the Inspector that they had visited the home and had lunch with the other “guests” (as they are referred to at Vermont House) before they made the decision to come into the home to stay. The home has a trial period for two to three months trial period to find out whether the home is suitable for them, after which there is a formal review about the residents wish to stay at the home. Residents then submit an application which is considered by the Board of Trustees to become a resident of the home. The home provides care for elderly Christian Scientists focusing on their spiritual needs. Residents have the support of Christian Scientist Practitioners, and the home has close links with the local Christian Scientist Church in Sutton Coldfield, and the Mother Church in Boston, U.S.A. The home can offer short stays for rest and study when vacancies are available. Christian Science centres upon reliance on the Power of God to heal and therefore residents do not use medicines and there is no medical intervention at the home. Vermont House DS0000016919.V344099.R01.S.doc Version 5.2 Page 11 Health and Personal Care
The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 7,8,9,10. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents’ health, personal and social care needs are meet within the confines of residents’ choice. EVIDENCE: People who live at Vermont all have a plan of their care that is person centred and reflects their needs. Residents are involved in both developing and reviewing their plan of care. Risk assessments for nutrition, skin integrity or wounds are not completed as requested by residents, as risk assessment which point towards a need for medical intervention are not appropriate as part of Christian Science. Residents at present fall into the category of low to medium dependency needs. Manual handling needs are reviewed regularly for residents.
Vermont House DS0000016919.V344099.R01.S.doc Version 5.2 Page 12 Guests health care needs are fully met in the form of spiritual support and with the support of their Christian Science Practitioner. No medication is kept or administered by staff to residents within the home. It was evident from looking around the home that residents are treated with respect and their right of privacy is upheld as promised in the Service user Guide. There is a “do not disturb” sign on all residents bedroom doors which they use if they do not want any disturbance and is primarily used as time to reflect on religious readings. Vermont House DS0000016919.V344099.R01.S.doc Version 5.2 Page 13 Daily Life and Social Activities
The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 12,13, 14 and 15. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents’ lifestyles, expectations and preferences are met by the home. EVIDENCE: Residents lifestyles, expectations and preferences are met at Vermont House. People who live at the home are able to maintain contain with their families and friends as they wish. Residents are able to spend their day as they please with the proviso that they tell staff that they are going out and an approximate time that they will return for safety reasons. One resident spoken to said: “ I can spend quiet time in my room to read but I can always go downstairs if I want a little company.” This same resident said that they frequently go for walk to the Sutton park which is close by and into Sutton. Vermont House DS0000016919.V344099.R01.S.doc Version 5.2 Page 14 Another resident said that she frequently goes out for lunch with friends and it was also nice that her friends can also come and have lunch with her at Vermont House. Another resident told the inspector that she has a shopping planned into Birmingham which she was looking forward to. The home have daily bible study although it is optional that residents attend, and on the day on the visit approximately half of the residents had taken up this opportunity. Residents attend the local Christian Scientist Church twice a week when transport is provided from the home. The inspector had a meal with residents and it nice to hear that when care staff worked over a meal time they also had a meal with residents which all enjoy. Residents said: “ We are like a happy family together, the guests and the staff”. Mealtimes are made a special occasion with the majority of residents coming into the dining room to sit at the large dining table together, which overlooks the pleasant large garden. The home has a dinner gong that is sounded to announce to residents that meals are ready. There is a five week menu with most foods home cooked. There is only one choice identified on the menu although residents spoken to said they was never any problem for an alternative to be provided. The meals of the day are identified on the large notice board in the dining room. Residents can have breakfast either in their room or in the dining room and there was a list of residents preferences for breakfast. One resident said that that the cook had been very good to ensure that a varied vegetarian menu were available for him. Residents said that the food is “ excellent” and is “99 lovely” and “ the soups are out of this world.” Vermont House DS0000016919.V344099.R01.S.doc Version 5.2 Page 15 Complaints and Protection
The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 16 and 18. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home listens to residents and has appropriate systems in place to ensure that residents are safeguarded. EVIDENCE: The home has a complaints procedure that is displayed within the home and also included within the service user guide. Residents spoken to were confident that they would raise any concerns with either the Manager or staff. The home also has a compliments book where good practice can also be highlighted and shared with others. The home or CSCI have had no complaints about the home since the previous inspection. Staff were clear on actions required if abuse was alleged. Staff have all had training in the protection of vulnerable people since the previous inspection. Vermont House DS0000016919.V344099.R01.S.doc Version 5.2 Page 16 Environment
The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 19,20, 21, 22, 23, 24,25 and 26. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is warm, well maintained and comfortable and provides a safe and clean environment for residents. EVIDENCE: The home is warm well maintained and comfortable and provides a safe environment for residents. All bedrooms are single and have ensuite facilities available. Residents are encouraged to bring treasured items such as photographs and pictures into the home and it was lovely to see that the majority of residents had taken this opportunity. All bedrooms have a lockable facility where belongings can be stored safety.
Vermont House DS0000016919.V344099.R01.S.doc Version 5.2 Page 17 The home has external contractors maintaining the grounds, which are safe and secure. The garden is accessible and residents informed the inspector that they enjoy sitting out in the garden under the gazebo. The home employs external cleaners to clean the home and all areas of the home visited were clean and there was no malodours. There are assisted bathing facilities around the home and arrangements are being made for the shower to have level access to enable residents in wheelchairs to be wheeled directly into the shower giving them greater choice of bathing facilities. The laundry is in the basement of the home. A new washing machine has been purchased since the previous inspection that meets all required standards to minimise the risk of cross infection. Vermont House DS0000016919.V344099.R01.S.doc Version 5.2 Page 18 Staffing
The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 27, 28, 29,30. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The number and skill mix of staff meet residents’ needs. Staff training opportunities are good enabling residents to be supported by experienced and knowledgeable staff. EVIDENCE: The home has an appropriate skill mix and compliment of staff to meet residents’ needs. All of the homes care staff have attained a care qualification which is an excellent achievement, this gives confidence that residents will be supported by knowledgeable staff. Staff recruitment and selection is generally good although two members of staff had commended work without a criminal records check (CRB). They did have a recent CRB from their previous employer which the Manager believed to be acceptable, until the new CRB was received. Legislature requires a minimum of a Protection of Vulnerable Adults check to have taken place prior to the new member of staff commencing employment and the Manager was informed of this.
Vermont House DS0000016919.V344099.R01.S.doc Version 5.2 Page 19 There were two references available within staff files checked and it was good to see that the Manager had rang to check the authenticity of the reference, there were also records of staff interviews. Job descriptions and contracts are also now available within staff files which was not the situation at the previous inspection. All new staff undertake the Skills for Care induction with records also available that they had had formal induction within the home when they had been introduced to the home, and its residents. The home just has one member of staff (the manager) who is a Christian Scientist and the Manager stated that she has been looking at ways that there are more Christian Scientist staff available. All staff receive awareness sessions of Christian Science and their beliefs and choices. Vermont House DS0000016919.V344099.R01.S.doc Version 5.2 Page 20 Management and Administration
The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 31,33,35,36 and 38. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home has effective leadership at the home. Health and Safety is adhered to and procedures ensure that residents are protected and not placed at any undue risk. EVIDENCE: The Care Manager is a Christian Scientist, Registered General Nurse and has also completed her Registered Manager’s Qualification. Residents said that the Care Manager was “very good.” Vermont House DS0000016919.V344099.R01.S.doc Version 5.2 Page 21 The home has a new quality assurance system. Feedback is sought from residents, visitors and staff as part of the development of the home. Staff meetings and resident take place at least three monthly and records were available of these meetings. It was positive to hear that the home has several residents who manage their own money. Small items of money can also be kept for residents if requested. Residents’ money is kept in individual wallets with appropriate accounting systems in place and whenever possible two signatures also confirm the transaction Staff supervision is taking place with records available to evidence this. The manager has identified key areas for a programme of supervision for her staff covering all aspects of practice including performance, career development and philosophy of the care in the home. Staff receive all required mandatory training with further training planned shortly. All maintenance records seen were up to date and complete. Regular checks are undertaken on the hot water temperature, fire alarm and emergency lighting with required records available. All required work on the electrical wiring and the lift has been undertaken since the previous inspection and records seen show that both are safe. The home also has a comprehensive fire risk assessment and staff have regular fire drills which was also required at the last inspection. Records are available of hot food temperature probing as required at the last inspection as well as the temperatures of the fridge and freezer. Records seen evidenced the imminent replacement of the dishwasher which was recommended at the previous inspection. Vermont House DS0000016919.V344099.R01.S.doc Version 5.2 Page 22 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 4 x N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 N/A 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 3 3 3 3 3 3 STAFFING Standard No Score 27 3 28 4 29 2 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 x 3 x 3 3 x 3 Vermont House DS0000016919.V344099.R01.S.doc Version 5.2 Page 23 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. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Vermont House DS0000016919.V344099.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Mucklow Office Park West Point Mucklow Hill Halesowen Birmingham B62 8DA National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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