Inspection on 26/04/07 for Vesta Lodge

This inspection was carried out on 26th April 2007.

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

Vesta Lodge 16/05/06

Vesta Lodge 14/02/06

Vesta Lodge 17/02/05

Vesta Lodge 23/11/04

Similar services:

Claremont House

Oak Ridge

Sun Court Nursing Home

Ashville House

Bramley Avenue (73)

Bilney Hall

Hill Barn

Mabbs Hall Nursing Home

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

CARE HOMES FOR OLDER PEOPLE Vesta Lodge Watling View St Albans Hertfordshire AL1 2PB Lead Inspector Jeffrey Orange Unannounced Inspection 26th April 2007 07:25 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 Vesta Lodge DS0000019602.V337557.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. Vesta Lodge DS0000019602.V337557.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Vesta Lodge Address Watling View St Albans Hertfordshire AL1 2PB 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) 01727 799600 01727 799663 vesta@quantumcare.co.uk www.quantumcare.co.uk Quantum Care Limited Patricia Marie Smith Care Home 61 Category(ies) of Dementia - over 65 years of age (61), Old age, registration, with number not falling within any other category (61), of places Physical disability over 65 years of age (61) Vesta Lodge DS0000019602.V337557.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: There are none Date of last inspection 21st December 2006 Brief Description of the Service: Vesta Lodge offers care and accommodation to sixty-one older people, who may also have dementia or a physical disability. Vesta Lodge is a purpose-built home set in extensive gardens and is operated by Quantum Care a not for profit organisation. The ground floor comprises two units - Willow, for people with dementia, and Laburnum for people with high dependency; the first floor has Freesia unit for dementia care and Mimosa for high dependency. Each unit consists of dining room, lounge, en-suite bedrooms, small kitchen, bathroom, shower room and sluice. At the front of the ground floor there is a large reception area, sun lounge, day care and activities room, offices, kitchen and laundry. There is a small parade of shops close to the home and St Albans town centre is easily accessible via public transport. The home has an information brochure, Statement of Purpose and Service User’s Guide available to prospective residents, together with copies of the latest inspection report from the Commission for Social Care Inspection.(CSCI) Current fees range from £505 to £590 per week. (At April 2007). (Additional charges are made for items and services such as newspapers, toiletries, hairdressing and chiropody.) Vesta Lodge DS0000019602.V337557.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection site visit took place over approximately six hours, starting at 7.30 am which provided an opportunity to observe the early morning routine in the home. It was also possible to speak to people who live in the home, to the staff who provide care for them and to the home’s management team. Key records were also examined, including those for the administration of medication, staff recruitment and care planning. This report is also informed by any information received by the CSCI since the previous key inspection in May 2006, and also includes the information obtained during a national themed inspection undertaken in December 2006. The ongoing process of inspection for Vesta Lodge will continue to take account of any information received from the home or from surveys that may be conducted by the CSCI. What the service does well: What has improved since the last inspection? The standard of medication administration has improved and the physical environment of the home has been improved through redecoration of those areas that had become rather tired and worn and in particular the communal bathrooms have been enhanced and made more attractive. Activities have benefited from the additional support of a dedicated activities organiser. Vesta Lodge DS0000019602.V337557.R01.S.doc Version 5.2 Page 6 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. The summary of this inspection report can be made available in other formats on request. Vesta Lodge DS0000019602.V337557.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 Vesta Lodge DS0000019602.V337557.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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 1 3 (Standard 6 does not apply to Vesta Lodge) Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. The information provided for prospective service users is clear and detailed and ensures that a well-informed judgement can be made about the home, what is offered and what the terms and conditions that apply are. The assessment process is thorough and should ensure that only those whose needs can be appropriately met, are admitted to Vesta Lodge EVIDENCE: The Quantum Care “Personal Guide” provides not only the minimum required information but also additional detail, all in a very clear and accessible format. Quantum Care also use their web site to provide information for those people who wish to access it that way. Vesta Lodge DS0000019602.V337557.R01.S.doc Version 5.2 Page 9 A series of files for recently admitted service users were seen and these contained the detailed information that staff would require in order to both identify and meet service user’s needs. “We are very lucky here” was a comment that typifies the very positive view expressed throughout this visit of the way that the care needs of people living in Vesta Lodge are being met. Vesta Lodge DS0000019602.V337557.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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 7 8 9 10 11 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People who live in Vesta Lodge have access to the healthcare services they require either in the home or community. Care plans are adequate and if the standard of the best was consistently achieved could be good. The home has thorough medication policies and procedures and the standard of practice and recording found during this visit was satisfactory. This should ensure that those people who rely on the home to administer their medication can be confident that it is done safely. Regular checks are made by the home’s management to monitor practice and a system for the recording of any errors that do occur is in place that should ensure that these are identified and rectified promptly. Vesta Lodge DS0000019602.V337557.R01.S.doc Version 5.2 Page 11 EVIDENCE: A Community Nurse spoken with during this inspection site visit confirmed that in her experience communication with the home was satisfactory and that the standard of care seen was good. Care plans contain detailed evidence of the involvement of a range of healthcare professionals with people who live in Vesta Lodge and arrangements for visits by community healthcare staff were made during this visit. Care plans are basically adequate, containing the information staff need to identify and review the care needs of people living in Vesta Lodge. The standard and accuracy of completion varies however. Spot checks were made of medication records on several units and those seen were up to date and accurate. The storage of medication has been improved and the manager in charge of medication routinely monitors staff performance in the administration of medication to people living in Vesta Lodge. Throughout this visit staff were seen to treat people living in the home with respect and dignity, for example when assisting them with meals or in making transfers from one part of the home to another. Comments from late residents’ relatives included; “She was helped to spend her final days in a peaceful and caring environment” and others described how staff helped to make the immediate aftermath of death a positive celebration of the resident’s life. Vesta Lodge DS0000019602.V337557.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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 12 13 14 15 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The range and scope of activities inside and outside the home has been improved and is being further developed to ensure that all people who live in Vesta Lodge can be involved in appropriate, meaningful activities. Service users are supported to make choices and decisions about how they wish to live in Vesta Lodge and receive well-cooked and nutritious meals. Visitors to people living in Vesta Lodge are both welcomed and encouraged. EVIDENCE: An additional activities organiser, with dedicated time and resources is now employed and several people living in the home were positive about the increased range of activities this has made possible. Vesta Lodge DS0000019602.V337557.R01.S.doc Version 5.2 Page 13 The specific provision for people living in the home with dementia has been maintained and further developments are being planned. Staff have obtained, through appropriate training, an increased awareness of the needs of people with dementia and this knowledge has been translated into improved care, insofar as care staff help to provide one to one and small group activities as part of the overall provision of activities within the home. Resident’s meetings are held at which people who live in Vesta Lodge can comment on the daily life of the home. Quantum Care also carry out a regular consultation process with those people living in their homes. Visitors spoken to during this visit confirmed that they are made to feel welcome and that their visits are never unreasonably restricted. Cooked breakfasts were being enjoyed during this visit and people living in Vesta Lodge confirmed that they are always offered choices of food at each meal. Vesta Lodge DS0000019602.V337557.R01.S.doc Version 5.2 Page 14 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 18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. There is a comprehensive, robust and well publicised complaints policy in place, which should provide confidence to people who live in Vesta Lodge that any complaint or concern will be dealt with appropriately. The provision of staff training and a good knowledge within the home about safeguarding potentially vulnerable people means that people living in Vesta Lodge can be confident that they will be protected from abuse. EVIDENCE: The complaints records have been reviewed and now capture in more detail some of the issues and concerns that were previously not necessarily recorded. Staff spoken to confirmed that they had received training in how to recognise actual or potential abuse and how to respond if it is seen or suspected. Details of the complaints policy and procedure is well publicised in preadmission documentation, in the home’s Service User Guide and in the home. Vesta Lodge DS0000019602.V337557.R01.S.doc Version 5.2 Page 15 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 21 22 26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Vesta Lodge provides an environment that is pleasant, safe and well maintained for the people who live and work there. The communal bathrooms are now more pleasant places in which to enjoy the bathing experience, provided that they are not cluttered with the storage of ancillary items. The home is well lit, clean and tidy and there are little or no problems with offensive smells. EVIDENCE: When the inspection visit started at 7.25 am, a quick tour of all floors found that communal areas were clean and tidy and free from any smells. Vesta Lodge DS0000019602.V337557.R01.S.doc Version 5.2 Page 16 Housekeeping staff spoken to were committed to the maintenance of a high standard of hygiene and this was evident throughout this visit. Housekeeping staff receive training in basic awareness of dementia as well as more obvious subjects such as dealing with potentially hazardous chemicals and infection control. Decorators were in action on one unit in particular, redecorating communal areas and those areas of the home that gave rise to some concern following the previous key inspection have been improved. Special attention was paid to bathroom areas, which have now been enhanced by the addition of appropriate ornaments and decoration. This should help make the bathing experience more attractive for people living in Vesta Lodge. The current use of bathrooms for storage potentially detracts from their appearance and functionality. Vesta Lodge DS0000019602.V337557.R01.S.doc Version 5.2 Page 17 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 good. This judgement has been made using available evidence including a visit to this service. People who live in Vesta Lodge can have confidence in the staff that care for them. There are consistently sufficient numbers of staff on duty, with the necessary skills and qualifications to meet the care needs of people living in the home. Quantum Care has a good system of staff recruitment and the checks made and information received should provide people living in the home with the confidence that unsuitable people will not be employed to care for them. Staff meetings take place regularly as does staff supervision, both of which offer support to the staff team and help to promote and monitor good care outcomes for those living in the home and receiving care. EVIDENCE: Staff spoken to were able to confirm the details of training that they have received which was appropriate to the specific needs of people with dementia as well as more general training in care. Training records were seen to detail when refresher training in key areas was required. Vesta Lodge DS0000019602.V337557.R01.S.doc Version 5.2 Page 18 The numbers of staff with at least NVQ level 2 in care is approaching 50 Minutes of staff meetings and records of staff supervision were seen. No adverse comments were received during this visit about staff, either in terms of their skill and efficiency or the numbers on duty. Recruitment records for recently recruited staff were found to include the required checks and information to ensure that people living in the home are protected. Vesta Lodge DS0000019602.V337557.R01.S.doc Version 5.2 Page 19 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 38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The management team at Vesta Lodge provide for the efficient operation of the home in order to meet the needs of the people living there. The home has comprehensive policies and procedures in place, which are effectively monitored in order to ensure services are provided safely and competently and that the needs of those people living in the home are at the centre of decisions made. EVIDENCE: Vesta Lodge DS0000019602.V337557.R01.S.doc Version 5.2 Page 20 The registered manager holds the Registered Managers Award and is supported by a well- qualified and experienced staff team, including some who have completed an extended dementia care course. Records of residents meetings are available and Quantum Care has a wellestablished system of quality assurance that includes residents’ forums and annual satisfaction surveys. An auditor was in the home on the day of this visit carrying out an audit of some of the home’s financial records and administrative practices. This should offer additional protection for those living in the home. There were again no obvious breaches of good health and safety practice seen during this visit. Vesta Lodge DS0000019602.V337557.R01.S.doc Version 5.2 Page 21 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 4 X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 3 10 3 11 3 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 X 3 2 X X X 3 STAFFING Standard No Score 27 3 28 2 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X X 3 Vesta Lodge DS0000019602.V337557.R01.S.doc Version 5.2 Page 22 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(2)(b) Requirement The process of active review of care plans must now be given a higher priority so that a consistently high standard is achieved. Timescale for action 30/08/07 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 2 Refer to Standard OP22 OP28 Good Practice Recommendations The storage needs of the home in respect of aids and equipment should be reviewed and action taken in the light of that review. The home should make every effort to increase the existing proportion of staff with at least NVQ level 2 in care to 50 . Vesta Lodge DS0000019602.V337557.R01.S.doc Version 5.2 Page 23 Commission for Social Care Inspection Hertfordshire Area Team CPC1 Capital Park Fulbourn Cambridge CB21 5XE 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 © 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 Vesta Lodge DS0000019602.V337557.R01.S.doc Version 5.2 Page 24 - 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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