Inspection on 19/10/06 for Vicarage Farm Nursing Home

This inspection was carried out on 19th October 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 found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Vicarage Farm Nursing Home 28/04/08

Vicarage Farm Nursing Home 21/08/07

Vicarage Farm Nursing Home 22/05/06

Vicarage Farm Nursing Home 16/11/05

Vicarage Farm Nursing Home 20/04/05

Vicarage Farm Nursing Home 16/12/04

Vicarage Farm Nursing Home 08/06/04

Vicarage Farm Nursing Home 17/02/04

Vicarage Farm Nursing Home 07/10/03

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

CARE HOMES FOR OLDER PEOPLE Vicarage Farm Nursing Home 139 Vicarage Farm Road Hounslow Middlesex TW5 0AA Lead Inspector Ms Jean Bovell Key Unannounced Inspection 19th October 2006 11:30 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 Vicarage Farm Nursing Home DS0000010962.V313968.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. Vicarage Farm Nursing Home DS0000010962.V313968.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Vicarage Farm Nursing Home Address 139 Vicarage Farm Road Hounslow Middlesex TW5 0AA 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) 020 8577 4000 020 8572 1221 vicaragefarm@schealthcare.co.uk Southern Cross Healthcare (Management) Limited Care Home 62 Category(ies) of Dementia (0), Mental Disorder, excluding registration, with number learning disability or dementia - over 65 years of of places age (0), Physical disability over 65 years of age (0) Vicarage Farm Nursing Home DS0000010962.V313968.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. 35 mentally ill 27 elderly medically frail 5 patients with mental illness over the age of 50 (included in the total of 35) 22nd May 2006 Date of last inspection Brief Description of the Service: The home is situated in a residential area of Hounslow. It is set back from the road and has good car parking facilities. There are local shops within walking distance. There are accessible local bus routes and the home is within ten minutes walk of Hounslow West underground station. The home is set on two floors. The ground floor provides accommodation for twenty-seven service users and the first floor provides accommodation for thirty-five service users. The home provides nursing care to older people with a range of care needs to include dementia, mental disorder and physical disability. There are fifty-four single rooms and four shared rooms in the home. There is a well-maintained central courtyard area with furniture suitable for service users and their visitors. Vicarage Farm Nursing Home DS0000010962.V313968.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was carried out between 11:30am and 4:35pm on 19th October 2006. A total of four registered nurses, nine care assistants and fifty-four service users were present within both elderly mentally ill and frail elderly units at the home. During the course of the inspection, the home’s records, documents, policies and procedures were viewed. A tour of the building was undertaken and observations were made. Two registered nurses, the activities organiser, five service users and four visiting relatives were spoken with. The requirements that were made at the last inspection and all outstanding Standards were examined. The Manager Designate who was on a training day returned to the home for the purpose of the inspection and provided appropriate assistance. What the service does well: The service users appeared appropriately dressed and content. Those who spoke to the Inspector indicated that they were happy with the care they received and felt comfortable within their personalised bedrooms. Two chefs are employed at the home and meals were varied, nutritious and appealing and cultural preferences were being catered for. The home’s policies and procedures had been updated and indicated that the best interests of the service users were being safeguarded. Visitors who spoke to Inspector expressed satisfaction with the basic standards of care that were being delivered and reported that their relatives had adjusted well into the home. Overall the home was found to be clean and hygienic. The atmosphere was pleasant and calm. Vicarage Farm Nursing Home DS0000010962.V313968.R01.S.doc Version 5.2 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. Vicarage Farm Nursing Home DS0000010962.V313968.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 Vicarage Farm Nursing Home DS0000010962.V313968.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, 4 and 5. Quality in this outcome area is good. This judgement had been made using available evidence including a visit to this service. The home’s statement of purpose and service users’ guide are satisfactory. Appropriate needs led assessments which includes prospective service users and their relatives being invited to home, are carried out prior to admission. Signed contracts/statement of terms and conditions confirming that identified needs would be met at the home, are in place. EVIDENCE: The home’s statement of purpose and service users’ guide contained the required information and had been up-to-dated. It was indicated on records viewed that background information had been submitted by placing authorities in relation to prospective service users. Appropriates needs led assessment were subsequently undertaken by the home and care managers, relatives and medical professionals were involved in Vicarage Farm Nursing Home DS0000010962.V313968.R01.S.doc Version 5.2 Page 9 determining the capacity of the home to meet separate identified healthcare, personal and social care needs. Prospective service users and their relatives were invited to the home prior to admission. Signed contracts/statement of terms and conditions were within service users’ files and confirmed that specific needs would be met at the home. Vicarage Farm Nursing Home DS0000010962.V313968.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 and 11. Quality in this outcome area is adequate. This judgement had been made using available evidence including a visit to this service. A requirement made under Standard 7 relating to risk assessments had not been met. Requirements under Standards 8 and 9 relating to documentation, bedrails, oxygen and lancets had been complied with. The specific/changing personal care needs of service users are not being met satisfactorily. The policy and procedures on the death of a service user are in place and comprehensive. EVIDENCE: Vicarage Farm Nursing Home DS0000010962.V313968.R01.S.doc Version 5.2 Page 11 The records were not reflective of individual risk assessments being reviewed following falls. This requirement under Standard 7 was made at the last inspection and remained outstanding. It was reported by visiting relatives that the contenance aids of one service user on the ground floor were not being regularly changed. The Inspector was also informed by visiting relatives that a service user received appropriate medical attention for chest and urinary infections and was currently on a second course of antibiotics. However, he/she had not received additional fluids that might aid recovery and water jugs were often found empty. The Inspector observed that the service user drank very little from a cup of tea provided. Relatives confirmed that the service user had lost his/her appetite due to being unwell. These matters were discussed with the Manager who said that immediate appropriate action would be taken. It was indicated on a recently admitted service user’s file that all relevant documentation had been promptly completed. The Registered Manager confirmed that this service user had no relatives but consent in relation to bedrails was being sought from the placing authority. These requirements under Standard 8 at the last inspection had been met. In compliance with requirements under Standard 9 at the last inspection, oxygen stored at the home was seen to be securely stored and the records indicated that lancets were being used for testing blood sugar levels. The home’s policy and procedures on death and dying were in place. The Manager Designate confirmed that specific wishes and requests were ascertained during the initial assessment process or at review meetings. Vicarage Farm Nursing Home DS0000010962.V313968.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. Quality in this outcome area is good. This judgement had been made using available evidence including a visit to this service. The social and cultural needs of the service users are being adequately met at the home. EVIDENCE: The Inspector was informed by the Manager Designate that weekly Roman Catholic and Church of England services were held at the home and that service users were able to receive holy communion. The Manager Designate confirmed also, that relatives ensured that service users of other faiths maintained their practices within the home. The Activities Co-ordinator reported that Duvali celebrations were being held at the home on 20th October 2006. Vicarage Farm Nursing Home DS0000010962.V313968.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 and 17. Quality in this outcome area is good. This judgement had been made using available evidence including a visit to this service. The complaints procedure is satisfactory and the legal rights of the service users are being protected. EVIDENCE: The complaints procedure was in place. One complaint was recorded in the complaints book and was appropriately investigated and resolved. Leaflets relating to advocates were seen to be easily accessible at the home. The Manager Designate reported that service users are able to use their postal votes but that all legal issues were handled by local authority social workers. Vicarage Farm Nursing Home DS0000010962.V313968.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, 21, 22, 24, 25 and 26. Quality in this outcome area is adequate. This judgement had been made using available evidence including a visit to this service. The home is satisfactorily clean and hygienic and equipment is in place for assisting the service users. Laundering is not being satisfactorily undertaken. Immediate attention is not being given to all appliances that are in need of repair. Requirements under Standards 19, 21, 24 and 25 at the last inspection have been met. These related to the environment and water temperature. EVIDENCE: In compliance with requirements under Standards 19, 21 and 24 at the last inspection, a programme of refurbishment planned to commence in November Vicarage Farm Nursing Home DS0000010962.V313968.R01.S.doc Version 5.2 Page 15 2006 was on display and included redecoration, new carpets, chairs, tables and beds. It was evidenced that the boiler and heating system were checked on 20th October 2006. This requirement was made under Standard 25 at the last inspection. A number of service users bedrooms were viewed and the contents of drawers and wardrobes were inspected. It was observed that pairs of trousers had been folded and put into drawers or at the bottom of wardrobes. Visiting relatives expressed concern that other people’s clothing was found among service users’ belongings. The housekeeper confirmed that there were issues in relation to the laundry service but explained that this was due to various workers being involved in carrying out laundering tasks. This was discussed with the Manager Designate who gave assurances that specific laundering staff would be allocated. During a tour of the building, a refrigerator used by service users and their relatives on the ground floor, was seen to be in need of repair. The Inspector was advised by a visiting relative that an out of order sign had been in place for ‘three weeks’. This matter was brought to the attention of the Manager Designate. Appropriate equipment for assisting the service users was in place and included hoists, passenger lifts, walking aids, nurse call systems, assisted baths and grab rails. Overall, the home was found to be clean and hygienic. The environment was pleasant and calm. Vicarage Farm Nursing Home DS0000010962.V313968.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. Quality in this outcome area is good. This judgement had been made using available evidence including a visit to this service. A requirement under Standard 27 at the last inspection had been met. EVIDENCE: In compliance with a requirement under Standard 27 at the last inspection, the Manager Designate reported that interviews for recruiting new members of staff were on ongoing. One registered nurse, eight care assistants and two domestics had so far been appointed. Vicarage Farm Nursing Home DS0000010962.V313968.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): 33, 34, 35, 36, 37 and 38. Quality in this outcome area is good. This judgement had been made using available evidence including a visit to this service. Accounting and financial procedures are satisfactory. Relatives or local authorities are responsible for the financial affairs of the service users. Adequate supervision is being delivered to the care staff. The home’s policies and procedures are satisfactory. EVIDENCE: Vicarage Farm Nursing Home DS0000010962.V313968.R01.S.doc Version 5.2 Page 18 In compliance with a requirement under Standard 33 at the last inspection, copies of monthly regulation 26 visits are being submitted to the CSCI. A valid Employers Liability Insurance Certificate was in place and the business and financial plan was satisfactory. The Manager Designate confirmed that relatives or local authorities held responsibility for the financial affairs of the service users. Documented evidence of regular staff supervision was in place. The records were reflective of staff training being delivered on fire safety, food hygiene and moving and handling. Training on the protection of vulnerable adults was scheduled. This complied with a requirement under Standard 38 at the last inspection. Vicarage Farm Nursing Home DS0000010962.V313968.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 3 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 2 9 3 10 X 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 X 14 X 15 X COMPLAINTS AND PROTECTION Standard No Score 16 3 17 3 18 x 2 X 3 X X 3 3 X STAFFING Standard No Score 27 3 28 X 29 X 30 X MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score X X 3 3 3 3 3 3 Vicarage Farm Nursing Home DS0000010962.V313968.R01.S.doc Version 5.2 Page 20 Are there any outstanding requirements from the last inspection? Yes 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 13(4) Requirement Risk assessments for falls must be updated following any falls. This is re-stated from the last inspection. Previous timescale 16/06/06. The Registered Person must ensure that increased amounts of fluids are provided to service users to assist recovery of illness or when required. The Registered Person must ensure that the personal care needs of service users are regularly attended to. The Registered Person must ensure that all laundering tasks in relation to individual services users are carefully undertaken. The Registered Person must ensure that an out of order refrigerator on the ground floor is repaired. Timescale for action 15/11/06 2 OP8 12(1)(a) 15/11/06 3 OP8 12(1)(b) 15/11/06 4 OP19 16(2)(e) 30/11/06 5 OP19 16(2)(g) 15/11/06 Vicarage Farm Nursing Home DS0000010962.V313968.R01.S.doc Version 5.2 Page 21 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 Vicarage Farm Nursing Home DS0000010962.V313968.R01.S.doc Version 5.2 Page 22 Commission for Social Care Inspection West London Area Office 11th Floor, West Wing 26-28 Hammersmith Grove London W6 7SE 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 Vicarage Farm Nursing Home DS0000010962.V313968.R01.S.doc Version 5.2 Page 23 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!