Inspection on 08/06/07 for Vicarage House Residential Home

This inspection was carried out on 8th June 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

Vicarage House Residential Home 17/04/09

Vicarage House Residential Home 18/07/06

Vicarage House Residential Home 17/02/06

Vicarage House Residential Home 14/07/05

Vicarage House Residential Home 08/11/04

Vicarage House Residential Home 07/09/04

Similar services:

The Vicarage

Fairfields Country Rest Home

7 Hyde Road

5 Seafield Road

Poldhu

Queensmount

Trevaylor Manor

Didsbury Court Rest Home

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

CARE HOMES FOR OLDER PEOPLE Vicarage House Residential Home 1 Honicknowle Lane Pennycross Plymouth Devon PL2 3QR Lead Inspector Jane Gurnell Unannounced Inspection 09:15 8th June 2007 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 House Residential Home DS0000003500.V334348.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 House Residential Home DS0000003500.V334348.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Vicarage House Residential Home Address 1 Honicknowle Lane Pennycross Plymouth Devon PL2 3QR 01752 779050 F/P 01752 779050 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) Dr Pepper’s Care Corporation Limited Vacant Care Home 32 Category(ies) of Old age, not falling within any other category registration, with number (32), Physical disability over 65 years of age of places (32) Vicarage House Residential Home DS0000003500.V334348.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 18th July 2006 Brief Description of the Service: Vicarage House is a detached, two storey property situated in the residential area of Pennycross, Plymouth. The home is registered to Dr Peppers Care Corporation Ltd and the Directors are Dr and Mrs Pepper. The home is registered to provide residential accommodation and personal care for a maximum of 32 older persons over the age of 65 who may also have a physical disability: an application has been made to the Commission to increase the registered numbers to 35 as an extension has created 5 new en suite single bedrooms. The home will then offer 35 single rooms. There is a chair lift and a passenger lift that provides access to the 1st floor. There is a choice of communal areas on the ground floor and a pleasant patio area. At the time of this inspection the current weekly fee ranged from £278 to £325. Items not included in the fees include chiropody treatment, hairdressing, newspapers, personal toiletries and transport costs. Information regarding the services provided at Vicarage House can be obtained directly from the home. Vicarage House Residential Home DS0000003500.V334348.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was unannounced an undertaken on 8th June 2007. The newly appointed manager was present and she and her staff team assisted the inspector throughout the inspection. Prior to the inspection, the Commission had provided the people living in the home, their relatives and staff with surveys that could be completed anonymously, allowing them to comment directly to the Commission about their experiences and views of the home. Twelve were returned and all commented favourably about the support and services provided. The inspector spoke to 19 people living in the home as well as the staff on duty and 3 visiting relatives. A tour of the building was made and documentation relating to the care of 3 people, medication practices, staff recruitment and the general running of the home were examined. Time was spent observing the daily routine of the home and the relationship between the staff and the people living in the home. Following the inspection, the inspector had the opportunity to discuss the health care needs of those living in the home with the District Nurse. She confirmed that the staff were proactive in seeking her advice and that she had confidence that health care needs were being met. What the service does well: What has improved since the last inspection? Vicarage House Residential Home DS0000003500.V334348.R01.S.doc Version 5.2 Page 6 Improvements to the pre-admission assessments and daily care notes provide much more detail about the needs of a person prior to their admission as well as their day-to-day care and support once they have moved into the home. Staffing levels have improved during the daytime and afternoon and staff no longer prepare the evening meal or wash the dishes as a cook and assistance have been employed in the afternoons and early evenings to undertake these duties. Fresh fruit is now made available at all times in the dining room. Bedroom doors have been fitted with locks to ensure each person’s privacy and the security of their belongings. An extension has been completed which provides 5 new en suite bedrooms: these have been decorated and furnished very pleasantly. The garden, although not fully completed, provides a pleasant decked patio area with seating which people said they enjoy. 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. Vicarage House Residential Home DS0000003500.V334348.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 House Residential Home DS0000003500.V334348.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): 1, 3, 4 and 5. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Pre-admission assessments and visits to the home enable people to have confidence that their personal care needs can be met at Vicarage House. EVIDENCE: Two newly admitted people to the home said that they had been able to visit before making any decisions. They said they had been given information about the services provided at the home and had been involved in an assessment to identify their care needs and whether Vicarage House was a suitable home for them. The files for one of these ladies was examined and the assessment provided a clear description of her care needs. The home’s Statement of Purpose and Service User Guide are the documents that describe the services provided at Vicarage House; these have both been updated to provide a more clear description of the management roles in the home and are available from the home upon request. Vicarage House Residential Home DS0000003500.V334348.R01.S.doc Version 5.2 Page 9 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): 8, 9, 10 and 11. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The health, personal and social care needs of those living at Vicarage House are being met and people are treated respectfully. Medication storage and administration practices are safe. EVIDENCE: Those residents spoken to and consulted prior to the inspection said they felt very well supported and received the assistance they needed promptly. Staff were described “very kind” and “friendly”. A relative said “the carers are gentle and put the wishes of the residents first”, another that “mum is treated as an individual, her likes and dislikes are respected”. The inspector spoke to 2 people who required significant assistance from staff both during the day and at night and both confirmed that their care needs were being met. They said that staff came promptly should they call for assistance. Vicarage House Residential Home DS0000003500.V334348.R01.S.doc Version 5.2 Page 10 The care plans for 3 people with whom the inspector had spent time were examined in detail. The information in the plans was very brief although a summery did give a description of the nature of the person’s care needs. The care plans did not support the care staff in proving consistent care or reflect the support being provided by the care staff. One plan was found to be out of date giving an inaccurate description of the person’s mobility, although the staff were aware of her changing needs and she confirmed she was being well cared for. Care notes provided a clear description of significant events and the action taken by staff and enabled the progress or otherwise of a person’s health and well being to be monitored. Risks associated with poor mobility, such as the development of pressure sores or of falling, were assessed and instructions given to staff to reduce the risk associated with this. The home is piloting a new style care plan format and if used as designed, would provide a much clearer, more person-centred, description of each person, their preferences, abilities and the nature of the assistance they required. The District Nurse visits the home 2-3 times a week to support the staff in meeting health care needs. The inspector spoke to the District Nurse following the inspection and she confirmed that the care staff sought advice frequently and she had confidence that peoples’ needs were being met. The manager described that the Registered Providers monitor accidents in the home, reviewing how these came about and whether any changes can be made to prevent reoccurrence. This demonstrates very good practice and the records of these reviews were available for inspection. Medication is stored safely and the records were accurate: should people wish to retain the responsibility for their medication they are supported to do so. Vicarage House Residential Home DS0000003500.V334348.R01.S.doc Version 5.2 Page 11 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): 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 can be assured of a comfortable lifestyle that encourages them to be independent and make choices. EVIDENCE: Those people spoken to, and who were able, said that they were free to come and go from the home as they wished. They were encouraged to maintain interests and friendships outside of the home. Activities are planned each weekday afternoon and a notice board in the dining room reminds people of the day’s events. Many people said they looked forward to and enjoyed these activities which include musical entertainment, bingo, keep fit and games. Once a month a visit to a local place of interest, or for a meal at a local restaurant is arranged. Two monthly residents’ meetings and a Newsletter provide people living in the home and their relatives with information about the home and forthcoming events. Vicarage House Residential Home DS0000003500.V334348.R01.S.doc Version 5.2 Page 12 Those relatives consulted prior to the inspection and those spoken to in the home confirmed they are made very welcome and have been kept fully informed about the care of their relative. The meals were described as very good and people confirmed that they can choose to take meals in their rooms or the dining room. People confirmed that they could ask for something to eat or drink at anytime and fresh fruit was seen to be available in the ding room. Vicarage House Residential Home DS0000003500.V334348.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. JUDGEMENT – we looked at outcomes for the following standard(s): 16, 17 and 18. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Complaints and suggestions from the people living in the home, relatives or other visitors to the home, are treated seriously. People are listened to and issues resolved promptly. EVIDENCE: Those people living in the home and the relatives consulted all confirmed the staff and manager were very approachable, saying they had confidence in bringing any concerns to them. The manager maintained a complaints/concerns register and this detailed the issues brought to her attention, the action taken by herself and the Registered Providers as well as the feedback given to the person(s) concerned. The two most recent entries provided evidence that the Registered Providers take seriously their responsibility to investigate concerns and ensure peoples’ needs are being fully met. All staff had received training in the protection of vulnerable adults ensuring they have knowledge about the different forms of abuse and their responsibilities should they suspect a person is at risk. Vicarage House Residential Home DS0000003500.V334348.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. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 20, 21, 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. Vicarage House provides a pleasant, well-maintained home that is comfortable and which provides sufficient facilities to meet the needs of those people current living there. EVIDENCE: The home was found to be very clean and tidy. Both private and communal areas were well maintained and pleasantly decorated. Those people consulted said they found their bedrooms very comfortable. The new bedrooms were particularly attractive and provided en suite facilities. All bedroom doors were fitted with locks to protect peoples’ privacy and the security of their belongings. The new laundry facilities were clean and spacious with sufficient equipment to meet the needs of the home. Vicarage House Residential Home DS0000003500.V334348.R01.S.doc Version 5.2 Page 15 Radiators are covered to prevent the risk of burns should a person come into contact with them when on. The hot water temperature to the baths is controlled to prevent the risk of scalding. Although the landscaping of the garden had not been fully completed, a pleasant seating area had been created which several people were seen to be enjoying. Toilets and bathrooms were clean and bath hoists are available to assist people with restricted mobility. Vicarage House Residential Home DS0000003500.V334348.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. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 and 3o. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People are cared for by well-trained and motivated staff in sufficient numbers to meet the care needs of those currently living in the home. Recruitment practices are safe. EVIDENCE: People said that they were well cared for and the staff were competent and very kind. Many of the staff have worked at the home for a number of years and as such have a great deal of experience in caring for older people. This continuity was appreciated by both the people living in the home as well as their relatives. Those staff who returned a survey, stated they felt well supported in their role and that Vicarage House had a happy atmosphere within which to work. At the time of the inspection there were 32 people living at Vicarage House. Since the previous inspection the number of care and support staff has increased: 4 care staff are available during the day, 3 in the later afternoon and evening and 2 during the night. These numbers do not include the manager who works 5 days a week. Care staff are supported by domestic and laundry staff each day staff. Catering staff are employed each day and there is Vicarage House Residential Home DS0000003500.V334348.R01.S.doc Version 5.2 Page 17 now a cook who prepares the evening meal and an assistant who washes the evening meal dishes meaning that care staff no longer take on these tasks. The manager and Registered Providers maintain a record of the current dependency levels of the people living in the home to assist in identifying the number of care staff needed at different times of the day or should there be an increase in someone’s care needs. The manager said that she consults with the staff to ensure the appropriate numbers of care staff are available, particularly at busy times of the day. The personnel files of 2 care staff were examined: one for a newly appointed member of staff. Both contained the necessary documentation including two written references and a Criminal Record Bureau Disclosure, ensuring as far as possible only suitable staff are employed. All staff were receiving Skills for Care training, a nationally recognised training course that provides them with information regarding the principles and values of good quality care as well as peoples’ rights. Vicarage House Residential Home DS0000003500.V334348.R01.S.doc Version 5.2 Page 18 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): 31, 32, 33, 25, 36, 27 and 38. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Vicarage House is a well managed home. Good consultation with the people living in the home, their relatives and the staff team ensure the home is run in the best interests of those living there. EVIDENCE: Since the previous inspection the management structure has changed. The newly appointed manager was previously the deputy manager and has worked in the home for a number of years. She confirmed that she will be applying to register with the Commission. The people living in the home, their relatives and the staff team all said that they felt the home was well run. Vicarage House Residential Home DS0000003500.V334348.R01.S.doc Version 5.2 Page 19 Comments from staff included “I feel the home is run really well due to the caring staff and managers. The home is a happy place and has a lovely atmosphere”. The Registered Providers visit the home at least weekly to meet with the people living in the home, any relatives who may be visiting and the staff. Formal meetings are held every 3 months for both people living in the home and staff and allow comment upon the quality of the services provided and information about the running of the home. The results of a recent survey by the Registered Providers regarding peoples’ experiences of being a resident at Vicarage House were displayed on the notice board and reflected a high level of satisfaction. People are encouraged to maintain responsibility for their own finances, however the home does provide safe storage should anyone wish to use this facility: individual records are maintained. Care staff received supervision to review their work performance and their training and development needs, ensuing they have the skills to met the care of older people. Staff confirmed they have received training in first aid, manual handling, fire safety as well as the care of people with dementia. The Registered Providers are committed to maintaining the home in a safe condition and have recently upgraded both the fire alarm and call bell systems. Servicing of these and the stair and passenger lifts ensure these are maintained in good working order. Vicarage House Residential Home DS0000003500.V334348.R01.S.doc Version 5.2 Page 20 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 X 3 3 3 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 3 18 3 3 3 3 X 3 3 3 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 3 X 3 3 3 3 Vicarage House Residential Home DS0000003500.V334348.R01.S.doc Version 5.2 Page 21 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. 1 Refer to Standard OP7 Good Practice Recommendations Each person’s care plan should provide an up to date description of their care needs ensuring staff have accurate information to guide the care and support given. Vicarage House Residential Home DS0000003500.V334348.R01.S.doc Version 5.2 Page 22 Commission for Social Care Inspection Ashburton Office Unit D1 Linhay Business Park Ashburton TQ13 7UP 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 Vicarage House Residential Home DS0000003500.V334348.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. 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