Inspection on 21/02/07 for Victoria House

This inspection was carried out on 21st February 2007.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. 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

Victoria House 10/12/08

Victoria House 16/06/08

Victoria House 22/11/05

Victoria House 12/07/05

Victoria House 03/11/04

Victoria House 14/05/04

Similar services:

St Vincents

The Cotswold Home

Newbeech House

Winton House

Rush Court

Hillyfield Rest Home

The Maypole Nursing Centre

The Briars

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

CARE HOMES FOR OLDER PEOPLE Victoria House 22 Nelson Place Ryde Isle Of Wight PO33 2ET Lead Inspector Ian Craig Unannounced Inspection 21st February 2007 10:00 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 Victoria House DS0000012550.V326879.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. Victoria House DS0000012550.V326879.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Victoria House Address 22 Nelson Place Ryde Isle Of Wight PO33 2ET 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) 01983 614515 01983 613370 Venetian Healthcare Limited Mrs Judith Garvey Care Home 22 Category(ies) of Dementia - over 65 years of age (1), Old age, registration, with number not falling within any other category (22), of places Physical disability (1), Physical disability over 65 years of age (5) Victoria House DS0000012550.V326879.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. This home is registered for up to 22 persons in the old age category including: 5 persons over the age of 65 years with a physical disability; 1 person over the age of 65 years with dementia. Date of last inspection 22nd November 2005 Brief Description of the Service: Victoria House is a well-appointed care home, which occupies a fine elevated site in Ryde. It boasts sea views from all the rooms at the front of the building. Whilst the home has a number of double rooms they are presently used as singles. The home has a passenger lift that provides access for residents to all levels of the building. The home offers a varied programme of social and recreational activities including music and art activities. For those that like animals the home has a large cat and a parakeet. The home has its own transport and outings are arranged to the theatre and other places of interest on the Island. The home’s fees range from £60.90 to £67.83 per day. Victoria House DS0000012550.V326879.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection consisted of a tour of the building, interviews and discussions with a number of residents and two residents’ relatives, conversations with 2 staff, discussions with the manager as well as examination of policies and procedures, records and documents. Staff were also observed interacting with residents. Four residents, and one relative of a resident, completed and returned survey forms. A visiting district nurse was also interviewed. The inspection also took account of information contained in the Commission service file. Four residents were ‘case tracked.’ This involved examination of care records and interviews of the residents. What the service does well: The home provides a comfortable and homely environment for the residents. A relative of a resident remarked that the home is always clean and that the garden is beautiful in the summer. Each bedroom has either an en suite toilet or bathroom. Staff are described by the residents as courteous and kind. Comments made included the following: • The staff are marvellous. I only have to press the bell and they come. • We’re lucky here. Nothing is too much for the staff. Residents also commented that they like the food and that there is always a choice. A visiting district nurse described the home as “good,” with high standards of personal care provided to the residents as well as careful monitoring of health needs. Residents’ needs are assessed before they come into the home, although the home does not record this. Each resident has a copy of the home’s Service Users’ Guide, which gives information about the facilities, staff, activities and complaints procedure. A Newsletter is also produced on a regular basis, which gives details of new staff, forthcoming activities and other relevant information. Victoria House DS0000012550.V326879.R01.S.doc Version 5.2 Page 6 A variety of activities are provided and the home has its own vehicle, which is used for taking residents on outings. Sufficient staff are provided and there is a staff training programme. 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 Victoria House DS0000012550.V326879.R01.S.doc Version 5.2 Page 7 contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Victoria House DS0000012550.V326879.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 Victoria House DS0000012550.V326879.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): 1, 2 and 3 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents receive information about the services provided by the home, which helps them decide if the home is the correct choice for them. Whilst the home assesses the needs of those referred for possible admission to ensure that the person’s needs can be met, these are not recorded. EVIDENCE: A copy of the home’s Service Users’ Guide is provided to each resident and is held in bedrooms. This gives details about the service provided by the home as well as the complaints procedure. Residents confirmed that they were given Victoria House DS0000012550.V326879.R01.S.doc Version 5.2 Page 10 information about the home before they moved in and a resident showed the inspector the Service Users’ Guide, which was in her bedroom. There are also opportunities for prospective residents and/or their relatives to visit the home before deciding whether or not to move in. A Residents’ information folder is available in the hall which contains copies of the most recent inspection report, the Service Users’ Guide, a residents’ charter and other relevant information. Residents confirmed that they are provided with a contract when moving in, although these were not available. Copies of contracts should be available in the home so that the home can demonstrate that this minimum standard is being met. The process of assessing potential residents needs was assessed for 4 residents recently admitted to the home. A resident confirmed that the manager interviewed her at home to assess if her needs could be met by the home. This was also confirmed by the manager, but is not supported by recording. The home has a pre admission assessment pro forma, which is not being completed. Instead, assessment details are being entered directly onto the care plan pro formas on the day of admission. Relevant social services assessments are also not being obtained prior to admission with records showing that these are received either on the day of admission or 2 days after. Victoria House DS0000012550.V326879.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): 7, 8, 9 and 10 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Whilst each person has a care plan setting out how needs are to be met, these are not always in sufficient detail. Resident’s health care needs are met with the exception that medication procedures are not safe. Residents are treated with dignity and respect. EVIDENCE: Victoria House DS0000012550.V326879.R01.S.doc Version 5.2 Page 12 The home uses a pro forma for assessing and recording each residents needs are how they are to be met. This includes mobility, personal care and hygiene, communication, mental state, nutrition and medical needs. Additional care plans are recorded setting out objectives and strategies for care and social needs. For one of the 4 residents’ records looked at, one was incomplete with no details recorded for several areas of need. Residents described the care provided by the staff as very good. One resident described how her needs require specific attention throughout the night, which staff always provide. Comments were also made by residents that staff treat them with respect and kindness. A visiting district nurse stated that he visits the home twice a week and reported that the standard of personal and health care is good. In particular, he stressed that the care staff are competent in identifying health needs and problems. Daily running records demonstrated that the home liaises with health care professionals such as general practitioners, district nurses, and that medical matters are appropriately referred. There is evidence that the home monitors weight and residents regularly see a chiropodist. Checks and treatment for eyesight and dental needs are more ad hoc with arrangements being made when needed. The inspector advised that the home should introduce a system whereby eyesight and dental checks and treatment are recorded for the purposes of monitoring, to ensure that regular checks take place. The home has policies and procedures for the handling and administration of medication. However, the home does not follow these. Each resident’s medication is removed from the blister packs supplied by the pharmacist and placed in named, lidded pots for the next 4 prescribed times, in other words, lunch, 5pm, 8pm and the following morning. These are placed on a tray for each prescribed time with the next tray balanced on top. Hence, 4 trays of medication in named lidded pots stacked on top of each other. The person carrying out the predispensing does not record the handling of medication. Staff record a signature to acknowledge that the resident has taken the medication. The inspector highlighted the risks in handling and administering medication in this way and that it is contrary to the home’s own written procedure as well as the guidelines of the Royal Pharmaceutical Society. Victoria House DS0000012550.V326879.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): 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 benefit from the provision of activities and stimulation both inside and outside the home. Relatives are made to feel welcome. The home provides a varied and nutritious diet. EVIDENCE: The home has an activity schedule, which is produced for each month. For February 2007 the activities include exercise to music, entertainment from a musician, singing sessions and reminiscence. Residents spoken to on the day of the inspection confirmed that activities are provided and include modelling, arts and crafts, painting, and musical entertainment. A relative stated that the home’s staff are skilled in gently motivating residents to take part in the activities. The survey forms sent to residents asked, “Are there activities arranged by the home that you can take part in?” One person responded Victoria House DS0000012550.V326879.R01.S.doc Version 5.2 Page 14 “always”, one person “sometimes” and the third “usually.” This indicates that the home should review the type of activities provided with a view to activities reflecting the wishes of the residents. Residents also confirmed that they have access to the home’s transport for outings especially during the summer. A relative stated that she has observed the residents using the garden during the summer. Two relatives stated that they can visit the home and are always made to feel welcome. Surveys confirmed that the residents and their relatives feel that residents are able to make decisions for themselves in the home, and that the staff listen and act on what the residents say. There is a 4-week menu plan showing a varied and nutritious diet. A number of residents were asked about the food and all the responses were that it was good, varied and supplied in ample quantities. The inspector observed the serving of the midday meal which looked appetising and contained fresh vegetables. There was a selection of desserts and fresh fruit is available for residents to help themselves to from a bowl in the hall. Victoria House DS0000012550.V326879.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): 16 and 18 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Residents’ views are listened to and the home’s procedures protect residents with the exception of staff recruitment, which leaves residents at risk of harm. EVIDENCE: Residents are supplied with a copy of the complaints procedure. Each of the residents interviewed or surveyed stated that they know what to do if they have a complaint, and residents also confirmed that they feel that staff listen to their views. The home also carries out surveys of the individual resident’s views about life at the home. Training records, notices of future courses, and interviews with staff all confirmed that staff receive training in adult protection. The Staffing section of the report highlights the recruitment procedures for newly appointed staff as not meeting minimum standards that adequately protect iresidents. Victoria House DS0000012550.V326879.R01.S.doc Version 5.2 Page 16 Victoria House DS0000012550.V326879.R01.S.doc Version 5.2 Page 17 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, 22, 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. Residents live in a clean, comfortable, well-equipped and well-maintained home. EVIDENCE: The home has historical and architectural interest. A comfortable lounge has windows giving views over the sloping garden to sea views of the Solent and Portsmouth. Residents commented how much they enjoy the views across the Solent. A dining room provides seating for all of the residents. Victoria House DS0000012550.V326879.R01.S.doc Version 5.2 Page 18 Bedrooms are located on 3 floors, which are served by a passenger lift. Bedrooms are single and each one has either an en suite toilet or en suite bathroom. Some of the residents chose to spend time I their rooms and others like to sit in the lounge. The majority of bedrooms were seen and these were found to be clean, decorated to a good standard and with numerous resident’s belongings. Bathrooms are located on each floor and the home has equipment for lifting residents in and out of the bath. There is a call point system for residents to ask for help. Several residents stated that staff always respond when the call point is activated. The home is clean and there is an absence of any unpleasant odours. Staff have received training in infection control. The home has a laundry with specialist heavy-duty washers and driers. Victoria House DS0000012550.V326879.R01.S.doc Version 5.2 Page 19 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 30 Quality in this outcome area is poor. This judgement has been made using available evidence including a visit to this service. Whilst the home provides a good level of staff that are generally well trained, the recruitment procedures for new staff do not protect the residents. EVIDENCE: The staff rota was examined which showed the provision at least three staff on duty between 8am and 8pm each day. On 18/02/07 the rota showed 4 staff on duty from 8am to 1pm, 3 staff from 1pm to 8pm and two ‘waking’ staff from 8pm to 8 am the following day. The home also provides 24 hours staff time for cleaning, a cook for 7 days a week from 7.45am to 2pm and administrative staff hours. Sufficient numbers of staff were on duty at the time of the inspection and residents expressed the view that staff numbers are adequate. Records, and discussions with staff, confirmed that each person completes mandatory training in the following: first aid, infection control, food hygiene, Victoria House DS0000012550.V326879.R01.S.doc Version 5.2 Page 20 health and safety and moving and handling. In addition to this, 70 of staff have attained NVQ level 2 or 3. Staff confirmed that they receive supervision and training. Records also showed that newly appointed staff had completed an induction programme. Additional training in the administration of medication, which follows Royal Pharmaceutical guidelines is needed and is covered in the Health and Personal Care section of this report. Recruitment procedures were checked for 2 recently appointed members of staff. These showed that the home carries out checks such as references, Criminal Record Bureau (CRB) and Protection of Vulnerable Adults (POVA), but, that the staff had commenced work before these were completed. A letter was sent to the home immediately following the inspection requiring that this is addressed urgently. Victoria House DS0000012550.V326879.R01.S.doc Version 5.2 Page 21 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, 33, 35 and 38 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Some aspects of the home’s operation are well managed, but there are also areas in need of improvement, namely, medication procedures, staff recruitment and quality assurance. These are essential to protect and benefit the residents. EVIDENCE: Victoria House DS0000012550.V326879.R01.S.doc Version 5.2 Page 22 The manager has completed the Registered Manager’s Award and the NVQ 4 in management. Medication procedures and staff recruitment need to be addressed by the home’s management. Residents complete surveys and the information is collated. Additional work is needed so that the home meets the minimum standard of having a quality assurance system involving an audit and an annual development plan. The home does not hold any residents’ monies or valuables; these are dealt with by each resident’s relative, or by the resident them self. Staff receive training in the relevant health and safety areas such as first aid, moving and handling, infection control and food hygiene. The home’s appliances are checked and serviced by qualified persons and the fire logbook showed that the fire safety equipment is tested according to fire safety regulations. There were no records to show that fire drills had been carried out, or that staff had received instruction in fire safety and evacuation since 2005. The manager stated that fire drills have been held but that the home has omitted to record this. Victoria House DS0000012550.V326879.R01.S.doc Version 5.2 Page 23 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 2 2 X X X HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 1 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 2 3 3 3 3 X 3 3 3 STAFFING Standard No Score 27 3 28 3 29 1 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 X 2 X 3 X X 2 Victoria House DS0000012550.V326879.R01.S.doc Version 5.2 Page 24 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 OP3 Regulation 14 Requirement The home must be able to demonstrate that an assessment of need has been carried out by either social services, or the homed, for those referred for possible admission. Assessments carried out by the home must be recorded. This is to ensure that the home only accommodates those whose needs it can meet. Information contained in residents’ care plans must include specific detail as to what care/assistance should be provided to meet their assessed needs. This refers to one resident’s care plan, which was incomplete. This is outstanding from the previous report. 3 OP9 17 (1) The home must handle and administer medication in accordance with the guidance of the Royal Pharmaceutical Society. Medication must not be predispensed in advance and DS0000012550.V326879.R01.S.doc Timescale for action 21/04/07 2 OP7 15 (1) 21/04/07 21/03/07 Victoria House Version 5.2 Page 25 must be administered from the pharmacist’s container at the prescribed time. This is an amended requirement, repeated from the last inspection. 4 OP29 19 Staff must only commence work 22/02/07 in the home after 2 written references have been obtained, a CRB has been applied for and a POVA ‘first’ check completed. The home must have a system of quality assurance that involves an audit and annual development plan and which incorporates the views of residents and others who are involved in the home. Fire drills must be carried out twice annually. Staff must receive instruction in fire safety twice annually. The above must be recorded. 21/05/07 5 OP33 24 6 OP38 23 (4) 21/05/07 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Victoria House DS0000012550.V326879.R01.S.doc Version 5.2 Page 26 Commission for Social Care Inspection Hampshire Office 4th Floor Overline House Blechynden Terrace Southampton SO15 1GW 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 Victoria House DS0000012550.V326879.R01.S.doc Version 5.2 Page 27 - 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!