Inspection on 22/11/05 for Victoria House

This inspection was carried out on 22nd November 2005.

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

Victoria House 10/12/08

Victoria House 16/06/08

Victoria House 21/02/07

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 Liz Normanton Unannounced Inspection 22nd November 2005 09:30 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 Victoria House DS0000012550.V251426.R01.S.doc Version 5.0 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.V251426.R01.S.doc Version 5.0 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.V251426.R01.S.doc Version 5.0 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 12th July 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 benefits from an experienced manager and motivated and experienced staff team. 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. Victoria House DS0000012550.V251426.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced inspection and the second of the inspection year. The inspection took place on 22nd November 2005 and the inspector was at the home from 9.30 am until 4.50 pm. The inspector focussed on key standards not audited at the last inspection and also looked at the environment. There were four care staff on duty that were supported by ancillary staff which included the cook and the cleaner. The maintenance man was also at the home refitting the new carpet in the dining room. The home’s proprietor was assisting him. Residents were observed to be relaxing in the two sitting rooms. During the course of the inspection the chiropodist was offering treatment in the small sitting room. A care manager was visiting a resident in the privacy of their own room. A lay preacher was observed reading biblical text to a few residents in the large sitting room. The inspector gathered information through discussion with the residents, manager, senior staff, care workers, cook and visitors. A very small number of residents raised issues about the tea-time meal, which is covered in the main body of the report. One resident was not happy that there are a larger proportion of residents who are now less mobile and require walking aids or wheelchairs. Comments from relatives were positive and they were happy with the care being provided. The inspector undertook a full tour of the property and found it to be in good order. Of the twenty standards audited eighteen were met, one was almost met and one was not met. What the service does well: The home continues to provide residents with a warm, comfortable, safe and friendly environment. The health and welfare of residents is paramount. Residents are treated with dignity and respect by all staff and management. The home employs a cook who offers residents a varied menu and is happy to discuss the menu with residents. There have been no formal complaints since 2004. The home has policies and procedures in place to protect residents from abuse. The communal areas are well decorated, have good lighting and ventilation. Attention is paid to the fabric and maintenance of the home, which provides homely pleasant surroundings. There are sufficient toilet and washing facilities to meet the residents’ needs. The home has manual handling equipment to enable staff to transfer residents from bed to seat etc. Bedrooms in the home meet with space requirements and there is sufficient space to accommodate items of residents’ furniture. The home pays attention to the need to control the spread of infection and has policies and procedures in place. The staff team are experienced and have the necessary skills, attributes, training and qualifications to meet the needs of older people. The home actively seeks feedback from residents and relatives and sends an annual questionnaire to stake holders. The home is financially viable. Residents or their representatives are given the autonomy to be responsible Victoria House DS0000012550.V251426.R01.S.doc Version 5.0 Page 6 for their financial affairs and management of their personal allowance. The home is kept clean, tidy and free from hazards. 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. Victoria House DS0000012550.V251426.R01.S.doc Version 5.0 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 Victoria House DS0000012550.V251426.R01.S.doc Version 5.0 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): The above standards were audited at the last inspection and all were met. EVIDENCE: Victoria House DS0000012550.V251426.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,9, and 10 Each resident had a care plan however these require more detailed information. The health care needs of the residents are met fully. The home has medication policies and procedures to safeguard residents, however there were a number of signatures missing from the Medication Administration Record (MAR) sheets. The home upholds the privacy and dignity of residents. EVIDENCE: The home has a policy and procedure for the storage and administration of medication. There is also a procedure for those who wish to self medicate. Medication is stored appropriately. Four care staff are designated to administer medication. A senior member of staff was observed preparing the medication for the lunchtime dosage. Medication was dispensed into named pots, which had the residents name on and then stored in the medication cupboard until time for the medication to be administered. The inspector discussed this procedure with the member of staff and the manager, as she believed that the procedure was open to mistakes being made. The manager explained that this procedure had been acceptable to the previous inspectors and that it would be extremely difficult to manage medication any other way as they have twenty-two residents. The inspector viewed the MAR sheets and found that on several occasions care staff had omitted to sign the sheet or had Victoria House DS0000012550.V251426.R01.S.doc Version 5.0 Page 10 not recorded the reason why medication had not been administered. There is a code system to record the reason why medication has not been taken and on a small number of occasions the code had not been used with the care staff putting a line. The inspector checked two residents’ medication against the MAR sheets and found them to be accurate. The home has a good relationship with the local pharmacist. Residents preferred name is written into the care plan. The home’s philosophy is to respect residents’ privacy and dignity. The home has a staff code of conduct. All new staff are taught about the significance of dignity and respect as part of their induction training. The inspector observed residents being treated with dignity and respect. Several residents confirmed that they are always treated with dignity and respect. Residents are able to meet with visitors in the privacy of their bedrooms. Care staff were observed knocking on doors. Victoria House DS0000012550.V251426.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 15 The residents are offered a choice of meals throughout the week. The weekly menu offers residents a balanced and wholesome diet. A small proportion of the residents complained about the tea-time meal, which they felt was not appealing and that often the portion they received was not sufficient to satisfy their appetite. Mealtimes were relaxed and the dining room provides pleasant surroundings. EVIDENCE: The inspector spent time talking with the cook who provides a four-weekly menu. The cook caters for residents with diabetes ensuring that she purchases diabetic products and bakes specialist cakes for them and provides separate milk puddings. The cook stated that they do consult with residents about food choices. The inspector noted that the residents are offered three meals a day and that there is a choice of two hot meals at lunchtime. Care staff were observed taking the dinner list around the home to establish residents’ choice of dinner. The inspector had dinner and found the meal to be well presented and a good sized portion. Residents stated that they had enjoyed their lunch. In discussion with a small group of residents three complained about the teatime meal which they felt was not appealing and that when fish fingers are on the menu they only get two and would prefer more. Drinks and snacks are offered between meals, and residents are offered hot milky drinks or soup at supper-time. The dining room was found to provide pleasant surroundings Victoria House DS0000012550.V251426.R01.S.doc Version 5.0 Page 12 with vases of flowers on each table. Residents are encouraged to mix with others so those who do not have dementia are rotated with the use of place names. Residents can take their time to eat meals and those not wanting to dine in the dining room can have meals elsewhere. Care staff offer residents assistance as required. Victoria House DS0000012550.V251426.R01.S.doc Version 5.0 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 18 The home has had no formal complaints since 2004. Residents and their relatives would complain directly to the manager. Residents are protected from abuse by the home’s policies and procedures. EVIDENCE: The home has a policy and procedure for handling complaints. The residents are informed that complaints will be dealt with within 28 days. Details of how to make a complaint are available in the service user guide. The inspector viewed the complaints book and noted that the last formal complaint was made in 2004. The inspector spoke with three relatives and they were aware of the complaints procedure and were very satisfied with their relatives care and had no complaints. There are policies and procedures for handling adult abuse. The home has a copy of the Isle of Wight Adult protection policy. Care staff that have completed NVQ level 2 training have covered the area of adult abuse as part of their training. The home has a “whistle blowing” policy. The inspector spoke with two care staff and both were aware of the home’s policies and procedures. Victoria House DS0000012550.V251426.R01.S.doc Version 5.0 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): 20, 21, 22, 23 and 26 The home offers residents comfortable clean and safe surroundings. There are sufficient toilet and washing facilities to meet residents’ needs. Specialist equipment is available to maximize residents’ independence. Residents’ bedrooms are appropriately furnished and are all personalised to reflect the individual’s personality. EVIDENCE: The inspector undertook a partial tour of the home, which included the communal areas and a majority of bedrooms. The home has a large dining room, with extensive views over the Solent and the home’s garden. The dining room has had a new carpet fitted and the proprietor and maintenance man were making adjustments to the carpet as it had ridden up and was a potential trip hazard. The large sitting room is well decorated and has had a new carpet fitted. The room is laid out to provide comfortable relaxing surroundings. There is also a smaller sitting room which offers a cosy environment, this room is also used when the chiropodist visits and offers residents privacy. All Victoria House DS0000012550.V251426.R01.S.doc Version 5.0 Page 15 communal areas are well furnished and decorated and provide pleasant relaxing surroundings. All bedrooms are fitted with en-suites, which includes w/c. There are separate toilet facilities for men and women on the ground floor. The ladies’ toilet is situated near the front entrance and is close to the sitting rooms. The gents’ toilet is situated near the dining room. The home has two bathrooms one on the ground floor and another on the first floor. The home has three Pedicare turntables to assist with transfers. There is a portable hoist, which was last serviced in July 2005. The first floor bathroom has a hoist, which was also serviced in July 2005. The ground floor bathroom has a battery operated hoist. The inspector observed that a large number of residents used walking aids to promote independence. Residents’ bedrooms were all found to be clean, well lit and ventilated. The bedrooms were fitted with radiators and the room temperatures were appropriate. A number of bedrooms were fitted with residents’ furniture and all had brought personal belongings to the home. The majority of the bedrooms had layout options to ensure that there is room at either side of the bed. The laundry is situated away from food preparation areas and has an impermeable floor. The washing machine has the appropriate programme for washing foul linen. There is a hand basin sited in the laundry. Residents’ clothing is labelled. The home has an infection control policy and procedure. Care staff and cleaners were observed wearing protective clothing. Soiled clothing is taken to the laundry in a yellow sack and kept separate from unsoiled items. Victoria House DS0000012550.V251426.R01.S.doc Version 5.0 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): 28 Residents are in safe hands at all times. EVIDENCE: The home is committed to training and the manager was pleased to inform the inspector that over 50 of the care staff have now completed NVQ training with others currently training. The NVQ certificates were not available for viewing as some staff have them at home and a number have not been sent out. Two care staff confirmed that they had NVQ level 2 and above. The manager is currently undertaking the Registered Managers Award (RMA) training. Victoria House DS0000012550.V251426.R01.S.doc Version 5.0 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 and 38 The home does have quality monitoring systems in place and the home is run in the best interests of service users. The home is financially viable. Residents are responsible for their own finances. There has been no formal recorded staff supervision. The welfare and safety of staff and residents is promoted and protected by the home’s policies and procedures. EVIDENCE: The registered manager and staff have daily dialogue with residents and relatives. An annual quality assurance survey questionnaire is given to residents and sent out to relatives and stakeholders. A pie chart was seen of last year’s audit giving feedback of the service that the home provides and the general outcome was positive. A separate questionnaire is provided for residents who have been in receipt of respite care. The manager stated that at the last residents’ meeting, which was held last year, residents asked for additional footstools, which the home then provided. The cook has distributed food choice slips out to residents to get feedback of their preferred meal Victoria House DS0000012550.V251426.R01.S.doc Version 5.0 Page 18 choices. The registered manager and care staff are committed to training and development with over 50 of the team trained to NVQ level 2 or above and the manager undertaking the RMA. The home meets requirements within the timescales. The home has a full complement of residents and there is an ongoing programme of maintenance work, refurbishment and staff training which are strong indicators that the home is financially viable and that residents are safeguarded by the home’s accounting and financial procedures. The proprietor was able to confirm that the home was doing well. Insurance cover is in place, the certificate is dated to June 2006 and is on display. The residents who are able maintain responsibility for their own finances. Relatives or solicitors who advocate on their behalf support residents who are less able to manage their financial affairs. The home does not have any responsibility for managing residents’ finances. There are lockable storage facilities provided in residents’ bedrooms. Residents are advised not to have large sums of money on the premises. A bill is sent to residents or their advocates for chiropodist treatment and hairdressing costs. In discussion with the registered manager the inspector discovered that care staff are not in receipt of formal supervision. The registered manager stated that care staff are supported on a daily basis and can come to her about any matter, this was confirmed by two staff. Annual appraisals had been undertaken in September. There are health and safety policies and procedures in-situ at the home which are kept in the office and readily available for staff to read. Safety notices are on display around the home. Fire tests are done weekly and tests are recorded. Island Fire Alarms tested the system on 18/08/05. The inspector asked a member care staff about the home’s fire procedure and they were able to describe what action they would take. All foodstuffs are appropriately stored and fridge/freezer temperatures are checked daily and recorded. All staff have received mandatory training in the area of health and safety and infection control. There is signed confirmation that staff have read the policies and procedures. The home has in place a generic risk assessment. There is a separate control of substances hazardous to health (COSHH) cupboard and COSHH policy and procedures. Environmental Health visited the home on the 01/11/05 there were a small number of requirements and these have been met. The home has an accident logbook and all serious incidents are reported to CSCI. Victoria House DS0000012550.V251426.R01.S.doc Version 5.0 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 x x x x x x HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 2 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 x 13 x 14 x 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 x 18 3 x 3 3 3 3 x x 3 STAFFING Standard No Score 27 3 28 3 29 x 30 x MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score x x 3 3 3 1 x 3 Victoria House DS0000012550.V251426.R01.S.doc Version 5.0 Page 20 Are there any outstanding requirements from the last inspection? 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 (1) Requirement Timescale for action 31/03/06 2 3 OP9 OP36 17 (1) 18 (2) Information contained in residents’ care plans must include specific detail as to what care/assistance should be provided to meet their assessed needs. All medication administered must 22/11/05 be signed for and a reason given if not taken. Care staff must receive formal 31/03/06 supervision at least every eight weeks and records must be kept on the staff file. 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 OP20 Good Practice Recommendations Further consideration to be given to the layout of the seating arrangements in the large communal lounge which would enable free access through the doors out into the garden without having to disturb residents who are seated near to the door. DS0000012550.V251426.R01.S.doc Version 5.0 Page 21 Victoria House Commission for Social Care Inspection Southampton, Portsmouth and Isle of Wight Ground Floor Mill Court Furrlongs Newport, IOW PO30 2AA 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 Victoria House DS0000012550.V251426.R01.S.doc Version 5.0 Page 22 - 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!