Inspection on 19/05/05 for Victoria House Care Home

This inspection was carried out on 19th May 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Excellent. 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 Care Home 19/12/07

Victoria House Care Home 21/06/06

Victoria House Care Home 20/12/05

Victoria House Care Home 06/05/04

Similar services:

Hillside

Applegarth

122 Scorer Street

Jubilee Villa Care Home

Thornham Grove

Beech Lodge

8 Thorndale Road (Homefield College)

Hunter`s Lodge

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

CARE HOME ADULTS 18-65 Victoria House 59 Victoria Street Newark Nottinghamshire NG24 4UG Lead Inspector Caroline Brailsford UNannounced 19 May 2005 10:30 th 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 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 Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationary 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 C53 C03 S60427 Victoria House V228204 190505 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Victoria House Address 59 Victoria Street Newark Nottinghamshire NG24 4UG 01636 708007 Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Mrs Dareen Marjorie Morgan Vera Allen CRH 3 Category(ies) of LD - Learning Disability - Both Male and Female registration, with number of places Victoria House C53 C03 S60427 Victoria House V228204 190505 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 6/5/04 Brief Description of the Service: Victoria House is a large detached property close to Newark town centre. The home caters for 3 adults with a learning disability.There is a large garden to the rear and parking to the front of the property.The home is within walking distance of all local amenities.There are 2 bedrooms to the first floor and 1 on the ground floor. There is a shower room and toilet on the ground floor and a bathroom with toilet and a separate toilet on the first floor.The home is newly registered and is decorated to a high standard. Victoria House C53 C03 S60427 Victoria House V228204 190505 Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection was unannounced and lasted for five hours. The inspector collected evidence through looking at three service users care plans and files and checking that their needs were being met. The inspector talked to all of the service users, 3 staff, the manager and the owner of the home. Some other key documents were also checked, for example risk assessments, fire logs etc. The inspector also had a tour around the building and two service users showed their rooms. What the service does well: Service users spoken with felt that their needs were well met by the home. Service users files are kept securely and appeared to be accurate on the day of inspection. Service users felt that they are involved in making decisions regarding their lives and the running of the home. The service users personal needs are documented in their care plans, as are their individual leisure and community needs. There is evidence that needs are met. The service users were happy that they go out and about and two out of the three have enjoyed a holiday abroad with the support of the staff. The menus were inspected and found to be providing a balanced diet. Service users were very happy with the food. The daily routines promote individual independence and individual needs are recognised by the staff. One service user has had particular health care needs involving regular hospital appointments and treatment. The responsible individual and the manager have ensured that the staff have had the correct training to offer the relevant support. The staff have done a good job in supporting this person through a difficult time. The premises are very clean bright and cheerful and pleasant. Service users needs are well met by a skilled, motivated staff team who clearly know the service user’s well and enjoy their job. Victoria House C53 C03 S60427 Victoria House V228204 190505 Stage 4.doc Version 1.30 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. Victoria House C53 C03 S60427 Victoria House V228204 190505 Stage 4.doc Version 1.30 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Standards Statutory Requirements Identified During the Inspection Victoria House C53 C03 S60427 Victoria House V228204 190505 Stage 4.doc Version 1.30 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users’ know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 1,2,3&5 The service users are aware of the purpose of the home and feel consulted about individual issues and the running of the home. Assessment and planning is good ensuring individual needs can be met. EVIDENCE: All service users have a copy of the Statement of Purpose. It details the service provided, although the numbers of service user’s the home can take was not included. The manager has now included details of staff and their qualifications in the document. Each service user has received a copy of the Statement of Purpose. Service users files inspected had assessments of needs completed by relevant professionals for example the community nurse. There were also other professionals involved where appropriate for example dieticians, dentists and specialists. The care plans have been developed and the files were readable, neat and well organised. There was evidence in the files tracked of service user involvement. Contracts were in place for each service user. Staff demonstrated knowledge of the service users needs and clearly knew the service user’s well. Where there are more specific individual needs these are clearly documented, staff receive the relevant training and other professionals are involved appropriately. Victoria House C53 C03 S60427 Victoria House V228204 190505 Stage 4.doc Version 1.30 Page 9 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate, in all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 6,7,8,9,&10 Service users were aware of their documentation and felt supported and consulted about their lives. Staff showed a good awareness of appropriate documentation and good processes are in place for the communication of information. EVIDENCE: Service users spoken with felt that their needs were well met by the home. One service user in particular had some complex health needs and reported that staff “always did it right” Care plans reflected these individual needs and were comprehensive and user friendly. Victoria House C53 C03 S60427 Victoria House V228204 190505 Stage 4.doc Version 1.30 Page 10 Each service user had detailed risk assessments, which included actions to be taken if they should go missing. Two risk assessments inspected did not however indicate the action required to be taken by the staff. Service users files are kept securely and appeared to be accurate on the day of inspection. The home has a policy on confidentiality and staff have signed this indicating that they have read and understood it. Service users felt that they are involved in making decisions regarding their lives and the running of the home. It is clear that staff support them in this decision-making appropriately for example choosing holidays and food etc. Service users also said that staff “helped them make their own decisions”. The responsible individual reported that the service users do not have access to an advocacy service at present. Victoria House C53 C03 S60427 Victoria House V228204 190505 Stage 4.doc Version 1.30 Page 11 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12,13,14,16,17 The daily routines promote individual independence and individual needs are recognised by the staff. The service users are supported to make their own decisions about leisure, education and employment and the budget is adequate for the activities, which take place. Staffing could be improved to facilitate more activities. EVIDENCE: The service users personal needs are documented in their care plans as are their individual leisure and community needs. There is evidence that needs are met. For example one service user’s enjoyment of gardening has been documented and this service user, with the support of the staff enjoys gardening at a local project several times a week. Relatives spoken with commented that access to leisure activities is good and the staff also felt that some leisure needs are met, staff however also reported that there is not always the staff on duty to go out as regularly as they would like. The service users were happy that they go out and about and two out of the three have enjoyed a holiday abroad with the support of the staff. One service user has not been on his holiday yet due to his health needs. Victoria House C53 C03 S60427 Victoria House V228204 190505 Stage 4.doc Version 1.30 Page 12 Staff reported that they work to meet individual needs rather that those of the group, they reported one particular service user came to them and was quite institutionalised whereas now they can see a positive difference in him, he is supported and improving in his own decision making. The menus were inspected and found to be providing a balanced diet. There has been involvement from a dietician and all service users said that they liked the food and that they could choose. Staff wear uniforms and although the services users said they did not mind, this could represent an institutional feel to the home to outsiders in the local community. Victoria House C53 C03 S60427 Victoria House V228204 190505 Stage 4.doc Version 1.30 Page 13 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 18,19,20,&21 Service users receive the personal support that they require and both physical and emotional needs are well met. EVIDENCE: One service user has had particular health care needs involving regular hospital appointments and treatment. The responsible individual and the manager have ensured that the staff have had the correct training to offer the relevant support. That is training in health care tasks required and emotional support, which may be required by that or any of the other service users. Staff were found to be competent in the knowledge and skills required and had good relationships with the service users to offer additional support. Staff have attended every hospital appointment with one service user and also supported him during a hospital stay. The relatives were happy with the support, which the staff have given. The service user said that “the staff could not be better” and they have “done a really good Job” in helping him through a difficult time. The care plan for this service user was clear and all staff spoken with were aware if relevant issues. Medication is stored appropriately and the MAR system is used. The home has a contract with a local pharmacist who has trained the staff. Codes for ‘refusal’ or ‘out of the building’ are used. There were two medicines, which had not been signed for although the manager said that they had been given. All Victoria House C53 C03 S60427 Victoria House V228204 190505 Stage 4.doc Version 1.30 Page 14 service users have been risk assessed and are not able to self medicate or keep their medication. All service users had made plans with the support of the staff in the event of their death and some sensitive work has been undertaken with one service user in particular in this area. All staff have been offered the relevant training and support on this issue. Victoria House C53 C03 S60427 Victoria House V228204 190505 Stage 4.doc Version 1.30 Page 15 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 22&23 Service users are well protected by robust policies and procedures and the staff have a good understanding of these. EVIDENCE: The home has an effective complaints procedure and staff spoken with were aware of the need to document any complaints made. Service users spoken with appeared to have a good knowledge of what to do should they need to complain and felt confident that their complaint would be dealt with. Staff demonstrated a clear understanding of adult protection issues. Appropriate strategies are in place to manage any difficult behaviour displayed by the service users and training for the staff on challenging behaviour has been organised by the manager. Victoria House C53 C03 S60427 Victoria House V228204 190505 Stage 4.doc Version 1.30 Page 16 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 24,25,27,28&30 Service users live in a homely environment, which is clean, well furnished, comfortable and safe. EVIDENCE: The premises are very clean bright and cheerful and free from offensive odours. The home is in keeping with the local community. There are no outstanding issues from either the Environmental Health Officer or Fire Officer The home is furnished to a high standard and there is a clear input evident from the service users. All service users have a single bedroom. All bedrooms have individual furniture and service users confirmed that they were involved with choosing the furniture for their bedroom. The service users spoken with stated that they had what they needed and were happy with their rooms. Victoria House C53 C03 S60427 Victoria House V228204 190505 Stage 4.doc Version 1.30 Page 17 The home has 1 shower room with a toilet on the ground floor and 1 bathroom with a toilet and a separate toilet on the first floor. All toilets and the bathroom are lockable. The home has a large, pleasant, well-established garden around the house. There is ample communal space inside the home, including an area for visitors to meet with service users in private if necessary. Staff are provided with a separate sleep-in room which is lockable. The home was very clean and free from offensive odours on the day of inspection. The laundry is sited so that soiled items do not have to go through the kitchen. The vegetables were stored in the laundry and the manager was asked to risk assess this to ensure the safety and welfare of the service user’s. The home has a policy on cross infection, which is up on the wall as a reminder to staff. Victoria House C53 C03 S60427 Victoria House V228204 190505 Stage 4.doc Version 1.30 Page 18 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31,32,33,35 Service users needs are well met by a competent motivated and committed staff team. EVIDENCE: Staff reported that they were clear regarding their roles and the roles of other’s working at the home. The staff team is a well-established group. All staff spoken with reported that they enjoyed working at the home and that there was a “good atmosphere” and “everybody got along”. Service users all reported that they liked the staff. It was evident on the day of inspection that the staff communicate well with the service users and have very positive relationships with each other. Files inspected indicated that the manager secures support from other professionals, as the service users need it. The rota was inspected and there were adequate numbers of staff to meet the needs of the service user’s. Although the service users, staff and relatives were happy with the amounts of staff on duty, the staff did report that they felt that the service users did not go out enough and an extra staff member would be beneficial. Staff appeared to know the service users well and appeared to be meeting the individual needs based on good communication systems, care planning and risk assessments. Victoria House C53 C03 S60427 Victoria House V228204 190505 Stage 4.doc Version 1.30 Page 19 Victoria House C53 C03 S60427 Victoria House V228204 190505 Stage 4.doc Version 1.30 Page 20 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. 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 are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 37,39,42 The home is well managed with clear lines of accountability. Health and safety legislation is adhered to ensuring the safety and welfare of the service user’s. EVIDENCE: The manager has now completed the NVQ 4 Award. She has ensured that all service users have effective care plans in well-organised files, which can be easily understood by staff and the service users. The manager has developed a quality assurance system; this includes a satisfaction questionnaire for the service users to complete. The proprietor now completes unannounced visits on a monthly basis, providing a written report for the manager and the Commission. The relevant fire checks take place in line with Nottinghamshire Fire department requirements. There were some risk assessment on the environment and these now need to be extended to all areas around the building. Victoria House C53 C03 S60427 Victoria House V228204 190505 Stage 4.doc Version 1.30 Page 21 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 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 CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score 3 x 3 3 3 Standard No 22 23 ENVIRONMENT Score 3 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 3 3 3 2 3 Score Standard No 24 25 26 27 28 29 30 STAFFING Score 4 3 x 3 3 x 2 Standard No 11 12 13 14 15 16 17 x 3 3 3 x 3 4 Standard No 31 32 33 34 35 36 Score 3 3 x 3 4 x CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Victoria House Score 3 4 3 4 Standard No 37 38 39 40 41 42 43 Score 3 x 3 x x 2 x C53 C03 S60427 Victoria House V228204 190505 Stage 4.doc Version 1.30 Page 22 yes 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 1 Regulation 4 Requirement The manager must ensure that the statement of purpose states how many service users the home can take.This is outstanding from the last inspection. The service users risk assessments need to be developed to ensure that all actions to be taken are clear. The vegetables should be removed from the laundry. Risk assessments must be undertaken for all areas of the home and activities. Timescale for action 1/9/05 2. 9 13 1/9/05 3. 4. 30 42 23 23 1/7/05 1/10/05 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. 2. 3. Refer to Standard 7 13 33,14 Good Practice Recommendations Service users should have access to an advocacy service should they require. The use of uniforms for staff should be reveiwed. Staffing should be reviewed to ensure that there are ample opportunities for the service users to access leisure and activities. C53 C03 S60427 Victoria House V228204 190505 Stage 4.doc Version 1.30 Page 23 Victoria House Victoria House C53 C03 S60427 Victoria House V228204 190505 Stage 4.doc Version 1.30 Page 24 Commission for Social Care Inspection Edgeley House Rivderside Business Park Tottle Road Nottingham NG2 1RT 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. 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