CARE HOME ADULTS 18-65
Victoria House Care Home 59 Victoria Street Newark Nottinghamshire NG24 4UG Lead Inspector
Dee Shelvey Unannounced Inspection 20th December 2005 10:30 Victoria House Care Home DS0000060427.V267885.R01.S.doc Version 5.0 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 Care Home DS0000060427.V267885.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 Adults 18-65. 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 Care Home DS0000060427.V267885.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION
Name of service Victoria House Care Home Address 59 Victoria Street Newark Nottinghamshire NG24 4UG 01636 708007 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) Mrs Dareen Marjorie Morgan Vera Allen Care Home 3 Category(ies) of Learning disability (3) registration, with number of places Victoria House Care Home DS0000060427.V267885.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION
Conditions of registration: Date of last inspection 19th May 2005 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 on- street parking to the front of the property.The home has easy access for service users and is within walking distance of all local amenities.There are 2 bedrooms on the first floor with a shared bathroom and a separate toilet. On the ground floor there is a further bedroom, a shower room and toilet.The home is furnished and decorated to a high standard. Victoria House Care Home DS0000060427.V267885.R01.S.doc Version 5.0 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. The inspection took place over three and a quarter hours and consisted of speaking with service users and staff, reading documents and examining records. A tour of the building also took place. What the service does well:
All the service users were spoken with and they expressed satisfaction with the home. They were aware that the home kept records and felt that they were involved in making decisions regarding their lives and the running of the home. The service users personal needs were documented in their care plans, this included individual leisure and community needs. There was evidence in records that needs are met and the service users confirmed this. The daily routines promote individual independence and staff encourage residents to be involved in domestic tasks of the home. The service users described active lives and were happy with the level of activity on offer. They are also enabled to take holidays with the support of the staff. Service users said they were very happy with the food and the menus were evidence of the provision of a varied and nutritious diet. 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. Service users needs are well met by a skilled, motivated staff team. Observations made during the inspection showed good working relationships between the owner, manager and staff. The relationship between the home personnel and service users was of mutual respect and affection. Victoria House Care Home DS0000060427.V267885.R01.S.doc Version 5.0 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 Care Home DS0000060427.V267885.R01.S.doc Version 5.0 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 Outcomes Statutory Requirements Identified During the Inspection Victoria House Care Home DS0000060427.V267885.R01.S.doc Version 5.0 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 the following standard(s): 1 and 4 Prospective service users would have sufficient information on the home to inform their choice EVIDENCE: The statement of purpose had been improved to give comprehensive information on the home. Prior to admission service users would be encouraged to visit for gradually increased amounts of time and stay for a weekend. Victoria House Care Home DS0000060427.V267885.R01.S.doc Version 5.0 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 the following standard(s): 7 and 9 Service users are encouraged to retain optimum control of their lives including taking risks. EVIDENCE: Service users had been offered an independent advocate via the community nursing service but no-one had felt the need for one. This decision is reviewed regularly. Those service users spoken with confirmed that they made decisions about all aspects of daily life with support from the staff. All care plans contain appropriate risk assessments and state how service users will be assisted to minimise risks. Victoria House Care Home DS0000060427.V267885.R01.S.doc Version 5.0 Page 10 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 the following standard(s): 11,13,14 and 15. Service users have a full and stimulating lifestyle. EVIDENCE: All the service users needs are identified in their care plans, as are the methods of meeting need. There was evidence of monitoring need in daily notes and care plan reviews. As the age range of service users is 60 to 70 years most activity centres around amenities in the local community. One service user had a one-to-one support worker and is enabled to follow a diverse selection of interests that include visiting local churches and gardening. In addition the staff had been redeployed to give them more time to spend with residents in social activities. Service users spoken with said that their visitors were made welcome and when appropriate could join in with activities. They also commented on the lovely holidays they had been on during the year. Staff demonstrated that they work to meet individual needs and did not just view service users as a group.
Victoria House Care Home DS0000060427.V267885.R01.S.doc Version 5.0 Page 11 The menus were inspected and provided evidence of a varied and balanced diet. A dietician had been consulted on nutrition and all service users said that they liked the food. Service users also confirmed that they had plenty of choice. Mealtimes were flexible to suit need and relatives could eat with the service users. Victoria House Care Home DS0000060427.V267885.R01.S.doc Version 5.0 Page 12 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 the following standard(s): These standards were not assessed on this occasion as they all met the requirements at the previous inspection. EVIDENCE: Victoria House Care Home DS0000060427.V267885.R01.S.doc Version 5.0 Page 13 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 the following standard(s): 22 and 23 Service users are well protected. EVIDENCE: These standards were briefly checked as they both met requirements at the previous inspection. The home had a set of appropriate policies on protection of vulnerable adults and service users spoken with were confident that their concerns would be taken seriously and acted upon. Victoria House Care Home DS0000060427.V267885.R01.S.doc Version 5.0 Page 14 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 the following standard(s): 26,29 and 30. The home offers an excellent standard of accommodation and although none currently require specialist equipment it would be provided if necessary. EVIDENCE: The premises were very clean, well decorated and comfortably furnished. The house cannot be distinguished from its neighbours and is in no way institutional. All service users have a single bedroom and they said they had been consulted about décor and furniture. The service users conducted the inspection of their rooms and confirmed that the layout met their needs. Each room reflected individual taste and contained evidence of people with different interests. The home had sufficient bathing facilities to meet resident need and all toilets and bathrooms were lockable to maintain privacy and dignity. There was ample communal space inside the home, including an area for visitors to meet with service users in private if necessary. Victoria House Care Home DS0000060427.V267885.R01.S.doc Version 5.0 Page 15 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 32, 34 and 35 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 and 36. Service users are supported by an efficient, well supported and supervised staff team. If stringently followed the recruitment policy would provided protection to service users. EVIDENCE: Staff on duty demonstrated a clear understanding of their roles and a good working relationship with both the proprietor and the manager. The staff team were well supported by the manager and receive regular supervision sessions, which were recorded. New staff receive induction training over 6-8 shifts and there was evidence of further training provided to equip staff fro their jobs. Service users all reported that they liked the staff. The homes recruitment policy was satisfactory but was not being followed with sufficient stringency. Open references had been accepted for one member of staff and there had been no reference from the last employer. A satisfactory check had been received from the criminal records bureaux. Victoria House Care Home DS0000060427.V267885.R01.S.doc Version 5.0 Page 16 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 37, 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 38,40,41,42 and 43. The home is run for the benefit of service users and their best interests are paramount. EVIDENCE: The proprietor and manager demonstrated a good working relationship and it was clear that there was a very open style of management at the home. The manager had completed the NVQ 4 award and had used h the knowledge gained to ensure that all service users had an effective care plans in wellorganised files. These plans were in plain English and could easily be understood by staff and service users. All other records required by statute were well kept, up to date and appropriately stored to protect confidentiality. The home had a full set of policies and procedures covering health and safety issues and there was evidence that these were reviewed annually and changed when necessary. All appropriate insurances were in place. Victoria House Care Home DS0000060427.V267885.R01.S.doc Version 5.0 Page 17 At the time of inspection the home was not keeping financial records of the service users personal allowance being paid into their bank accounts. As service users could not demonstrate an understanding of finance the manager should assist them to keep proper accounts of income and expenditure as protection against financial abuse. All relevant safety checks were made at appropriate intervals and the results properly recorded. During the inspection no potential health and safety hazards were seen. Victoria House Care Home DS0000060427.V267885.R01.S.doc Version 5.0 Page 18 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 X 3 X Standard No 22 23 Score 3 3 ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score X 3 X 3 X Standard No 24 25 26 27 28 29 30
STAFFING Score X X 3 X X 3 3 LIFESTYLES Standard No Score 11 3 12 X 13 3 14 3 15 3 16 X 17 Standard No 31 32 33 34 35 36 Score X X 3 2 X 3 CONDUCT AND MANAGEMENT OF THE HOME X PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21
Victoria House Care Home Score X X X X Standard No 37 38 39 40 41 42 43 Score X 3 X 3 2 3 3 DS0000060427.V267885.R01.S.doc Version 5.0 Page 19 No 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 YA34 Regulation Requirement Timescale for action 01/03/06 2 YA41 19(b)(i)(c) New staff must not commence work until 2 satisfactory written references have been received and the manager must assure the authenticity of such references. 17(2) The manager must assist service Schedule users to manage their finances 4 9(a) and keep full accurate records. 01/03/06 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 YA18 Good Practice Recommendations This recommendation is with reference to requirement number 2. The manager should do a risk assessment with service users on financial management and agree a method of assistance and record keeping. Victoria House Care Home DS0000060427.V267885.R01.S.doc Version 5.0 Page 20 Commission for Social Care Inspection Nottingham Area Office Edgeley House Riverside 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. Extracts may not be used or reproduced without the express permission of CSCI Victoria House Care Home DS0000060427.V267885.R01.S.doc Version 5.0 Page 21 - 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!