Inspection on 25/04/07 for Victoria Residential Care Home

This inspection was carried out on 25th April 2007.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Victoria Residential Care Home 10/08/06

Victoria Residential Care Home 21/02/06

Victoria Residential Care Home 24/11/05

Victoria Residential Care Home 15/11/04

Victoria Residential Care Home 19/05/04

Victoria Residential Care Home 23/07/02

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

CARE HOMES FOR OLDER PEOPLE Victoria Residential Care Home 166 Church Street Wallasey Wirral CH44 8AL Lead Inspector Jeanette Fielding Key Unannounced Inspection 25th April 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 Residential Care Home DS0000018952.V335711.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 Residential Care Home DS0000018952.V335711.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Victoria Residential Care Home Address 166 Church Street Wallasey Wirral CH44 8AL 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) 0151 638 7863 Dr David Charles Downward Sheila Ann Hodgin Care Home 56 Category(ies) of Old age, not falling within any other category registration, with number (56) of places Victoria Residential Care Home DS0000018952.V335711.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 10th August 2006 Brief Description of the Service: Victoria Care Home is a large, three storey building situated in Wallasey, Wirral. The building was originally the nurses’ home for Victoria Central Hospital. The home provides care for 56 residents. All rooms are comfortably furnished and for single occupancy. There are no en-suite facilities. The home has three large living rooms and two dining rooms, a smokers’ lounge is also provided. The home is well maintained and in good decorative order. Victoria Care Home has many aids and adaptations to meet the needs of residents and there are two passenger lifts. The home does not have a garden; there is a small car park to the front of the premises. The home has a mini bus, which in fine weather is used for many outings. The home is situated near to local amenities in Liscard, which has a park, shops, pubs and churches. The home is on the bus route to Birkenhead. The fees charged are £352.24 per week. Victoria Residential Care Home DS0000018952.V335711.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection was conducted in one day over a period of seven hours. Records relating to the care of service users were inspected together with the records relating to the staff. Health and safety records and certificates were inspected and all were found to be well maintained and up to date. A tour of the premises showed that the home is clean and well maintained and that every effort is made to provide a homely atmosphere. Staff, service users and relatives were spoken to and all spoke positively about the care, the meals and the general ambiance of the home. What the service does well: What has improved since the last inspection? What they could do better: Consideration should be given to reviewing the lighting in some of the corridors and replacing these in areas that are dark and in shadow. Victoria Residential Care Home DS0000018952.V335711.R01.S.doc Version 5.2 Page 6 Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Victoria Residential Care Home DS0000018952.V335711.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Victoria Residential Care Home DS0000018952.V335711.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 3 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Detailed assessments are made on prospective service users to ensure that their care needs can be met by the home. EVIDENCE: Full information about the services and facilities that the home has to offer is available on request. Improvements have been made to the information available and this is now provided in pictorial form as well as in the written form. Considerable work has taken place to produce this information which is clear and informative. The manager or deputy manager of the home undertakes a detailed assessment of prospective service users to identify their individual care needs. During the assessment, the service users health, care and social needs are Victoria Residential Care Home DS0000018952.V335711.R01.S.doc Version 5.2 Page 9 identified and are recorded in their care files. This assessment takes place either in the service users own home or in hospital as appropriate. Information is gathered from the service user, their family and any other healthcare professional involved in their care. A specific form is used to record this information and sufficient information is gathered to enable a plan of care to be prepared. Service users are encouraged to visit the home prior to admission as this provides an opportunity for the service user to view the room available, meet with other service users and staff and for a further assessment to be made in relation to their individual abilities. The assessment also identifies specific equipment or diets that the service user will require and gives the home the opportunity to provide these in preparation for admission. Individual preferences are also recorded which are then included in the plan of care to provide information for staff. The home does not offer intermediate care. Victoria Residential Care Home DS0000018952.V335711.R01.S.doc Version 5.2 Page 10 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, 10. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The systems for the administration of medications are good with clear arrangements in place to ensure that service users medication needs are met. EVIDENCE: Work is taking place to improve the care plans for service users. Additional information is being added to some care plans and some are being rewritten following a review of the service users needs. The plans are updated in line with the changing needs of the service users to ensure that staff have full and up to date information on the care to provide. The plans are now reviewed on a monthly basis and more necessary as necessary. Risk assessments are prepared and risk management plans set in place to reduce or remove any potential risks. These are clear and informative and are agreed with the service user or their relatives as appropriate. Victoria Residential Care Home DS0000018952.V335711.R01.S.doc Version 5.2 Page 11 Records are held of all visits made to and by GP’s and other healthcare professionals together with any advice given or changes required to care provision. Medication administration records were well maintained, up to date and stored appropriately. Information is held in the home regarding all medications prescribed for service users and any potential side effects. All medications are stored safely and only designated and trained staff are permitted to administer medications to the service users. All storage areas were clean and organised. Staff were observed to speak sensitively to service users and those service users spoken to said that the staff were kind and helpful. Victoria Residential Care Home DS0000018952.V335711.R01.S.doc Version 5.2 Page 12 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, 15. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Dietary needs of service users are well catered for with a balanced and varied selection of food available that meets service users tastes and choices. EVIDENCE: The assessments on service users identifies their social, cultural and religious preferences and the records held in the home provide evidence that every effort is made to meet these. A high number of recreational and social activities are provided for service users which include reminiscence, quizzes, bingo and light exercises. The home has a minibus which is used to take service users to church, pubs, theatres and on shopping trips. Some service users recently enjoyed a boat trip. Entertainers visit the home to provide additional enjoyment for the service users. Some service users are taken out by staff and some by their families. A programme of activities is displayed on the notice board in the home. Victoria Residential Care Home DS0000018952.V335711.R01.S.doc Version 5.2 Page 13 Visitors are made welcome at the home at any time and service users meet with their visitors in the privacy of their own bedroom or in one of the communal areas. The home also has a relative’s room which provides an area where service users can meet with visitors away from their bedroom but in a private area. The meal served at the time of the inspection smelled delicious and was attractively served. Menus follow a four week rotation but are reviewed and amended according to season and in line with service users preferences. The menus provide evidence that a balanced and varied diet is offered and that choices are available. The kitchen area was clean and organised and a plentiful supply of food was stored. Fresh foods are delivered on a regular basis and are used for the majority of meals although this is supplemented by frozen foods to offer greater choice when fresh goods are not in season. Special diets can be provided on the advice of the GP or dietician or on the request of the service users. Service users spoken to during the inspection said that they enjoyed their meals and confirmed that they had the opportunity to comment on them, or make suggestions, at the residents meetings. Service users spoke highly of the staff team and the care given to them and also confirmed that their privacy and dignity were maintained at all times. The home enjoys visits from the local Church Ministers each week. Some service users are assisted to attend the local churches by other church attendees. One service users has chosen to attend church each day and is enabled to do this. Victoria Residential Care Home DS0000018952.V335711.R01.S.doc Version 5.2 Page 14 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 good. This judgement has been made using available evidence including a visit to this service. Staff have a good knowledge and understanding of Adult Protection issues which protects service users from abuse. EVIDENCE: The home has a comprehensive complaints procedure which is detailed in the statement of purpose and is also displayed on the notice board in the home. The records show that complaints made against the home have been fully investigated and responded to in accordance with the policy and procedure. Training has been given to all staff on adult abuse and of the action to be taken in the event of it being suspected. Staff were able to demonstrate their knowledge of adult abuse and adult protection during discussions with them at the time of the inspection. The home displays information on independent advocacy agency and a member of Age Concern visits the home on a monthly basis. This affords service users with the opportunity to discuss issues or seek advice independently if they choose. Victoria Residential Care Home DS0000018952.V335711.R01.S.doc Version 5.2 Page 15 A copy of Wirral Adult Protection policy is held in the home and updated training is given to all staff on a regular basis. Records of all training undertaken by the staff is held. Health and safety issues are addressed as soon as they are identified to further protect the service users. Victoria Residential Care Home DS0000018952.V335711.R01.S.doc Version 5.2 Page 16 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 and 26. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Regular investment continues to improve the appearance of the home creating a comfortable and safe environment for those living there and visiting. EVIDENCE: At the time of the inspection, it was evident that the planned programme of redecoration and improvement of the home was continuing. Corridors were being redecorated, and a number of bedrooms had been redecorated since the last inspection. The lighting in the corridors appeared dull and would benefit from being reviewed and, where necessary, replaced, to further brighten these areas. The smoking lounge has been identified for redecoration and the advice of the fire officers will be sought in relation to this room to ensure that it meets the new legislation in relation to smoking. Victoria Residential Care Home DS0000018952.V335711.R01.S.doc Version 5.2 Page 17 Bedrooms are personalised to reflect the choices and lifestyles of the service users and it is evident that staff and relatives have strived to provide a homely environment for the service users. Lounges are large, bright and pleasant and furniture was seen to be in good condition. The corridors are wide and full access to all areas of the home for those service users who require the use of a wheelchair. Two passenger lifts provide access to the upper floor. Ramps are provided on the outside of the home to provide full access. Sufficient bathrooms and toilets are provided and were clean and well maintained. The home provides hoists to assist those service users who have mobility difficulties and staff receive training in the use of these to ensure safe moving and handling. Hoists are regularly serviced and certificates were available for inspection. The décor throughout the home is good and all areas are well maintained. All areas of the home were found to be clean and there were no unpleasant odours. Victoria Residential Care Home DS0000018952.V335711.R01.S.doc Version 5.2 Page 18 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, 30. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home employs a well trained staff team to ensure that service users are provided with a high quality of care. EVIDENCE: The staff rotas show that the home employs a full staff team to provide care for the service users. Agency staff are employed to cover annual leave and sickness as necessary, although only a few agency staff hours are required to be used. Training continues to be given to all staff with 55 of the care staff team holding NVQ at level 2 or above. Additional staff are working towards this qualification. Recent training includes Adult Protection, First Aid and Basic Food Hygiene. In house training is given to staff by the senior staff and external training courses are offered. All staff have been given training on Adult Protection. All prospective staff are required to complete an application form prior to be called for interview. Two references are taken together with Criminal Record Bureau and Protection of Vulnerable Adult register checks. A full induction Victoria Residential Care Home DS0000018952.V335711.R01.S.doc Version 5.2 Page 19 programme is followed for all new staff. Records of completion of the induction programme are held on the staff files. Information about training courses are displayed in the staff room. Staff meetings are held regularly and provide a forum where staff can obtain information and offer suggestions to improve the service. All staff are given regular supervision where training needs are identified and plans for this set in place. Annual appraisals are undertaken on all staff. A selection of staff files were inspected and were found to be maintained to a good standard with all necessary information held. Victoria Residential Care Home DS0000018952.V335711.R01.S.doc Version 5.2 Page 20 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, 38. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The management of the home is strong to support and supervise the staff team and ensure that a high level of care is given to the service users. EVIDENCE: The manager and deputy manager are both experienced in care provision and hold NVQ in management at level 4. From observation of the running of the home during the time of the inspection, and from the records held, it is evident that there is an extremely strong and supportive management of the home. Both the manager and deputy work extremely well together to support and Victoria Residential Care Home DS0000018952.V335711.R01.S.doc Version 5.2 Page 21 supervise the staff and to oversee the care of the service users. It was evident that service users benefit from this leadership and management. Discussion with service users provided evidence that the service is run for their benefit and in their best interests. Service users confirmed that they were free to choose their own lifestyle within the home and that they were supported to continue with that preferred lifestyle. The service users spoke highly of the staff team. Positive reports were made about the care, the domestic and the catering staff, their attitude and the way they all worked to promote a high level of care. One service user said that the cleaners chatted to her each day and that she often heard one of them singing. She said that this was lovely and reminded her of herself when she was younger. The home does not hold any money for service users and an arrangement has been made with a local bank for a service users specific account to be made available for those who wish to use it. The manager and deputy manager were observed to supervise staff in their daily work and the records show that formal supervision is given on a regular basis. The records held in the home were well maintained an up to date. The health and safety of staff and service users is ensured through regular servicing of equipment, health and safety training and review of all services offered by the home. Questionnaires are sent to all service users and their families on a regular basis to obtain their views. These questionnaires also provide an opportunity for suggestions to improve the service. The responses to the questionnaires are audited and the records show that suggestions made are responded to. Victoria Residential Care Home DS0000018952.V335711.R01.S.doc Version 5.2 Page 22 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 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 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 3 3 X X X X X X 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 4 X 3 X 3 X X 3 Victoria Residential Care Home DS0000018952.V335711.R01.S.doc Version 5.2 Page 23 Are there any outstanding requirements from the last inspection? No STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 Refer to Standard OP19 Good Practice Recommendations Consideration should be given to reviewing the lighting provision in the darker areas of the corridors. Victoria Residential Care Home DS0000018952.V335711.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Liverpool Satellite Office 3rd Floor Campbell Square 10 Duke Street Liverpool L1 5AS 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 Residential Care Home DS0000018952.V335711.R01.S.doc Version 5.2 Page 25 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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