Inspection on 10/05/06 for Vine House

This inspection was carried out on 10th May 2006.

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 found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Vine House 05/10/05

Vine House 17/05/05

Vine House 23/11/04

Vine House 09/06/04

Similar services:

The Shelley

Springfield House

Sutton Lodge Nursing Home

St Helier`s Residential Hotel

St Joseph`s

Ridgemount

Wingham Court

Old Hastings House

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

CARE HOMES FOR OLDER PEOPLE Vine House Vanzell Road Easebourne Midhurst West Sussex GU29 9AZ Lead Inspector Mrs L O’Donnell Unannounced Inspection 19th May 2006 09:00 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 Vine House DS0000014819.V295297.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. Vine House DS0000014819.V295297.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Vine House Address Vanzell Road Easebourne Midhurst West Sussex GU29 9AZ 01730 815441 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) Mr Alan David Michael Hill Mrs Judith Anne Lawson Care Home 17 Category(ies) of Old age, not falling within any other category registration, with number (17) of places Vine House DS0000014819.V295297.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 5th October 2005 Brief Description of the Service: Vine House is a care establishment providing personal care and accommodation for seventeen older people (over the age of sixty five years). The home is a large detached house situated in the village of Easebourne, approximately one mile from the town centre of Midhurst with its shops and other amenities. Accomodation is provided in nine single and four double rooms situated on the ground and first floors, all bedrooms have en-suite facilities. There is a care park to the front of the home and a garden to the rear. The double rooms are let as single accommodation unless two people request to share. On the ground floor there is a lounge and dining room and there is a lift to aid access to the first floor. Vine House DS0000014819.V295297.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This visit was unannounced and took place over 6 hours, commencing at 10.15am. Prior to the inspection, the Inspector reviewed the previous inspection report and any communication received since that inspection. During the visit, the Inspector spent approximately 50 of the time speaking with residents, and 50 speaking with staff, the Registered Manager and reviewing a variety of records including, care plans, staff recruitment and training records, and accident and incident forms. Three surveys completed by residents of the home have also been received, along with one relatives/visitors comment card. In addition a full tour of the home was undertaken. It was noted that as a result of work undertaken at the home, all but one of the requirements made at the last inspection had been met. What the service does well: What has improved since the last inspection? Risk assessment and weekly monitoring is now in place for residents who selfadminister medication. New induction training is in place for staff 9 members of the staff team are now studying for their National Vocational Qualification There are clear lines of responsibility in place between the Registered Manager and the Registered Provider. Environmental issues highlighted at the last inspection have been addressed. Vine House DS0000014819.V295297.R01.S.doc Version 5.2 Page 6 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. Vine House DS0000014819.V295297.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 Vine House DS0000014819.V295297.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 3, 6 Quality in this outcome area is good. This judgement has been made from evidence gathered both during and before the visit to this service. The individual needs of prospective residents are assessed prior to admission to the home. Intermediate care is not a service offered at the home. EVIDENCE: Although no new residents had moved into the home since the last inspection, a pre admission assessment had been carried out for a prospective resident who was expected to move into the home shortly. In addition a pre admission assessment was seen for one other current resident. Both of these demonstrated that in using the standard pre admission assessment format sufficient information was obtained on health, personal and Vine House DS0000014819.V295297.R01.S.doc Version 5.2 Page 9 social care needs to determine if the home can meet the individual needs of the prospective resident. Vine House DS0000014819.V295297.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 at least once during a 12 month period. 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 from evidence gathered both during and before the visit to this service. Residents have a care plan in place which provides details of their health, personal and social care needs and how these are to be met. The health care needs of residents are promoted and maintained. Residents, where appropriate, are responsible for their own medication and are protected by the homes policies and procedures for dealing with medicines. Residents are treated with respect and their right to privacy is upheld. EVIDENCE: The care plans of three residents were reviewed during the inspection. Each of these detailed the individual health, personal and health care needs of each resident and how these were to be met by the staff team. Vine House DS0000014819.V295297.R01.S.doc Version 5.2 Page 11 The care plans are reviewed at least each month. In addition daily notes are kept for each resident and it was noted that within these a detailed record is maintained, particularly where a residents needs are changing. Risk assessments are in place for identified risk areas. It was noted that relatives had been involved in agreeing and signing care plans. It was clearly demonstrated through reviewing care plans, speaking with residents and staff, and a visiting health professional, that the health care needs of residents are promoted and maintained. Residents were satisfied that their health care needs were met. Staff demonstrated a good awareness of individual needs. The visiting health care professional advised that they had provided training to assist staff in meeting specific needs. Residents have access to doctors as required and the outcome of any health professional visit is recorded within their care plans. Mental health care needs are monitored and any changing needs are recorded within care plans with referrals made to health professionals as necessary. Appropriate policies and procedures are in place in respect of the administration of medication. Medicines were seen to be stored securely and all records were up to date. The home has a pharmacy agreement in place with a local pharmacist who has also provided training for staff members. Residents are able to self-administer medication, following assessment. It was noted that lockable storage in their rooms is available. A risk assessment is in place and weekly monitoring of medication is undertaken. During the inspection, it was noted that staff treated residents respectfully and upheld their right to privacy. Residents were satisfied that staff treated them with respect. All residents who completed a survey were satisfied that they always received the care and support they needed. Within the relative/visitor comment card they advised that they were satisfied with the overall care provided. Vine House DS0000014819.V295297.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 at least once during a 12 month period. 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 from evidence gathered both during and before the visit to this service. Routines of daily living and activities provided are flexible and varied and meet the needs and expectations of residents. Residents are able to have visitors at any reasonable time. Residents are supported to exercise choice and control over their lives. Residents enjoy a varied, appealing and balanced diet. EVIDENCE: The social care needs of residents are recorded within care plans. Residents expressed satisfaction with the routines of daily living and activities provided. Residents advised that they can chose what they wish to do and when. Some residents are able to maintain links with the local community and use local amenities; others enjoy activities provided within the home including a variety of visiting musical entertainers. Comments on resident surveys included ‘I enjoy the entertainments and activities arranged by the home. Vine House DS0000014819.V295297.R01.S.doc Version 5.2 Page 13 Residents confirmed that they are able to have visitors at any reasonable time and are able to see their visitors in private. Within the comment card received the relative/visitor advised that they are welcomed within the home and can visit their relative/friend in private. A number of residents have made friends with each other and visit each other in their rooms as they wish. Residents are supported as necessary to exercise choice and control over their lives. A number confirmed that they were able to bring their own furniture and personal possessions into the home when they moved in. In discussion with the cook and reviewing menus and records kept of food served within the home it was clear that a wide range of nutritious and appealing meals are served within the home. The vast majority of meals are home cooked using fresh ingredients. Residents have a choice at each mealtime, with further alternatives available. All residents confirmed that they enjoyed the meals served, and that they always had a choice. Residents who completed surveys confirmed that they usually liked the meals served with comments including ‘an alternative of ones choice is always available’ and ‘the cook is always very helpful in sorting out meals’ (to meet individual needs). Residents chose where they wish to eat their meals, either in the dining room or within their rooms. The cook and other staff demonstrated a good awareness of individual likes, dislikes and dietary needs, and this was confirmed by the meals served at lunchtime, with both the fish and accompanying vegetables cooked in different ways to meet those individual needs and preferences. The Inspector joined the residents for lunch in the dining room. The main choice that the residents had was fish, however jacket potatoes or egg salad were also available. Lunchtime was relaxed and unhurried with staff available to assist residents as necessary. Vine House DS0000014819.V295297.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 inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16, 18 Quality in this outcome area is good. This judgement has been made from evidence gathered both during and before the visit to this service. There is a clear and accessible complaints procedure available. Residents are protected from abuse EVIDENCE: There is an appropriate complaints procedure in place, a copy of which is displayed within the entranceway to the home. No complaints had been received since the previous inspection. Residents advised that they had had no reason to complain or raise concerns about life within the home, but were aware of who they would speak with if necessary. Residents who completed surveys advised that they knew who they would speak with if they were not happy about something, and how they would make a complaint if necessary. Appropriate policies and procedures were in place in respect of the protection of vulnerable adults. Staff have received training in this. In addition it was noted that adult protection and abuse awareness training is included within the induction training of new staff. Vine House DS0000014819.V295297.R01.S.doc Version 5.2 Page 15 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): 19, 26 Quality in this outcome area is good. This judgement has been made from evidence gathered both during and before the visit to this service. Residents live in a safe, well-maintained environment. The home is clean, pleasant and hygienic EVIDENCE: A full tour of the home was undertaken with the Registered Manager. This demonstrated that the home is suitable for its stated purpose, it is accessible, safe and well maintained. At the last inspection a number of requirements had been made in respect of the environment. During this inspection it was noted that work has been undertaken to address this, in particular, all portable electrical equipment has now been tested, the carpet in one room considered to be a trip hazard has been replaced, and the radiator at the top of the stairs has been covered. Vine House DS0000014819.V295297.R01.S.doc Version 5.2 Page 16 There is a pleasant lounge with access to the rear garden, which is well maintained, and also provides external seating. There is a separate dining room, which some residents chose to use for mealtimes. All communal areas were clean and tidy. Residents who completed surveys confirmed that the home was always clean and fresh. There is a separate laundry area. It was noted at the last inspection that improvements could be made to the laundry floor to ensure that it is impermeable. This was discussed with the Registered Manager who advised that the Responsible Individual is currently reviewing this with the intention of improving the current flooring. Vine House DS0000014819.V295297.R01.S.doc Version 5.2 Page 17 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): 27, 28, 29, 30 Quality in this outcome area is good. This judgement has been made from evidence gathered both during and before the visit to this service. Residents needs are met by the numbers and skill mix of staff Residents are supported and protected by the homes recruitment policy. Staff receive training appropriate to meet the needs of residents. EVIDENCE: Staffing rotas were reviewed during the inspection and these showed that two members of staff are available on both the late and early shift and also a cleaner and cook work on a daily basis. At night there is a waking night and sleeping-in person on shift. Concerns were raised at the last inspection, as the then acting manager, now Registered Manager, was one of the staff on the rota to provide care, with no time allowed for her to carry out her management roles and responsibilities. This was discussed with the Registered Manager who confirmed that she now has administrative support for two mornings each week, and she considers that this allows her suffient time to fulfil the management responsibilities. Concerns had also been raised regarding staffing levels particularly in the morning given the dependency levels of residents at that time. It was noted at this inspection that the dependency levels have changed with fewer residents Vine House DS0000014819.V295297.R01.S.doc Version 5.2 Page 18 requiring full support of one or more carers, and therefore the current staffing levels would appear to be appropriate. However the Registered Manager and Responsible Individual must keep staffing levels under review, in order to ensure that they are sufficient to consistently meet residents needs. The recruitment records for three new members of staff were seen and these demonstrated that all appropriate checks are undertaken on staff prior to commencement of employment. Staff members now have contracts in place. Records seen showed that training in areas such as abuse awareness have been undertaken. The training priority for staff at present is the National Vocational Qualification level 2, with 9 members of the staff team starting this recently. The Registered Manager advised that other mandatory training will also be provided as required. Throughout the day residents spoke highly of the staff team, with comments including, ‘they are very kind’, ‘all you have to do is ask and they will help’. Comments on surveys included ‘the staff are always friendly and helpful’. Vine House DS0000014819.V295297.R01.S.doc Version 5.2 Page 19 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): 31, 33, 35, 38 Quality in this outcome area is good. This judgement has been made from evidence gathered both during and before the visit to this service. The Registered Manager is qualified, competent and experienced to run and manage Vine House There are quality assurance and quality monitoring systems in place however these would benefit from being further developed to include an annual development plan. The financial interests of residents are safeguarded The health, safety and welfare of residents and staff are promoted and protected as far as is reasonably possible. Vine House DS0000014819.V295297.R01.S.doc Version 5.2 Page 20 EVIDENCE: The Registered Manager has recently successfully completed the registration process with the Commission to become the Registered Manager, through this process she demonstrated her fitness to act as manager. In discussion with the Registered Manager it was clear that following her registration there are now clear guidelines in place in respect of her role and responsibilities, particularly in relation to how those fit with the role of the Responsible Individual, which had been an area of concern at the last inspection. A quality assurance system has been used at the home. This was based on satisfaction questionnaires, which were sent to residents and their families and friends. The outcomes of these were published and are placed on the notice board of the home. No further work has been done on this. The importance of effective quality assurance and monitoring systems was discussed, along with the production of an annual development plan. The Registered Manager was advised that the Commission will be producing a tool to assist homes in this and the Registered Manager confirmed that they will incorporate this into their own system once it is available. Residents spoken with confirmed that either they or their relatives manage their financial affairs. The Registered Manager advised that on occasion they do keep small amounts of money for residents, however no money was being held for any of the current residents. There are policies and procedures in place in relation to safe working practices. All equipment within the home is regularly serviced. Risk assessments are in place and all accidents or injuries are recorded. Vine House DS0000014819.V295297.R01.S.doc Version 5.2 Page 21 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 2 STAFFING Standard No Score 27 3 28 2 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X X 3 Vine House DS0000014819.V295297.R01.S.doc Version 5.2 Page 22 Are there any outstanding requirements from the last inspection? Yes STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard OP33 Regulation 26 Requirement Where the registered provider is an individual, but not in day to day charge of the care home, he shall visit the care home at least once a month, and interview service users and their representatives in order to form an opinion of the standard of care, inspect the premises, inspect if record of events and records of any complaints and prepare a written report on the conduct of the home. The Registered Provider shall supply a copy of the report to the Commission. (Previous date for compliance 31/10/05) Timescale for action 30/06/06 Vine House DS0000014819.V295297.R01.S.doc Version 5.2 Page 23 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 OP23 Good Practice Recommendations To assist with infection control consideration should be given to re-painting the laundry room floor. Vine House DS0000014819.V295297.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Worthing LO 2nd Floor, Ridgeworth House Liverpool Gardens Worthing West Sussex BN11 1RY 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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