Care Home: Old Vicarage

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What the care home does well People who live at The Old Vicarage are supported by a team of staff who they like and who treat them with respect. The atmosphere within the home is warm and friendly. People particularly like the large gardens that are well looked after. Staff enjoy working at the home. They feel that The Old Vicarage `provides an excellent home.` Visitors are made welcome and relatives are consulted and involved. One visitor to the home spoke of `an excellent staff team`. The management team work well together and paperwork is well organised and kept up to date. What has improved since the last inspection? This is the first inspection of The Old Vicarage under the new providers, Select Healthcare (2006) Limited, however as the home was previously operating before this inspection improvements have been noticed. People living at the home have made changes to their lives that have made them more relaxed and comfortable in their home. In particular some people have moved bedrooms. A maintenance worker has been appointed to make sure that all routine maintenance tasks and repairs are carried out in good time and without delay. This has also improved the standard of the accommodation. What the care home could do better: The Old Vicarage is currently performing well offering good outcomes for the people who live there. However staffing levels do not fully enable people to access the community when they want to and enjoy leisure and social activities. Increasing staffing levels will improve the overall quality of people`s life. The home must also update a policy that is currently offering conflicting advice about adult protection procedures. It is recognised that Select health care (2006) Limited have identified plans to improve both the standard of the accommodation and paperwork to make it more user friendly. The manager is aware of what he has to do and is working closely with the organisation to achieve it. CARE HOME ADULTS 18-65 Old Vicarage Church Road Baschurch Shrewsbury Shropshire SY4 2ED Lead Inspector Sue Woods Unannounced Inspection 26th February 2008 09:45 Old Vicarage DS0000070791.V356628.R01.S.doc Version 5.2 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 Old Vicarage DS0000070791.V356628.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 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. Old Vicarage DS0000070791.V356628.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Old Vicarage Address Church Road Baschurch Shrewsbury Shropshire SY4 2ED 01384 70275 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) Select Health Care (2006) Limited Daniel Andrew Brown Care Home 8 Category(ies) of Learning disability (8) registration, with number of places Old Vicarage DS0000070791.V356628.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The registered person may provide the following category of service only: Care Home Only (Code PC) to service users of the following gender: Either Whose primary care needs on admission to the home are within the following categories: 2. Learning Disabilities (LD) 8 The maximum number of service users to be accommodated is 8. Date of last inspection Brief Description of the Service: The Old Vicarage is a care home registered with the Commission for Social Care Inspection to provide personal care and accommodation for a maximum of eight adults with a learning disability. The Registered Provider of the home is Select Healthcare (2006) Limited. The registered manager is Mr Daniel Brown who is also the registered manager for The Coach House, a care home on the same site. The home is situated in the village of Baschurch, Shropshire and is within walking distance of the post office, general convenience store and local pubs. The accommodation provided is very spacious and furnished to a high standard. People who live there have their own room, some have ensuite bathrooms. Bedrooms are decorated to reflect individual choice. The home is situated in well-maintained extensive gardens. Information is shared with people who live at the home in the Service User Guide. Advocacy support is promoted and a quality assurance system is in place in the form of questionnaires. Old Vicarage DS0000070791.V356628.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 2 star. This means that people who use this service experience good quality outcomes. The inspection of The Old Vicarage took place on 26th February 2008 between 9.45 am and 3.00 pm. The inspector was joined by an expert by experience for part of the inspection who produced a report of his findings. This was the first inspection of The Old Vicarage under the new providers and we, the commission, reviewed all 22 key standards. Information to produce this report was gathered from the findings on the day and also by review of information received by CSCI prior to the inspection date. A quality rating based on each outcome area for service users has been identified. These ratings are described as excellent/good/adequate or poor based on findings of the inspection activity. As part of the fieldwork activity we spoke with everyone who lives at the home and staff on duty. Feedback via surveys was also received prior to the inspection from four people who live at the home, a relative and an advocate. Staff also completed surveys and we reviewed care plans and other documents detailed within the report. The registered manager of The Old vicarage was on duty at the time of the inspection. What the service does well: People who live at The Old Vicarage are supported by a team of staff who they like and who treat them with respect. The atmosphere within the home is warm and friendly. People particularly like the large gardens that are well looked after. Staff enjoy working at the home. They feel that The Old Vicarage ‘provides an excellent home.’ Visitors are made welcome and relatives are consulted and involved. One visitor to the home spoke of ‘an excellent staff team’. The management team work well together and paperwork is well organised and kept up to date. Old Vicarage DS0000070791.V356628.R01.S.doc Version 5.2 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. The summary of this inspection report can be made available in other formats on request. Old Vicarage DS0000070791.V356628.R01.S.doc Version 5.2 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 Old Vicarage DS0000070791.V356628.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standard 2 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. Procedures are in place to support the successful admission of a new service user to the home. EVIDENCE: As part of this inspection we spent time talking with the latest person to move in to the Old Vicarage and reviewed assessment documents that supported her move. The person was very happy with how her move had been planned and she had been involved in her assessment and with training staff to meet her identified needs. Prior to the move she had had a Community Care assessment and appropriate health and social care professionals had supported the move. The person moving in said that she had received a brochure about the home which she found useful. Old Vicarage DS0000070791.V356628.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 6, 7 and 9 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. Detailed care plans enable staff to offer the people who live at The Old Vicarage opportunities to make choices and assist with decision making as well as delivering care in a way that they prefer. Risk assessments ensure that support is given in a safe manner EVIDENCE: Care plans seen were up to date and reflected information seen in individual needs assessments produced by outside agencies. Plans are reviewed regularly and are updated, as people’s needs change. The majority of people who live at The Old Vicarage feel that they are consulted about how they spend their time, what they wear and what they eat. Likes and dislikes are recorded in care plans and staff are aware of these. The person who recently moved in to the home felt that she had been listened to and staff at the home had supported her to move in when she wanted to. Old Vicarage DS0000070791.V356628.R01.S.doc Version 5.2 Page 10 People who completed surveys said that staff treat them well and listen and act upon what they say. Risk assessments were seen on both files seen and they had been reviewed and updated to reflect new activities and opportunities. Old Vicarage DS0000070791.V356628.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 12, 13, 15, 16 and 17 Quality in this outcome area is adequate This judgement has been made using available evidence including a visit to this service. People benefit from and enjoy taking part in activities both within and outside of the home however staffing levels mean that spontaneous or more individualised activities cannot take place and this affects the overall quality of life for some people living at the home EVIDENCE: People we spoke with said that they enjoy going to social clubs, to college and to day services. While at home people enjoy singing, watching DVDs, listening to music and helping with household tasks. One person said that he is looking forward to going on a barge trip later in the year. Opportunities were limited for people to have one to one activities with staff and outings are often arranged around the needs of others. People we spoke to said that they would like opportunities for activities to improve and on the day of the inspector people had to wait for the chance to go out which was causing some frustration. Old Vicarage DS0000070791.V356628.R01.S.doc Version 5.2 Page 12 The manager and the senior staff member on duty both acknowledged that staffing levels did impact on opportunities for people and the manager agreed to review staffing levels to ensure this improved. People living at The Old Vicarage are supported to maintain and develop family relationships and stay in touch with friends. One person enjoys having a guest to stay over. Records show that people enjoy a varied diet although by not using a menu the manager cannot demonstrate that there is a choice of food on offer. People living at the home said that they like the food and have on occasion helped with meal planning and preparation. Peoples special dietary needs are understood and catered for. Old Vicarage DS0000070791.V356628.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 18, 19 and 20 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. People living at The Old Vicarage benefit from appropriate support from staff and health care professionals who ensure their personal and health care needs are met. People are safeguarded by the home’s system for handling, storing and administering medication. EVIDENCE: Personal care and support plans are very detailed and through conversations with managers and staff it was evident that they know the people who live at The Old Vicarage very well. Records detail health care appointments and the home worked closely with health care professionals to support the admission of the latest person to move in. Manual Handling assessments were in place and staff had received training to use hoists and other pieces of equipment safely. One person’s mobility needs however were not being fully met as she is waiting for specialist equipment. Old Vicarage DS0000070791.V356628.R01.S.doc Version 5.2 Page 14 Everyone who spoke with the inspector gave examples of how staff support them to meet their needs and staff on duty at the time of the inspection supported people with their personal care sensitively and discreetly. Surveys supported this observation as an advocate for the people living at The Old Vicarage noticed ‘how well respected and spoken to all clients are by staff’. He went on to say that ‘carers always listen to service users and they are always treated well’. Medication arrangements are satisfactory and the manager has recently implemented protocols to support the administration of medicines required ‘as and when’. All records seen were complete and the medication cupboard was well organised. Old Vicarage DS0000070791.V356628.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 22 and 23 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. People are protected by procedures in place for managing complaints and can be confident that their concerns will be listened to. EVIDENCE: The Old Vicarage has a complaints procedure that is shared openly with relatives and advocates as well as the people living at the home. The complaints policy was seen to detail how complaints will be managed. Select Healthcare have recently introduced their own policies and procedures for complaints, protection and abuse. These are being introduced to the home gradually over the next few months but are available for reference. We reviewed the Abuse Policy and it did not support locally agreed practices. The area manager was informed of this and will review it before its implementation. There have been no complaints received by CSCI or the home about the service provided at The Old Vicarage Arrangements for the handling of people’s money are said to be being ‘radically changed’ by the new providers and therefore were not reviewed on this occasion. Old Vicarage DS0000070791.V356628.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standard 24 and 30 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. People benefit from living in a clean, well-maintained and safe home. EVIDENCE: As part of the inspection we were invited by four people living at the home to look at their rooms. People were proud of their rooms and they were all seen to be very personalised, very tidy and very clean. One person in particular was very pleased with her en suite facilities. The maintenance worker for the home reported that, although he doesn’t yet have a budget for his works, all maintenance tasks are authorised without a problem. On the day of the inspection he was seen to be repairing a shower room. The senior care worker stated that his appointment has been very positive for the home and that all tasks are carried out promptly. Select Health care have identified areas of the home that they would like to see redecorated and refurbished. Reports produced by the area manager Old Vicarage DS0000070791.V356628.R01.S.doc Version 5.2 Page 17 identify works to be carried out including a new floor for the laundry and the refurbishment of four bedrooms. People using a wheelchair independently can not currently access all areas of the home and the management team are working to address this before one person receives a ‘motorised’ chair. Old Vicarage DS0000070791.V356628.R01.S.doc Version 5.2 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 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 32, 33, 34 and 35 Quality in this outcome area is adequate This judgement has been made using available evidence including a visit to this service. People are supported by an enthusiastic team who work hard to meet peoples needs however staffing levels within the home are not enabling people to access community resources on a regular basis meaning that they may miss out on opportunities. People who live at the home will receive a better quality service if staff that are supporting them attend all mandatory training opportunities in safe working practices. EVIDENCE: Staff who we spoke with or who completed a survey prior to the inspection were enthusiastic about their roles and enjoyed their work. One staff member said that the home provided ‘Good communication and support’ Staff also felt that The Old Vicarage ‘provides an excellent home’ and ‘service users have plenty of choice of what they would like to do’. Old Vicarage DS0000070791.V356628.R01.S.doc Version 5.2 Page 19 A visitor to the home spoke of ‘an excellent staff team’. Someone else said that ‘all staff actually care about the service users’. Although feedback into the inspection suggested that staff were well trained there were a number of gaps in peoples training in mandatory subjects. The manager reported that the new provider is aware of this and is looking to prioritise staff training. Staff files were well organised although some key information was missing. The manager reported that the new provider is aware of gaps and have produced a matrix to demonstrate that identified information is being chased up. The manager has improved practice recently by following up at least one of the two references received. Records of recent staff supervision were seen on files reviewed. Staffing levels within the home are an area where improvement is required to enable people to have better opportunities to access community resource on a more individual basis. Staff receive regular and recorded supervision and the manager stated that he is always available for informal discussions. Old Vicarage DS0000070791.V356628.R01.S.doc Version 5.2 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 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standard 37, 39 and 43 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. People living at The Old Vicarage benefit from being supported by an effective management team. The health and safety and welfare of people living at the home and support staff is promoted and protected. EVIDENCE: Daniel Brown is the registered manager of both the Old Vicarage and The Coach House. He has a Care and Management qualification. In addition he has attended short courses and is now a Fire Warden within the home The manager feels well supported by the new providers and in particular his line manager. Old Vicarage DS0000070791.V356628.R01.S.doc Version 5.2 Page 21 The registered manager of The Old Vicarage is supported by a senior support worker who is both knowledgeable and well qualified. She supported the inspection and demonstrated a calm and organised approach. New policies and procedures are being introduced gradually to the staff team and the manager is going to review and adapt all policies to make them specific to his service. Health and safety arrangements within the home are satisfactory. A Health and safety policy statement was completed by the new provider and routine safety checks are carried out as required. The manager is in the process of carrying out risk assessments for people who use cleaning products within the home Old Vicarage DS0000070791.V356628.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 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 Standard No Score 1 X 2 3 3 X 4 X 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 2 ENVIRONMENT Standard No Score 24 3 25 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 2 34 3 35 3 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 X 3 X LIFESTYLES Standard No Score 11 X 12 3 13 2 14 X 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 3 X 3 X X 3 X Old Vicarage DS0000070791.V356628.R01.S.doc Version 5.2 Page 23 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 YA13 Regulation 16 (2) (m) Requirement Timescale for action 24/04/08 2 YA23 12 (1) (a) The manager must make sure that people have opportunities to access community resources for leisure and social activities in order for them to live full and active lives as they choose. 25/04/08 The manager must ensure that the policy in place to safeguard people from abuse reflects current good practice and does not compromise guidelines for reporting crime or abuse. This is to make sure that any allegation is reported to the right people and that inappropriate evidence gathering does not compromise any investigation. RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Old Vicarage DS0000070791.V356628.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection West Midlands West Midlands Regional Contact Team 3rd Floor 77 Paradise Circus Queensway Birmingham, B1 2DT 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 Old Vicarage DS0000070791.V356628.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. 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