Care Home: The Old Rectory

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What the care home does well Residents at the home were being well cared for and supported by the managers and staff. Residents spoken with said the quality of the care was good. Visitors are made welcome at any time. The premises are clean and safe and the standard of the accommodation is good. Staff were well trained and show commitment towards giving good care. What has improved since the last inspection? There had been a noted improvement in the activities offered. The menus offered more residents choices. Residents spoken with confirmed that the atmosphere with in the home was more relaxed. What the care home could do better: At the time of the inspection there were no improvements required. It is important that the home sustains the above improvements ensuring good outcomes for residents living at the home. Key inspection report Care homes for older people Name: Address: The Old Rectory 195 Wigan Road Standish Wigan Greater Manchester WN6 0AE     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home is meeting the needs of the people who use it. We give a quality rating following a full review of the service. We call this full review a ‘key’ inspection. Lead inspector: Judith Stanley     Date: 3 0 0 3 2 0 1 0 This is a review of quality of outcomes that people experience in this care home. We believe high quality care should • • • • • Be safe Have the right outcomes, including clinical outcomes Be a good experience for the people that use it Help prevent illness, and promote healthy, independent living Be available to those who need it when they need it. The first part of the review gives the overall quality rating for the care home: • • • • 3 2 1 0 stars - excellent stars - good star - adequate star - poor There is also a bar chart that gives a quick way of seeing the quality of care that the home provides under key areas that matter to people. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Care Homes for Older People Page 2 of 24 We review the quality of the service against outcomes from the National Minimum Standards (NMS). Those standards are written by the Department of Health for each type of care service. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The mission of the Care Quality Commission is to make care better for people by: • Regulating health and adult social care services to ensure quality and safety standards, drive improvement and stamp out bad practice • Protecting the rights of people who use services, particularly the most vulnerable and those detained under the Mental Health Act 1983 • Providing accessible, trustworthy information on the quality of care and services so people can make better decisions about their care and so that commissioners and providers of services can improve services. • Providing independent public accountability on how commissioners and providers of services are improving the quality of care and providing value for money. Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report Care Quality Commission General public 0870 240 7535 (telephone order line) © Care Quality Commission 2010 This publication may be reproduced in whole or in part in any format or medium for non-commercial purposes, provided that it is reproduced accurately and not used in a derogatory manner or in a misleading context. The source should be acknowledged, by showing the publication title and © Care Quality Commission 2010. www.cqc.org.uk Internet address Care Homes for Older People Page 3 of 24 Information about the care home Name of care home: Address: The Old Rectory 195 Wigan Road Standish Wigan Greater Manchester WN6 0AE 01257421635 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Mr Megraj Jingree,Mrs Premila Jingree Name of registered manager (if applicable) Mrs Premila Jingree Type of registration: Number of places registered: care home 10 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 old age, not falling within any other category Additional conditions: 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: Old age, not falling within any other category - Code OP. The maximum number of service users who can be accommodated is: 10. Date of last inspection Brief description of the care home The Old Rectory is a large detached property in Standish. The home is situated on the main road to Wigan and Standish town centres and is approximately five minutes drive from local amenities. The home offers 8 single rooms on the first floor, of which 3 have en suite facilities and 1 shared room on the ground floor. Bathrooms and toilets are on the first floor and toilets are on the ground floor. There is limited parking at Care Homes for Older People Page 4 of 24 Over 65 10 0 0 4 0 4 2 0 0 9 Brief description of the care home the front of the home and a small garden area at the rear. The Old Rectory Care Home provides care and support for 10 older people. The current scale of fees per week ranges from 430 pounds to 450 pounds. Additional charges are made for hairdressing, newspapers, trips out, chiropody, alternative therapy and toiletries. Care Homes for Older People Page 5 of 24 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: This inspection included an unannounced visit to the home on 30 March 2010 between 09:15 and 14:15. During this visit we spoke to residents, relatives and staff and the owner/managers. We looked at documents and records the home has to keep, such as residents care records, medicine records, written polices and other records. Prior to the inspection, we asked the manager to complete a form called an Annual Quality Assurance Assessment (AQAA) to tell us what they felt they did well and in what areas they could do better. This helps us to determine if the management of the home sees the service they provide the same way that we see the service. We felt this form had been completed in sufficient detail and provided useful information. To help gather further information, we sent surveys to residents and staff asking what they thought about the home. We received completed surveys from four staff and eight residents. Residents comments included: The staff make me feel wanted and cared Care Homes for Older People Page 6 of 24 for and part of a family. Another said, The staff are dedicated to helping the residents and spending time with them especially the social aspect. Staff comments were positive, they indicated that they received enough information about the people they were caring for, that training was good and relevant to their role. One said, We take good care of our residents, we are a dedicated staff team. Care Homes for Older People Page 7 of 24 What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line 0870 240 7535. Care Homes for Older People Page 8 of 24 Details of our 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) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 9 of 24 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. There were systems in place to assess and monitor individual needs, ensuring that a suitable service is provided based on personal needs and preferences. Evidence: The home provides prospective residents with satisfactory information prior to moving in to the home. The statement of purpose and the service user guide tells people about the services and facilities they can expect if they make a decision to move in to the home. The last reports from the Care Quality Commission (CQC) are also available. New residents are welcome to visit the home prior to admission to meet with other residents and staff. The manager confirmed that all residents receive a written contract of terms and conditions regardless of how their care is funded. Two residents care plans were chosen for inspection. On examination both contained a Care Homes for Older People Page 10 of 24 Evidence: pre admission assessment to ensure the residents health, personal and social care needs could be met. The assessment covers residents well being, areas of risk including falls, mobility, bathing, personal care, medication etc. Some of the residents had varying levels of confusion, however it was observed that staff could meet the needs of these people and staff had undertaken training in dementia awareness. Care Homes for Older People Page 11 of 24 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Care plans were clear and provided staff with the information they need to meet the needs of the residents. Evidence: Two care plans were chosen for inspection. The information contained in the care plans gave staff detailed information about the care each resident required. A social profile was also available that informs staff of the life experiences of the residents, this helps staff to get to know residents better. The profile includes family background, work life experiences, likes and dislikes and interests and hobbies. Other information in the care plans included risk assessments for example risk of falls, mobility, nutrition, pressure care and moving and handling. A record of what people have eaten is maintained, this is completed after each meal. There was evidence to demonstrate that outside agencies, such as doctors, district nurses and the chiropodist are contacted and visit the home as required. Care Homes for Older People Page 12 of 24 Evidence: The way residents medicines were being looked after was safe and secure. Staff had been suitably trained in the handling of medication. A medical administration record is maintained for each resident. These had been completed appropriately. The manager conducts checks to ensure the management of medicines within the home continues to be safe and secure. The home has a small amount of a controlled drug, this was securely stored in a controlled drugs cupboard and when administered was recorded in a controlled drugs register with two signatures as required. Observation throughout the inspection showed that the personal care needs of the residents were being met. Attention to all residents was given to personal grooming, residents clothes were nicely laundered and coordinated. Staff were attentive to the needs of the residents and if they had any spare time this was spent with the residents chatting and sitting with them. The atmosphere within the home was relaxed and friendly, it was apparent that good relationships had been formed between the staff and residents. Care Homes for Older People Page 13 of 24 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are enjoying a good quality of life and are involved with a range of activities both in the home and local community. Evidence: The routines of daily living and social activities available were flexible and varied and meet the residents expectations, preferences and capacities. Residents were supported to access a wide range of social and leisure activities and entertainments. Forthcoming events, activities and entertainments were prominently displayed. Residents said the activities had improved with people going out shopping and to the library. The home had held a clothes and underwear party for the ladies to purchase items if they wished. Relatives and friends are actively encouraged to participate in all social and leisure activities available. Residents were able to follow their own religious practices and as in other areas of life in the home were available to exercise their own personal choice in respect of this. On the day of our visit representatives from the local church attended the home to offer a service of holy communion to residents. Residents may receive visitors in the privacy of their own room or in the communal Care Homes for Older People Page 14 of 24 Evidence: areas down stairs if preferred. Residents also said they were able to exercise and independence in their daily lifes. Comments included: I get up when I am ready and can have my breakfast either in my room or in the dining room. Its up to me if I want to join in the planned activities or not. Residents have the choice of an alcohoic drink sometimes with their meal or in the evening as requested. The menus are displayed on the dining tables and in the foyer. A record of what residents have chosen is kept in the care plan. Residents confirmed that the food was good, nicely cooked and presented. It was noted that some extra dishes had been served, such as black pudding and tripe. These were requested by the residents for a change and according to residents spoken with were throughly enjoyed. The dining room was comfortable with the tables set with matching crockery, cutlery and condiments. Residents have the choice of where they wish to dine, either in the dining room or in their own room. Care Homes for Older People Page 15 of 24 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. There is an accessible procedure in place to deal with complaints. Staff have been provided with safeguarding training and there were procedures in place that describe how to protect residents and keep them safe. Evidence: A complaints procedure exists and any complaints would be properly recorded, along with the outcome. There has been no complaints within the last twelve months and no complaints have been brought to the attention of the Care Quality Commission. Residents spoken with had no complaints or concerns, one said, I think things have recently improved within the home, it has a more relaxed atmosphere. Relatives and friends were spoken with and were very complementary about the way the home was run and with the staff. One said, We can not thank the staff enough for the kindness and loving care shown. The dedication of all the staff has been wonderful. There had been no safeguarding referrals or investigations. Staff were trained in the Protection of Vulnerable Adults and had access to policies and procedures if needed. Care Homes for Older People Page 16 of 24 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home provided a clean, pleasant, comfortable and suitably adapted enviroment for residents. Evidence: The home was in a good state of repair and decoration. It was evident that there was an ongoing programme of maintainance. The lounges and dining areas were clean, apporopriately and adequately heated, comfortably furnished and provided a suitable environment for residents to be cared for and supported properly. Televisions, music centres and other leisure equipment were available throughout the home. Suitably equipped and adapted bathing and toilet areas were provided. The home has generally been suitably adapted and equipped to meet the needs of residents. For example, passenger lift, grab rails, nurse call system, ramps to outside etc. Residents bedrooms that were looked at were clean, suitably furnished and equipped and some were very personalised. Some residents had their own telephones lines. Residents expressed their satisfaction with the standard their accomodation. The home was clean and fresh and no odours were detected. Suitable arrangements were in place to manage residents laundry needs. Appropriate measures were taken to minimise the potential spread of infection within the home such as hand washing Care Homes for Older People Page 17 of 24 Evidence: facilities and the provision of protective clothing for staff as well as appropriate cleaning practices within the home. Care Homes for Older People Page 18 of 24 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The staffing arrangements, staff recruitment process and the training arrangements at the home seek to ensure residents were cared for and supported safety and appropriately. Evidence: Staffing arrangements at the home were supporting residents ensuring their needs were met. Discussion with residents revealed that there were sufficient staff available to make sure they were looked after. There were appropriate arrangements in place to ensure there were sufficient staff in respect of the caring, catering and housekeeping functions of the home. There is a proper process in place in respect of recruiting staff. This is important to ensure residents are being cared for and supported by suitable people. The recruitment process included making police checks, obtaining two written references, other proof of identity and a written application form to ensure the suitability of the applicant working with vulnerable people. The arrangements for training staff ensure that residents care and support needs were being met by competent staff. There was a well organised and suitable training programme in place for all staff employed at the home. Training for NVQs was ongoing. Care Homes for Older People Page 19 of 24 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The Old Rectory is managed with systems, policies and procedures in place to ensure the health and safety of the people living there are promoted and protected. Evidence: The management arrangements within the home remain stable. The manager has a significant number of years in working with the elderly. The manager is a registered nurse and has the Registered Managers Award. The home had a relaxed atmosphere and was busy with visitors to the home. The owner/managers are committed to their own training as that of their staff and sees this as an essential element to delivering good care. On the day of the inspection relatives and friends were seen approaching the managers and engaging in conversation. The office was organised and all the necessary paperwork required by regulation was Care Homes for Older People Page 20 of 24 Evidence: on hand. There is a system in place for self monitoring of the home, which includes satisfaction questionnaires, residents and relatives meetings etc. Some of the residents have small amounts of money held at the home to pay for shopping, hairdressing and if they want to go out. We checked some of the monies against the balance sheets and no discrepancies were noted. Suitable arrangements were in place to promote and protect the health, safety and welfare of residents and others in the home. In particular staff had been provided training in respect of safe moving and handling techniques, fire safety, food hygiene and infection control. Electrical, gas, fire safety, lift and other equipment at the home had been regularly serviced and certificated. The accident reports were available for inspection. These were suitably recorded and the CQC are informed when necessary. The premises were secure at the time of the inspection. The front door has to be opened by staff. The home operated policies in respect of safe working practices. All staff receive induction training when they start work at the home. Care Homes for Older People Page 21 of 24 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 22 of 24 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No Refer to Standard Good Practice Recommendations Care Homes for Older People Page 23 of 24 Helpline: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. Care Homes for Older People Page 24 of 24 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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