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Care Home: The Old Rectory [Musbury]

  • The Old Rectory [Musbury] Musbury Axminster Devon EX13 8AR
  • Tel: 01297552532
  • Fax: 01297553511

The Old Rectory provides support and personal care for 15 people with a learning disability who are over the age of 35 years. The home is a detached, converted and extended property on the edge of the small village of Musbury. It is a short car journey to either Seaton or Axminster. Each person`s bedroom is for single occupancy and has en-suite facilities. Peoples share the use of the lounge, dining room and conservatory. There is a large private garden with a decked area outside of the conservatory. The Old Rectory is run as a family business with many family members working at the home. At the time of this inspection weekly fees ranged from £395 to £1150 Copies of inspection reports are available from the manager on request.

  • Latitude: 50.744998931885
    Longitude: -3.0320000648499
  • Manager: Mr Robin Andrew Barrie Farrington
  • Price p/w: £773
  • UK
  • Total Capacity: 12
  • Type: Care home only
  • Provider: Oakprice Limited
  • Ownership: Private
  • Care Home ID: 16359
Residents Needs:
Learning disability

Previous Inspections

This may not be the latest inspection for this service as we are having techinical problems updating from CQC - please check directly on the regulators website for the most recent report; bestcarehome hopes to be back to regular updates shortly.

For extracts, read the latest CQC inspection for The Old Rectory [Musbury].

CARE HOME ADULTS 18-65 The Old Rectory [Musbury] Musbury Axminster Devon EX13 8AR Lead Inspector Clare Medlock Unannounced Inspection 29th October 2007 10:00 The Old Rectory [Musbury] DS0000039128.V354072.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 The Old Rectory [Musbury] DS0000039128.V354072.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. The Old Rectory [Musbury] DS0000039128.V354072.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service The Old Rectory [Musbury] Address Musbury Axminster Devon EX13 8AR 01297 552532 01297 553511 oakpriceltd@hotmail.co.uk 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) Oakprice Limited Mr Robin Andrew Barrie Farrington Care Home 15 Category(ies) of Learning disability (15), Learning disability over registration, with number 65 years of age (15) of places The Old Rectory [Musbury] DS0000039128.V354072.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. To take service users over the age of 35 years only Date of last inspection 19th October 2006 Brief Description of the Service: The Old Rectory provides support and personal care for 15 people with a learning disability who are over the age of 35 years. The home is a detached, converted and extended property on the edge of the small village of Musbury. It is a short car journey to either Seaton or Axminster. Each person’s bedroom is for single occupancy and has en-suite facilities. Peoples share the use of the lounge, dining room and conservatory. There is a large private garden with a decked area outside of the conservatory. The Old Rectory is run as a family business with many family members working at the home. At the time of this inspection weekly fees ranged from £395 to £1150 Copies of inspection reports are available from the manager on request. The Old Rectory [Musbury] DS0000039128.V354072.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place on Monday 29th October 2007. The registered manager/provider was present throughout the inspection. Some of the people living at the home have limited verbal communication skills. They were therefore unable to contribute verbally to the inspection process. Time was spent with all people at the home and observations were made during the inspection. Prior to the inspection the manager completed a questionnaire, called an AQAA (Annual quality assurance assessment). This provides information about people who use the service, staffing levels, fees, and home maintenance records. It informs us whether these records and procedures are in place. Before the inspection we also sent out questionnaires to the people living in the home, their families and their health care professionals. We received 8 questionnaires from people who use the service. Six questionnaires from relatives or advocates and three from health care professionals. We also received six questionnaires from staff. All this information gives us a picture of what it may be like at the inspection and helps focus the inspection on what matters to the people who use the service. On the day of inspection we “case tracked” two people who use the service. This means the inspector spoke with staff about individual care, read the persons records and either spoke with the person or made observations if the person was unable to speak with us. We spoke with staff who were on duty. We also looked around the building and inspected other records. These included, accident records, staff files, medicine records, complaint records, care plans, communication books and other workbooks. What the service does well: The home is managed well with an atmosphere that is warm, friendly and fun. The environment is bright, homely and furnished and decorated to a high standard. The people who were able said they liked living in the home and said The Old Rectory [Musbury] DS0000039128.V354072.R01.S.doc Version 5.2 Page 6 staff are caring, respectful and kind towards them. This was observed throughout the inspection. The admission procedure at the home is good. Staff at the home gather enough information to decide whether the home can meet their needs. The person and their family also receive enough information and have time to decide whether the home is the right place for them to be. Care Plans at the home have enough information to identify each person’s basic needs and highlight any risks the person may have in their lives. Staff have an in depth knowledge and understanding of the needs of people who use the service. Personal care is provided in an appropriate and caring way. Verbal and informal communication is very good at the home, which means that information about people in the home is passed on to all staff. Staff at the home are good at identifying these risks and working with ways that enable the person to be safe whilst making decisions and taking appropriate risks. People who use the service are encouraged to maintain links with their friends and family and have access to advocacy services. People at the home have access to leisure facilities both in and out of the home. This means that people are encouraged to lead stimulating and fulfilling lives. Meals are good at the home with balanced and varied food being enjoyed by people who use the service. Discreet help and specialist crockery are provided where required to promote independence. Access to health care is maintained at the home and the medication systems are managed well. Complaints and allegations of abuse are managed well at the home when they occur and people who use the service feel able to speak with any staff about what worries them. The environment is good at the home. It is clean, hygienic, safe and a pleasant place for people to live and is well maintained by the provider and outside contractors. Staff are aware of their health and safety responsibilities. A stable and dedicated staff group care for people who use the service. Staff are supervised well and benefit from an effective management team Recruitment of staff is good meaning staff have all the necessary checks performed before they work. The induction process is thorough which means that staff are provided with enough information to perform their roles safely. Staff have access to specialist training which relates to the people in the home. The quality of the service is always kept under review informally on a day-today basis with the presence of the manager and more formally through The Old Rectory [Musbury] DS0000039128.V354072.R01.S.doc Version 5.2 Page 7 questionnaires and audits. This means that the service changes to reflect the changing needs of people in the home. What has improved since the last inspection? What they could do better: Care plans must be improved so that care needs can be communicated more effectively. Care Plans must reflect the level of care that is given and be used as a working document to help communication and promote consistency for the people who receive care. The Old Rectory [Musbury] DS0000039128.V354072.R01.S.doc Version 5.2 Page 8 The manager should consider ways of maintaining communication with health care professionals. This will show that he can show that changes in a person’s condition or health care needs have been communicated. Communication can also be improved by the reintroduction of staff meetings. This will provide opportunities for staff to voice their concerns and communicate new ideas, which may improve the quality of life for people at the home. The manager must continue to improve the activities programme so that all people in the home have access to appropriate activities. This will mean their lives can be more fulfilling and stimulating. The manager should consider responding to requests of people at the home to go to the bank to withdraw their money. This would mean the person feel involved in their financial management and would provide an opportunity to maintain links with the community. People should also be protected by ensuring staff have all the information and training they need to keep people safe. Staff must have access to details of who to contact if any allegations of abuse or complaints are made. The manager should ensure all posters displayed in the home have correct and up to date information provided. The manager must ensure staff are always up to date with mandatory training and must ensure new staff receive POVA (Protection of vulnerable adult) training. This would mean that staff have all the information needed to perform their roles safely. 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. The Old Rectory [Musbury] DS0000039128.V354072.R01.S.doc Version 5.2 Page 9 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 The Old Rectory [Musbury] DS0000039128.V354072.R01.S.doc Version 5.2 Page 10 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): 1,2,3,4,5 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. The effective admission and assessment procedures in place ensure that peoples are able to make an informed choice about where they want to live. EVIDENCE: The Manager told us that once an enquiry has been received from someone considering moving to The Old Rectory, he would normally visit the person to carry out an assessment of their needs and at this stage he will give as much information as possible about life at The Old Rectory. The manager told us this is both verbal information and written information. There are audiotapes for those who have reading difficulties. The person is invited to visit The Old Rectory as many times as they want in order to get to know the home and help them decide if it is the right place for them. Questionnaires received from relatives confirmed that they are provided with enough information before making a decision about their relative moving to the home. The Old Rectory [Musbury] DS0000039128.V354072.R01.S.doc Version 5.2 Page 11 People who use the service told us they came for visits before moving to the to the home. One person said he liked meeting the staff and other people in the home. Pre admission assessment forms are then stored in the persons care plan folder and this information is used to plan care. Care plan files and assessment documents were inspected and found to contain good information about their health, social and personal care needs. The information gathered by the home showed that they had carefully considered the suitability of the home before offering to accommodate them. The care plans from the previous homes had been obtained, plus information from health and social care professionals. All of the people living at the home have received a written contract of residence. The Old Rectory [Musbury] DS0000039128.V354072.R01.S.doc Version 5.2 Page 12 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): Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. Staff are provided with some information, but improvements to the care plans are needed to ensure each persons’ needs are met safely and consistently. People are supported to take responsible risks, but improvements to record keeping would show that all people are able to make decisions. EVIDENCE: Each person who uses the service has a plan of care that highlights care and health needs. Two care plans were read in detail as part of the case tracking process as described in the summary. The daily records reflected what was written in the care plans. These records help staff to regularly monitor each person’s needs. All staff were very knowledgeable about the needs of the people they care for and the standard of care seen throughout the inspection was high. However the care plan is not a working document and it did not reflect the care that was The Old Rectory [Musbury] DS0000039128.V354072.R01.S.doc Version 5.2 Page 13 seen. An example of this was that staff were aware that one person has particular triggers that affects their behaviour. Although all staff we spoke with were aware of this need care plans did not clearly show this. Some care plans had not been kept under review and did not show the 1:1 care that was given throughout the day. Some records did not show that people had been supported to make their own decision. The manager produced a draft review care plan for the people we were case tracking. These plans were detailed and would mean that care could be provided consistently and would not rely on verbal communication alone. The manager explained that all people at the home were going to be reviewed by social services who pay for their care. The manager said this would be welcomed, as some of these people had not had a formal review for many years. Care Plans showed that these people had been reviewed by the home. Some people at the home have advocates who will help them to make decisions, or to act on their behalf. Residents’ meetings are held regularly, and these also enable people to make decisions about all aspects of daily life at the home. One person told me he likes the meetings but he talks to the staff every day. This person explained that he likes going out for walks and that staff now take a chair so he can still go out but can sit down if he feels tired. Care plan files include risk assessments for all activities where there is a history or clear likelihood of harm. One area of risk that was highlighted at the last inspection was the kitchen. The manager has now made changes to the environment, which enables people to continue to have free access to the kitchen, help with meal preparation whilst keeping everyone safe. The front door is locked on a daily basis. The manager explained that this was because it is situated in part of the house that cannot always be seen. People who use the service were seen to freely enter and exit the home through the conservatory door, which enables people to come and go whilst being monitored by staff. The Old Rectory [Musbury] DS0000039128.V354072.R01.S.doc Version 5.2 Page 14 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): 12,13,14,15,16,17 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. People are cared for with respect and have access to some activities, however improvements to the activity programme would ensure all people have access to a more stimulating and fulfilling life. The nutritional needs of people at the home are met through a varied and appetising range of meals. EVIDENCE: On the day of the inspection most people were sat in the lounge or conservatory watching TV. Some people were knitting and another person was in their room colouring in. Two people we spoke with said they helped with some household chores which they enjoyed doing. They also said they attended occasional day activities away from the home. For example “Link up”, The Old Rectory [Musbury] DS0000039128.V354072.R01.S.doc Version 5.2 Page 15 this charity run organisation provides a variety of creative pursuits. The manager explained there have been problems with this as the activities are not always appropriate or if not enough people are interested they get cancelled at short notice. One person was excited about their hydrotherapy session and told us they like going underwater. Other people told us they enjoyed going out shopping or going to cafes or pubs. One person said he was looking forward to the holiday staff at the home were organising. Staff told us they take a small number of people to a local holiday camp. Some people seen on the day of inspection were active and able to join in with household chores. Other people were seen to sit in the lounge all morning and did not participate in activities. Feedback regarding activities showed that relatives, staff and health care professionals all thought more activities could be provided. One staff comment read ‘It would be nice to get out more with the residents’. Funding is an issue but we get round that as best we can’. Relative and advocate comments included ‘I would like to know more about the activities he does so I know whether he likes them or not’ and ‘More could be done to stimulate him’ and ‘He tells me he wants to do more because he is bored’ and ‘More activities and outings are needed’ Health care professional questionnaires included a comment that read ‘There is a poor attendance of activities’ Activity records are now kept on what a person does each day. The manager explained that there has been an issue with funding but that a new activities programme was being drawn up to include appropriate activities for people in the home. The manager told us that there are musicians that come to the home once a month and there are groups that some people attend called ‘speaking up’ which is where people are encouraged to speak out load and raise issues or concerns. The manager also told us that there are plans in place to support people to access and use local public transport. The manager said that a change in the way people are charged for journeys has changed and that this is now fairer by charging per mile. People who were able said that staff support them to maintain contact with their relatives and friends. The care plans provide good information about family contact. One person goes out each week with his brother and another goes out with his advocate occasionally. This person said he enjoys the visits to the pub. The manager informed us that a local priest now visits the home to meet people who chose to not to go to church or who are unable to go. One person said the food at the home was really nice. All of the people who use the service who completed a survey form before this inspection said they The Old Rectory [Musbury] DS0000039128.V354072.R01.S.doc Version 5.2 Page 16 always enjoy the meals. The meal on the day of inspection was home made quiche, potato wedges and homemade crumble. Lunchtime was a sociable time. Food portions were good and there was no waste. Discreet help was provided to those people who have difficulty feeding themselves. Specialist crockery was provided where required to promote independence. The dining room has been attractively decorated and furnished, making mealtimes a pleasant experience. Relative and advocate questionnaire comments included ‘There is a nice atmosphere, nice lunches. The smell of home cooking tells me that’ The Old Rectory [Musbury] DS0000039128.V354072.R01.S.doc Version 5.2 Page 17 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): 18,19,20 and elements of 21 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. Each person’s privacy is respected and they benefit from their health needs being closely monitored and met. Changes to record keeping would improve communication. The effective medication practices protect the person’s health and welfare. EVIDENCE: People who use the service were observed receiving support in a respectful manner. Staff told us that some people have routines and that sometimes gentle prompting was required to encourage people to keep clean. One person told us he likes being woken up with a cup of tea and that he goes to bed when he wants and that this is usually directed by what he watches on TV. People are able to choose their own clothes and hairstyles, which reflects their preferences and personalities. People at the home receive their post unopened. The Old Rectory [Musbury] DS0000039128.V354072.R01.S.doc Version 5.2 Page 18 At the inspection people received their post at lunchtime and staff were available to help open the letter if requested and appropriate. Staff told us there are routines at the home but these are flexible and that there is no rush to get people up in the morning, but that most people are up by 10am. Questionnaires from relatives confirmed that people who use the service are well cared for. Comments included ‘He always says he is satisfied about his care’ and ‘He is always dressed well and his hygiene is very good’. The care plans clearly set out how the staff should assist each person with any personal or health care needs. Each person is accommodated in a single room, and all but one bedroom has en-suite facilities, therefore providing privacy and dignity. Adaptations have been carried out where necessary to enable a person to have a shower independently. Daily reports were sampled and these clearly show the tasks that have been carried out in line with the care plan. There is a balance of male and female staff to ensure that a staff member of the same sex can assist people if they prefer. Regular healthcare checks and treatments are provided as required. A comment card completed by a general practitioner contained a comment that read ‘Very caring and skilled staff working with the learning disabled’. Another health care professional comment included ‘The staff are friendly, supportive and caring to all the residents, attending to their needs at all times’ A visiting reflexologist spoke highly about the home and staff. He told us that he has known a small number of the people since they have moved to the home people are able to communicate their specific needs. People at the home are supported in accessing a range of health care services. Examples we saw included GP (General Practitioner-doctor), nurse specialist in epilepsy, specialist doctor in dementia, community dentist and chiropodist and consultant in learning disabilities. On the day of inspection a visiting reflexologist was at the home. Observation confirmed the people who were receiving this service were enjoying the therapy. Some feedback regarding care at the home was not positive. Questionnaires received from health care professionals included ‘Poor feedback to learning disabilities team re progress of people’ and ‘Poor communication to health care professionals when situation has changed’ One comment we received was that sometimes the approach at the home was institutional, although this was not seen during the inspection. The Old Rectory [Musbury] DS0000039128.V354072.R01.S.doc Version 5.2 Page 19 None of the people living at the home were able to self medicate. The majority of people at the home are not able to provide obvious consent to their medication, however staff were knowledgeable about the non-verbal communication, which could be demonstrated if a person, did not want their medicine. The management of medication at the home was good. Records of medicines entering and leaving the home are kept on medication administration records and separately. Copies of repeat prescriptions and patient information leaflets are stored for quick reference. Medication administration records were well completed and included the application of creams and other topical products. Storage and stock control was good. There are cupboards provided for suitable drugs storage. The home uses a monitored dosage blister pack system, which are more appropriate for the people who use the service. Staff who are responsible for the administration have received medication training. Care Plans have been written in a way that includes details of what a person or their families wants request in event of illness or death. The Old Rectory [Musbury] DS0000039128.V354072.R01.S.doc Version 5.2 Page 20 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): 22,23 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. People who use the service and their relatives can be confident that they are listened to and will have their complaints dealt with appropriately. Systems are in place to protect people from abuse but improvements would mean that staff are aware of the correct procedures to follow. EVIDENCE: All of the people we spoke with told us they like living at The Old Rectory. They told us they feel well cared for and that staff treat them well. One person said the staff were very kind and that they felt safe at the home. People we spoke with said they would speak with one of the staff if they were unhappy about anything. No complaints have been received by the home or by the Commission since the last inspection. The complaints procedure is displayed in the hallway but this contained out of date contact details for the Commission for Social Care Inspection. People who use the service completed survey questionnaires prior to this inspection. They said they knew who to talk to if they are worried or upset, or if they want to make a complaint. Relatives who completed survey forms also confirmed this. The Old Rectory [Musbury] DS0000039128.V354072.R01.S.doc Version 5.2 Page 21 The questionnaires people completed stated that staff always treated them well. Relative questionnaires contained two comments that read ‘I am well confident that he is well cared for’ and ‘I think the care home is well adapted to deal with mood swings and behavioural problems, but they still treat him with much love and affection’. The staff we spoke with were aware of what the different types of abuse were. Staff were all aware that allegations needed to be reported. One member of staff we spoke with knew abuse needed to be reported but did not know how to do this in the event of the manager being absent. This was confirmed by staff questionnaires, which showed that not all staff knew what to do if anyone had concerns about home. There were no clear contact details displayed in the home and the contact details for the Commission for Social Care Inspection were out of date. Contact details for reporting authorities and the Commission for Social Care Inspection were given at the inspection. Staff told us that they felt comfortable talking to the manager about any concerns they had about any staff, including members of the family who also work at the home. The majority of staff have received POVA (Protection of vulnerable adultsprevention of abuse) training. The manager gave assurances that new staff would be booked on a course as a matter of priority. All but one person have their own bank account. The provider supports peoples to manage the accounts. Changes to the way this is done mean the process is more robust and transparent. Three people are now responsible for checking financial records. This has been introduced to protect the manager and his wife and also the people who use the service. One person is under the Court of Protection. Financial records were clear and auditable. One person told us that the manager sorts his money out but that he would like to go to the bank himself as a trip out. The Old Rectory [Musbury] DS0000039128.V354072.R01.S.doc Version 5.2 Page 22 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): 24,25,28,30 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. People live in a comfortable, safe, clean and attractive environment. EVIDENCE: All areas of the home were well maintained, decorated and furnished to a high standard. Each person has a single bedroom that has been decorated and furnished to suit their tastes and preferences, and clearly reflect their personality and interests. All but one bedroom has en suite facilities. In one bedroom specialist furniture has been purchased to suit the height and stature of the person. Questionnaires from relatives contained comments including ‘The home is lovely and homely’ The Old Rectory [Musbury] DS0000039128.V354072.R01.S.doc Version 5.2 Page 23 People have been encouraged to help choose the decorations and furnishings in the communal areas. The atmosphere is one of a relaxing and comfortable environment where people who live at the homes can feel truly at home. Access around the home is good. A call bell system is in place to enable people s to obtain assistance from staff if needed. The lounge is comfortably decorated and furnished and there is also a large and comfortable conservatory providing an alternative sitting area. People who use the service were able to wander around the home as they chose or were able. The gardens are large and well maintained and provide space for relaxing and socialising in the summer months. All rooms have lovely views over the gardens and surrounding countryside. New garden furniture and decking has been provided to improve access and appearance and the garden has been landscaped. Decoration is ongoing. Recently the dining room and downstairs hallway have been redecorated. One room has also been fitted with a new shower. All areas of the home were found to be clean and tidy. Aprons and gloves were seen in areas where personal care would be given. The laundry was in good order, with commercial machines and good storage facilities. In the last 2 years the home has been enlarged and improved to provide further bedrooms, and to improve existing rooms. Adaptations have included the provision of a lift between the ground and first floors. The manager told us there is a maintenance plan but repairs and improvements tend to occur quicker than planned because of the wear and tear on the building. The Old Rectory [Musbury] DS0000039128.V354072.R01.S.doc Version 5.2 Page 24 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): 31,32,33,34,35,36 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. A stable well-supervised staff team meets the needs of people at the home. The re introduction of staff meetings would mean communication would improve. People are protected by good recruitment procedures. EVIDENCE: Copies of staff rotas provided for this inspection show that there are sufficient numbers of staff employed to meet the needs of the people at the home. This was also confirmed by questionnaires completed by people and their relatives. Two new staff files were checked during this inspection. They showed that all staff have completed an application form, at least two satisfactory references have been received, and POVA and Criminal Records Bureau police checks have been carried out before the staff have been confirmed in post. The manager told us new staff visit the home before interview so that people who The Old Rectory [Musbury] DS0000039128.V354072.R01.S.doc Version 5.2 Page 25 use the service have an opportunity to meet and provide feedback for interview. Good detailed induction procedures are in place providing evidence of basic competency in all aspects of care. Staff told us they thought the induction was good with time allowed to shadow other staff and get to know the way each person needed to have their care needs met. Three of the 10 staff hold a National Vocational Qualification (NVQ) to level 2 or above and four are in the process of studying towards an NVQ. The manager told us the home ‘block book’ training sessions with outside training providers to ensure training sessions use best practice. Examples of training outside mandatory training courses included dementia, administration of medicines, epilepsy and challenging behaviour. Staff said supervision sessions are held and that more informal supervision occurs regularly when staff work with the manager who is also the provider. Staff said they have had staff meetings but these have been missed recently because of staff sickness. Financial records showed that the manager has funds allocated for staff training and that access to free training has also been sourced. Training records have improved. All of the staff who completed questionnaires prior to this inspection said they receive regular supervision and support. Comments from staff include –‘ The manager is supportive and understanding. He gives praise where needed but is not unrealistic’ and ‘the home provides staff with the training they need’ The Old Rectory [Musbury] DS0000039128.V354072.R01.S.doc Version 5.2 Page 26 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): 37,38,39,42,43 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. People who use the service benefit from a generally well run home with methods in place to review the quality of care. Improvements to the mandatory training programme would improve safety. EVIDENCE: The Manager has many years of experience as a registered manager. He has worked in a number of homes for people with learning disabilities. He holds a National Vocational Qualification at level 4 and the Registered Managers’ Award. People staff, and relatives expressed complete satisfaction in the The Old Rectory [Musbury] DS0000039128.V354072.R01.S.doc Version 5.2 Page 27 management and ethos of the home. The manager told us that he has not been on any recent training sessions to ensure his knowledge is up to date. Good systems are in place to monitor the quality of the care and services provided. These include questionnaires, meetings, and staff supervision sessions. The quality assurance questionnaires were not dated. Prior to the inspection the manager completed a questionnaire, called an AQAA (Annual quality assurance assessment), which provides information about service users, staffing, fees and confirms that necessary policies and procedures are in place. This gave details of what has improved in the last year and what is planned. Many shortfalls identified at this inspection have already been highlighted by the home. Information provided in the AQAA also showed that all equipment has been regularly serviced and maintained and that health and safety checks have been carried out. The manager told us outside contractors are used for this purpose. Records checked during this inspection included the fire logbook and accident book. These provided evidence that the safety of people in the homes and staff have been given a high priority. Mandatory training records showed that some mandatory training was out of date. The manager confirmed that dates for future training had been booked. Insurance certificates were displayed in the corridors of the home. The Old Rectory [Musbury] DS0000039128.V354072.R01.S.doc Version 5.2 Page 28 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 3 2 3 3 3 4 3 5 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 2 23 2 ENVIRONMENT Standard No Score 24 3 25 3 26 X 27 X 28 3 29 X 30 3 STAFFING Standard No Score 31 3 32 3 33 2 34 3 35 3 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 2 3 3 3 3 LIFESTYLES Standard No Score 11 X 12 3 13 3 14 2 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 2 3 3 3 3 2 3 3 2 3 The Old Rectory [Musbury] DS0000039128.V354072.R01.S.doc Version 5.2 Page 29 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 YA6 Regulation 15(2) Requirement The manager must make sure that the care plan: • Is kept under review • Is written in a way so staff are aware of how a persons needs can be met consistently • Reflects what 1:1 care is given The manager must ensure that people have access to a range of appropriate activities to make their lives more stimulating and fulfilling The Manager must ensure all staff have received vulnerable adult abuse awareness training to ensure they know how to recognise abuse and how to correctly report allegations. The manager must ensure all mandatory training is up to date. This includes Moving and handling, first aid, food hygiene and Infection Control Timescale for action 01/12/07 2 YA14 16(2m,n) 01/12/07 3 YA23 13(6) 01/12/07 4 YA42 13(4)&(5) 23(4c) 13(4) 13(3) 01/01/08 The Old Rectory [Musbury] DS0000039128.V354072.R01.S.doc Version 5.2 Page 30 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. 2. 3. 4. Refer to Standard YA6 YA19 Good Practice Recommendations The manager should ensure that evidence is provided that the care plan is written with consultation of the person, their family or advocate. The manager should ensure records are kept and systems are in place to show that health care professionals are informed of changes in condition of people at the home. The manager should correct the out of date information displayed on the notice board so staff know who to correctly report complaints and allegations of abuse to. The manager should consider enabling people to attend the bank if they chose to withdraw their money. This will protect the person from abuse, promote independence and provide links with the community. The manager should ensure staff meetings are recommenced to enable staff an opportunity to express their opinion and views. The manager should ensure any quality assurance surveys performed are dated. YA22 YA23 5. 6. YA33 YA39 The Old Rectory [Musbury] DS0000039128.V354072.R01.S.doc Version 5.2 Page 31 Commission for Social Care Inspection Devon Area Unit D1 Linhay Business Park Ashburton TQ13 7UP 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 The Old Rectory [Musbury] DS0000039128.V354072.R01.S.doc Version 5.2 Page 32 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!

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