Care Home: The Old Vicarage Residential Home

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What the care home does well The Old Vicarage offers a homely environment for people to live in. The staff are friendly and welcoming and people living here told us they were very happy. They said "It is a small friendly home and I am happy here". People`s needs are assessed in full before they move into the home. This process will make sure that the home is aware of and can meet people`s requirements when they move in. People told us they felt confident in making their concerns or complaints known. They said "I am unhappy, I am sure it will be sorted out promptly nothing is too much trouble". All of the food is freshly prepared and home cooked. People said "the food is lovely here", "if you don`t like what`s on you can choose something else". What has improved since the last inspection? There were no requirements from the last inspection the home needed to address. They have told us in the AQAA they are planning to introduce large print service user guides. This will help those people who have difficulty seeing smaller print and allow them to access information about the home. Since our last visit one member of staff has undertaken further training in activity planning. This means that more activities and organised events will be happening both inside and outside of the home. What the care home could do better: We have recommended a few minor improvements to the medication systems within the home. these recommendations will build upon the current good practice and offer more safeguards for people. We have also recommended that staff take part in training in safeguarding vulnerable adults. Again this will build upon current knowledge and make sure that staff are aware of local authority guidance in relation to safeguarding. CARE HOMES FOR OLDER PEOPLE The Old Vicarage Residential Home Vicarage Road Tean Stoke On Trent Staffordshire ST10 4LE Lead Inspector Mandy Beck Key Unannounced Inspection 22nd September 2008 09:30 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address DS0000005022.V371940.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. DS0000005022.V371940.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service The Old Vicarage Residential Home Address Vicarage Road Tean Stoke On Trent Staffordshire ST10 4LE 01538 723441 01538 723810 theoldvicarage2002@hotmail.com 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) Mrs Patricia Ann Cope Mr Richard Cope Miss Lisa Marie Shaw Care Home 15 Category(ies) of Dementia - over 65 years of age (3), Old age, registration, with number not falling within any other category (15), of places Physical disability over 65 years of age (4) DS0000005022.V371940.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 22nd September 2006 Brief Description of the Service: The Old Vicarage is a residential home for older people. The property was built around 1859 as the local vicarage, and has been updated by the current providers to meet the national minimum standards. The property is two storeys, serviced by a shaft lift, and provides 15 single occupancy rooms, with 12 of these having an en-suite facility. Aids and adaptations are in place throughout the home to assist service users with restricted mobility, and there is an assisted bath on each floor, and ramp access to all external entrances. Bathrooms and toilets are close to bedroom and communal areas. There is a large lounge with small conservatory off, and a pleasant dining room, again leading to a small conservatory. All areas of the home are tastefully decorated and a homely atmosphere exists. Adequate laundry and kitchen facilities are provided. Adequate car parking is available at the front of the property, which is set in private grounds. The current range of fees people would be expected to pay for residency is £377 to £390. People may also be expected to pay for extra services such as hairdressing, newspapers and some excursions. A copy of the latest inspection report is available upon request. DS0000005022.V371940.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. We looked at all the information that we have asked for from the service. This included: • The annual quality assurance assessment (AQAA) that was sent to us by the service. The AQAA is a self-assessment that focuses on how well outcomes are being met for people using the service. It also gave us some numerical information about the service. • Information we have about how the service has managed any complaints. • What the service has told us about things that have happened in the service, these are called ‘notifications’ and are a legal requirement. • The results of any other visits we may have made to the service. • Relevant information from other organisations. • We also spent time talking to the people who use the service and to the staff who support them. • We looked at the care of two people who use this service in depth. This is part of our case tracking process and helps us makes judgements about the home’s abilities to meet people’s needs. What the service does well: The Old Vicarage offers a homely environment for people to live in. The staff are friendly and welcoming and people living here told us they were very happy. They said “It is a small friendly home and I am happy here”. People’s needs are assessed in full before they move into the home. This process will make sure that the home is aware of and can meet people’s requirements when they move in. People told us they felt confident in making their concerns or complaints known. They said “I am unhappy, I am sure it will be sorted out promptly nothing is too much trouble”. All of the food is freshly prepared and home cooked. People said “the food is lovely here”, “if you don’t like what’s on you can choose something else”. DS0000005022.V371940.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. DS0000005022.V371940.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection DS0000005022.V371940.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 3,6 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Each person who moves into this home will have their needs assessed in full. The service will be confident it can meet people’s needs before agreeing to offer them a home. EVIDENCE: We looked at the care records of two people who live in this home. We found in both cases the manager had visited each person at home prior to their admission to discuss their individual needs. Each person’s assessment had been complimented by the care manager’s additional assessment. This means that the home is possession of all the information they need about people before they agree they can meets their needs. People told us “I was asked what care needs I have and they have tried very hard to meet them”. Another person told us “I spent time in respite here before I agreed to move in”. The home does not provide intermediate care services. DS0000005022.V371940.R01.S.doc Version 5.2 Page 9 DS0000005022.V371940.R01.S.doc Version 5.2 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,9,10 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People living in this home can feel confident that both their personal and healthcare needs will be met. The home has good systems in place to manage the administration of medication. People can be assured that at all times they will be treated with respect and dignity. EVIDENCE: We looked at the care records of three people as part of our case tracking process. This process enables us to make judgements about how the home is meeting the needs of the people living in the home. We saw that each person had care plans and risk assessments that detailed the care they needed. Care plans are kept under regular review and changes to care are recorded. The home makes sure that risk assessments in relation to malnutrition and moving and handling are completed and kept under review. This will mean that any person considered to be at risk will be known to staff and a risk management plan drawn up. DS0000005022.V371940.R01.S.doc Version 5.2 Page 11 People told us they had been consulted about they care they need and the care they want. They said that staff respect their choices about when they want to get up and when they go to bed. There was plenty of evidence to show the home is supported by other healthcare professionals, such as the memory clinic, community mental health nurses, district nurses and continence nurses. The home has a very good relationship with the doctor, who visits regularly to see people in the home. Medication practices in this home are safe and protect the people living here. There are good systems in place for ordering, receipt and safe storage of medication. Staff who administer medication have all received accredited training and are expected to understand the home’s medication policy before they begin to administer medicines to the people living there. We have made some recommendations that will make improvements to the medication systems in the home. When recording handwritten entries on to the Medication Administration Record (MAR) sheet two members of staff should sign the entry to reduce the risk of error. The home should also record the temperature of the room where medication is stored. This should be done to make sure that it does not rise above 25oC. This will ensure that medication is stored as recommended by manufacturers. Staff were observed during the inspection to be committed to the personal care of people. They spent time with them and shared the day together. Every effort was made to ensure that the individual’s needs were met. DS0000005022.V371940.R01.S.doc Version 5.2 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,14,15 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People are encouraged to take part in activity both in and outside of the home. They can feel assured the home will support them in maintaining contact with their family and friends. People living here enjoy nutritious and well balanced meals in pleasant surroundings. EVIDENCE: Since our last visit to the home, an activity coordinator has been appointed. We were told that she had recently attended a training course in activity provision. “it was very good and I got to speak to other home’s as well and find out what they are doing”. The activity programme has been improved and people told us “there is always something going on”. On the day of this inspection the local entertainer was due to visit. People said “he plays all the music we like but we won’t tell you because you’ll know how old we are”. People who completed our questionnaires also commented on the popularity of this particular entertainer. The home has arranged for the mobile museum to visit the home. The bus is equipped with a mini Black Country museum and is mobile making it more DS0000005022.V371940.R01.S.doc Version 5.2 Page 13 accessible for people to use. Other activities on offer include crafts, bingo and other outside entertainers. The home has an open visiting policy and people can see their visitors in the privacy of their own rooms should they choose to do this. People are encouraged to personalise their rooms to their own individual tastes and this was evident when we looked around. Meals are freshly prepared on the premises and the menu choices are a direct result of people having been consulted about their likes and dislikes. The dining room is pleasantly decorated, with tables laid with fresh flowers and individual name cards for people. Care staff prepare meals for people and are aware of individuals special dietary requirements. Snacks and drinks are available throughout the day. People can choose to eat their meals in the dining room or in the privacy of their own rooms. DS0000005022.V371940.R01.S.doc Version 5.2 Page 14 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): 16,18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People using this service can feel confident their views will be listened to and acted upon. Further staff training will enhance the current safeguarding procedures in the home. EVIDENCE: The complaints procedure and policy is available for people to read in their service user guide. People told us that they knew who to talk to if they were unhappy about any aspect of their care. They said “If I am unhappy I know who to speak to”. The home has not received any complaints since our last visit. We, the commission have not been made aware of any concerns about this service. The home has policies and procedures in place for the safeguarding of vulnerable adults. Staff have some knowledge of adult abuse and what to do if an allegation is made to them. They have not however had any training in safeguarding vulnerable adults. We have recommended that this should be arranged. This will mean that staff will have a clear understanding of what abuse is, the types of abuse and who to report abuse to. The home should also obtain a copy of the local authority guidance in safeguarding vulnerable adults so they can be sure they will follow the correct procedures should an allegation or incident occur. DS0000005022.V371940.R01.S.doc Version 5.2 Page 15 There are currently no types of restraint being used in this home such as bed rails and lapbelts on wheelchairs. The recruitment practices of the home help protect the people living here. All staff that are recruited are only employed following the receipt of a satisfactory Criminal Record Bureau disclosure (CRB). DS0000005022.V371940.R01.S.doc Version 5.2 Page 16 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 19,26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People living in this home live in a cosy, homely environment. The building is well maintained and safe for people to live in. EVIDENCE: We looked around most of the home but not all of it. We saw that it was clean and free from any offensive odours. The lounges and dining rooms were pleasantly decorated and felt welcoming. We had the opportunity to see some of the people’s bedrooms who live there. They were personalised with their own possessions and felt cosy. The home has limited en suite facilities but there are a number of toilets and bathrooms available for people’s use. The bathroom on the ground floor is currently out of use and is to be replaced in the near future. DS0000005022.V371940.R01.S.doc Version 5.2 Page 17 The home also has beautiful gardens for people to take advantage of. We were told in the AQAA the home has a rolling programme for redecoration and renewal of furniture. Recent improvements have included some new carpets and redecoration of some people’s bedrooms. There are facilities on site to manage people’s laundry and the home has provided liquid soap and paper towels in toilets and bathrooms for hand washing purposes. Staff have access to gloves and aprons and are also taking part in infection control training. These measures will help reduce the risks of cross infection to people living in the home. DS0000005022.V371940.R01.S.doc Version 5.2 Page 18 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 27,28,29,30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People are supported by a friendly and stable staff team. The home has good systems in place to make sure people are recruited safely and that they receive the training they need to perform their duties. EVIDENCE: The home is sufficiently staffed. The staff team consists of care workers and domestic staff. There is no dedicated kitchen staff, care staff do the cooking for people living in this home. Whilst one care worker is doing the cooking there are still two care staff available to assist people with their needs. Staff continue to work towards their National Vocational Qualifications (NVQ) level 2 and 3. The home has told us that some of the care staff are reluctant to take up this training. They have also told us they will fully support and encourage all of their staff to complete their NVQ’s. At present over 50 of the current staff group have completed their NVQ’s. The home has good systems in place for the safe recruitment of new workers. We looked at the care files of three workers and found that their files contained all the relevant information. The home is making sure that Criminal Records Bureau disclosures (CRB’s) are completed before people being working in the home. They are also making sure that two written references are obtained and DS0000005022.V371940.R01.S.doc Version 5.2 Page 19 authenticated. These measures will help prevent unsuitable people from working with vulnerable adults. The home has an induction programme in place but at present there are no staff undertaking an induction. DS0000005022.V371940.R01.S.doc Version 5.2 Page 20 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31,33,35,38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People living in this home can be confident that it will be run in their best interests and their health and safety will be promoted and protected. EVIDENCE: Since the last inspection the manager Lisa Shaw has completed her National Vocational Qualification (NVQ) level 4 in management. Ms Shaw continues to manage the home well with the support of the providers, Mr and Mrs Cope. People we spoke to said “I am very happy and any thing was wrong I would talk to either one of them, they would all help”. Some of the staff who answered our questionnaires told us “I feel so privileged to work in this environment especially with the team I work with. I really do enjoy my job”. DS0000005022.V371940.R01.S.doc Version 5.2 Page 21 The quality assurance systems in place are informal and ensure that each person’s voice is heard. The manager told us that meetings are held regularly and people are encouraged to air their views. Regular checks are also conducted on the environment to make sure that it is a safe place for people live. The home supplied us with the AQAA, the document was completed and gave us a reasonable picture of the current situation within the service. The evidence to support comments made is satisfactory, although there are areas where more supporting evidence would have useful to illustrate what the service has done in the last year, or how it is planning to improve. For example “we have improved the menu, and fuller activites programme”. People are supported to manage their own money. Each person has a lockable space in their rooms for safekeeping of money and valuables if they choose to. The home is also able to keep small amounts of money on people’s behalf. Health and safety checks throughout the home are completed as required. Staff have training in health and safety, moving and handling, infection control and fire safety. There is also training for staff in first aid, and food hygiene. Training is arranged on a rolling programme and all staff we spoke to confirmed that they do take in regular training. Some safety certificates were spot checked and found to be in order. Fire alarms, emergency lighting and fire drills are also being regularly recorded by the home. We were told during this inspection that three people were in hospital, we had not been notified of this. We have recommended the home obtain the updated guidance from the commissions professional website, for notifications and regulation 37’s. DS0000005022.V371940.R01.S.doc Version 5.2 Page 22 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 2 3 X X X X X X 3 STAFFING Standard No Score 27 3 28 2 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X X 3 DS0000005022.V371940.R01.S.doc Version 5.2 Page 23 Are there any outstanding requirements from the last inspection? No STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 Refer to Standard OP9 Good Practice Recommendations The home should consider developing the selfadministration of medication risk assessment. This should be done so that people are clear about the reason why someone can or cannot administer their own medication. The home should make sure that when handwritten entries are made onto the MAR sheet, two staff should sign the entry. This will further reduce the risk of error occurring. The temperature of the room where medication is stored should be recorded on a daily basis. The home should do this in order to demonstrate they are storing medication as per manufacturers recommendations. For example 25oC or below. All staff should receive training in safeguarding vulnerable adults. The training should include recognition of abuse and how to report allegations/incidents appropriately. The home should have a copy of the local authority guidance for safeguarding vulnerable adults available to DS0000005022.V371940.R01.S.doc Version 5.2 Page 24 2 3 OP9 OP9 4 5 OP18 OP18 6 OP38 6staff on the premises. The home should obtain copy of the CSCI guidance on notifications and regulation 37. DS0000005022.V371940.R01.S.doc Version 5.2 Page 25 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 DS0000005022.V371940.R01.S.doc Version 5.2 Page 26 - 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. 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