Care Home: The Old Vicarage Residential Home

What the care home does well Relatives who met or have spoken with the inspector before at the last key inspection visit still say that they are happy with the care at the home. They can also see the improvements taking place and are satisfied by them. The Registered Nurse from the consultancy agency had reviewed the care records and composed an up to date care plan for each person in the care home. So far three staff members have also been shown how to include the changes and improvements in the care plans. Two staff members spoke with the inspector. They were more aware of the individual care needs of the two people case tracked. The care plans that the inspector saw contained detailed information such as the recognition of needs and how to assist with the individuals` needs. In this way each individual will now be able to receive care that is consistent, gives staff guidance as to what they should do to improve care when things change for the worse and to call in help from external professionals and not to ignore situations and to report them early. If the staff at this care home follow the care plans and learn from the advice and help that the consultancy team has given them, individuals living at the care home, will receive care that is safe and meets the basic standards required to provide care for people living at the home. One person seen briefly by the inspector at last key inspection was seen at this inspection. They were in a very pleasant mood and quite sociable. The nurse explained that when this person had their meals on time as per care plan that she had written for staff to follow the individual remained in good spirit. A special chart was to be started for monitoring the individuals behaviour and other specialist staff were actively involved in their plan of care. A walk around the building with the registered owner, was carried out with the inspector and a senior staff member from the consultancy team. The downstairs shower room was checked. Window locks were now in place. Window locks were also in place in upstairs rooms. Most of the bedrooms except for two were looked at. They were clean and tidy. Environmental Risk Assessments are in place. New handrails have been put in places where required. Some improvements in lighting have been made and the registered owner said that further improvements were to take place as long strips of bright lights are to be added to the hallways. All bedrooms now have lockable facilities in them. All areas of the home must be kept clean and free from offensive odours. Although this has been met it in most cases it should continue on a rolling programme. What the care home could do better: The activities board displayed in the hall way at the front to the home and in the bottom lounge, had `exercise and pub quiz` on it as the activities for a Tuesday. The inspector asked individuals living at the home if they had taken part in any activities on the day of inspection or the day before. They replied that it was " non existent " . However , when the inspector arrived there were five people in the top lounge playing cards with a member of staff and later in the afternoon watching a film together. The requirement for activities is being met in part but will remain as not all individuals feel that they are involved in activities that satisfy their needs. The Statement of Purpose and Service User Guide should also include how activities for people with dementia is to be met on a daily basis to meet the needs of registration within this area of care. A meal at lunchtime was seen. More staff was seen. They were available to help individuals and the atmosphere appeared more relaxed. However in the bottom lounge individuals complained about the length of time taken for them to be served their meals and for the long break between the main course and the pudding. At lunch time better organization of the staff is still needed as some people are kept waiting for too long between the different meal courses. We looked at two staff records, all required information was in place for example application forms, forms of identity and Criminal Records Bureau Checks were in place. However the owner still has risk assessments to do on staff records that initially would need further exploration as to their continued suitability for working in a care environment. Two references sought and received; although one was a personal reference and it is recommended that a further reference is sought. Basic training is being provided including fire safety, safeguarding adults and Moving and Handling. Nutritional training is being provided by a dietitian. Staffing levels are currently being maintained at five in the morning, four or five in the afternoon and two waking staff at night. Ancillary staff are provided in the morning to carry out cleaning and cooking tasks the inspectors were told. These staffing numbers are enabling more 1:1 attention to service users and more individualized attention at meal times, which is having a positive effect on service user`s well being.Health and Safety measures included Fire training planned for 11th February, all staff attending including night staff. Fire evacuation plan in place but this has yet to be approved by the fire officer who will re-inspect the home for fire safety specifically in March 2009. Fire doors have been upgraded and appliances tested. Further smoke alarms are to be fitted to hallways on 11th February the inspectors were told. A five year electrical circuit test has been completed and the certificate was available. Hoist, slings and stair lift have been serviced. The certificate needs to be checked by the provider to ensure that it is Lifting Operations and Lifting Equipment regulations 1998 (LOLER) compliant and it is recommendation that the provider contacts the Health and Safety Executive or Environmental Health for advice. Portable Appliance Testing has been carried out; however there is no register of appliances and this is necessary to show which appliances have been tested. Lighting in corridors has been improved, although there are still areas, which are not as well lit; some personal rooms also need brighter lighting. Environmental Risk Assessments are in place; although there are currently two files in place, which may confuse staff and pose a risk as staff may not follow the correct information. The Statement of Purpose and Service User Guide must also identify how people with physical disabilities are able to move around the home now that the four steps have been indentified as a potential risk to them should they attempt to use them. Legionella testing schedule is being put in place, with testing to be carried out on a regular basis by the handyman. Control of Substances Hazardous to Health (CoSHH) information in place, a contract is now in place to provide cleaning materials, corresponding data sheets and training. Moving and Handling training is planned for February. A new manager has been appointed and will commence 2nd March and should be in the process of making an application to the Commission for Social Care Inspection (CSCI). However, since visiting and completing this report we have been informed that the new manager did not stay and the registered person is again in the process of seeking a new manager and until such time it is expected that the assistance of the management consultancy group will remain to ensure continuity and improvements in the care standards obtained so far. The Management consultancy remains in place; discussion to take place between the provider and the consultancy in order to make a planned withdrawal. Policies and procedur Inspecting for better lives Random inspection report Care homes for older people Name: Address: The Old Vicarage Residential Home Silver Street Whitwick Coalville Leicestershire LE67 5EW zero star poor service The quality rating for this care home is: The rating was made on: A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. This is a report of a random inspection of this care home. A random inspection is a short, focussed inspection. Details of how to get other inspection reports for this care home, including the last key inspection report, can be found on the last page of this report. Lead inspector: Lesley Allison-White Date: 1 0 0 2 2 0 0 9 Information about the care home Name of care home: Address: The Old Vicarage Residential Home Silver Street Whitwick Coalville Leicestershire LE67 5EW 01530831802 F/P01530831802 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Conditions of registration: Category(ies) : The Old Vicarage Residential Home Ltd care home 19 Number of places (if applicable): Under 65 Over 65 0 19 0 dementia old age, not falling within any other category physical disability Conditions of registration: 19 0 19 To specify the minimum age: No person under 18 years of age who falls within the categories OP, PD or DE may be admitted to the Old Vicarage Residential Home. Date of last inspection Brief description of the care home The Old Vicarage is a residential home for older people situated in the heart of the village of Whitwick. The home is a Grade II listed building of historic interest. It has 19 single bedrooms, most of which have en-suite facilities, two lounges, a small reading room, and a dining room. To the rear of the home is a large secluded garden. There is a car park. Fees range from £334.00 to £396.00 per week. An old copy of the Care Homes for Older People Page 2 of 13 Brief description of the care home Statement of Purpose and Service Users Guide is available at the entrance to the home (these provide information on how the home is organised and what services they provide). A current Employers Liability certificate of insurance is displayed in the hallway and a copy of the inspection report should also be available on request. Care Homes for Older People Page 3 of 13 What we found: This is an overview of what the inspector found The quality rating for this service is 0 star. This means the people who use this service experience poor quality outcomes. We came to this quality rating at the last key inspection. The focus on inspections undertaken by the Commission for Social Care Inspection is on outcomes for individuals and their views of the service provided. The inspection took place on a Tuesday. It took over six hours to complete. This random was completed as a result of the number of requirements made at the last key inspection and by concerns raised by other care professionals. What the care home does well: Relatives who met or have spoken with the inspector before at the last key inspection visit still say that they are happy with the care at the home. They can also see the improvements taking place and are satisfied by them. The Registered Nurse from the consultancy agency had reviewed the care records and composed an up to date care plan for each person in the care home. So far three staff members have also been shown how to include the changes and improvements in the care plans. Two staff members spoke with the inspector. They were more aware of the individual care needs of the two people case tracked. The care plans that the inspector saw contained detailed information such as the recognition of needs and how to assist with the individuals needs. In this way each individual will now be able to receive care that is consistent, gives staff guidance as to what they should do to improve care when things change for the worse and to call in help from external professionals and not to ignore situations and to report them early. If the staff at this care home follow the care plans and learn from the advice and help that the consultancy team has given them, individuals living at the care home, will receive care that is safe and meets the basic standards required to provide care for people living at the home. One person seen briefly by the inspector at last key inspection was seen at this inspection. They were in a very pleasant mood and quite sociable. The nurse explained that when this person had their meals on time as per care plan that she had written for staff to follow the individual remained in good spirit. A special chart was to be started for monitoring the individuals behaviour and other specialist staff were actively involved in their plan of care. A walk around the building with the registered owner, was carried out with the inspector and a senior staff member from the consultancy team. The downstairs shower room was checked. Window locks were now in place. Window locks were also in place in upstairs rooms. Most of the bedrooms except for two were looked at. They were clean and tidy. Environmental Risk Assessments are in place. New handrails have Care Homes for Older People Page 4 of 13 been put in places where required. Some improvements in lighting have been made and the registered owner said that further improvements were to take place as long strips of bright lights are to be added to the hallways. All bedrooms now have lockable facilities in them. All areas of the home must be kept clean and free from offensive odours. Although this has been met it in most cases it should continue on a rolling programme. What they could do better: The activities board displayed in the hall way at the front to the home and in the bottom lounge, had exercise and pub quiz on it as the activities for a Tuesday. The inspector asked individuals living at the home if they had taken part in any activities on the day of inspection or the day before. They replied that it was non existent . However , when the inspector arrived there were five people in the top lounge playing cards with a member of staff and later in the afternoon watching a film together. The requirement for activities is being met in part but will remain as not all individuals feel that they are involved in activities that satisfy their needs. The Statement of Purpose and Service User Guide should also include how activities for people with dementia is to be met on a daily basis to meet the needs of registration within this area of care. A meal at lunchtime was seen. More staff was seen. They were available to help individuals and the atmosphere appeared more relaxed. However in the bottom lounge individuals complained about the length of time taken for them to be served their meals and for the long break between the main course and the pudding. At lunch time better organization of the staff is still needed as some people are kept waiting for too long between the different meal courses. We looked at two staff records, all required information was in place for example application forms, forms of identity and Criminal Records Bureau Checks were in place. However the owner still has risk assessments to do on staff records that initially would need further exploration as to their continued suitability for working in a care environment. Two references sought and received; although one was a personal reference and it is recommended that a further reference is sought. Basic training is being provided including fire safety, safeguarding adults and Moving and Handling. Nutritional training is being provided by a dietitian. Staffing levels are currently being maintained at five in the morning, four or five in the afternoon and two waking staff at night. Ancillary staff are provided in the morning to carry out cleaning and cooking tasks the inspectors were told. These staffing numbers are enabling more 1:1 attention to service users and more individualized attention at meal times, which is having a positive effect on service users well being. Care Homes for Older People Page 5 of 13 Health and Safety measures included Fire training planned for 11th February, all staff attending including night staff. Fire evacuation plan in place but this has yet to be approved by the fire officer who will re-inspect the home for fire safety specifically in March 2009. Fire doors have been upgraded and appliances tested. Further smoke alarms are to be fitted to hallways on 11th February the inspectors were told. A five year electrical circuit test has been completed and the certificate was available. Hoist, slings and stair lift have been serviced. The certificate needs to be checked by the provider to ensure that it is Lifting Operations and Lifting Equipment regulations 1998 (LOLER) compliant and it is recommendation that the provider contacts the Health and Safety Executive or Environmental Health for advice. Portable Appliance Testing has been carried out; however there is no register of appliances and this is necessary to show which appliances have been tested. Lighting in corridors has been improved, although there are still areas, which are not as well lit; some personal rooms also need brighter lighting. Environmental Risk Assessments are in place; although there are currently two files in place, which may confuse staff and pose a risk as staff may not follow the correct information. The Statement of Purpose and Service User Guide must also identify how people with physical disabilities are able to move around the home now that the four steps have been indentified as a potential risk to them should they attempt to use them. Legionella testing schedule is being put in place, with testing to be carried out on a regular basis by the handyman. Control of Substances Hazardous to Health (CoSHH) information in place, a contract is now in place to provide cleaning materials, corresponding data sheets and training. Moving and Handling training is planned for February. A new manager has been appointed and will commence 2nd March and should be in the process of making an application to the Commission for Social Care Inspection (CSCI). However, since visiting and completing this report we have been informed that the new manager did not stay and the registered person is again in the process of seeking a new manager and until such time it is expected that the assistance of the management consultancy group will remain to ensure continuity and improvements in the care standards obtained so far. The Management consultancy remains in place; discussion to take place between the provider and the consultancy in order to make a planned withdrawal. Policies and procedures are being updated; again there are two systems in place, which may cause confusion and pose a risk to service users or staff. Financial viability is not currently a cause for concern, invoices for services are currently being paid. Care Homes for Older People Page 6 of 13 The planned change for the responsible individual has now been notified in writing to the Commission (CSCI). Although many of the requirements were satisified at this random inspection, issues around training will need to be rechecked for compliance and so have remained until the next key inspection . 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 set out on page 2. Care Homes for Older People Page 7 of 13 Are there any outstanding requirements from the last inspection? Yes R No £ Outstanding statutory requirements These requirements were set at the last inspection. They may not have been looked at during this inspection, as a random inspection is short and focussed. The registered person must take the necessary action to comply with these requirements within the timescales set. No. Standard Regulation Requirement Timescale for action 1 10 13 (6) The registered person 08/02/2009 shall make arrangements, by training staff or other measures to prevent service users being harmed or suffering or being placed at risk of harm or abuse. Care practices have identified that staff are unsure as to what they need to do and how abuse can take place intentionally and unintentionally. In this way all individuals will be protected from abuse. 2 12 16 (2) The registered person shall having regard to the size of the care home and number and needs of the service users n) consult service users about the programme of activities arranged by or on behalf of the care home, and provide facilties for recreation including, having regards to the needs of services, activities in relation to recreation, fitness and training. Activities must be provided to improve the daily experiences of the individuals living at the home. Individuals with dementia 08/02/2009 Care Homes for Older People Page 8 of 13 need to be provided with activities appropriate to their condition. 3 20 13 The registered person shall 08/02/2009 ensure that (4)(c) all unnecessary risks to health or safety of service users are identified and so far as possible eliminated. Lighting in communal areas are domestic in character, they must be sufficiently bright and positioned to facilitate reading and other activities. This will avoid unnecessary injuries such as falls. 4 28 18 The registered person shall, 08/02/2009 having regard to the size of the care home, the statement of purpose and the number and needs of service users (a) ensure that at all times suitabley qauified, competent and experienced persons are working at the care home in such numbers as are appropriate for the health and welfare of service users. A minimum ratio of 50 trained members of care staff (NVQ level 2 or equivalent must be achieved and maintained. In this way individuals living at the home will be in safe hands. 5 29 19 The registered person shall 08/02/2009 not employ a person to work at the care home unless a) the person is fit to work at the care home; (b) subject to paragraph (6), he has obtained in respect of that perosn the informatin and documents specified in (i) paragraphs 1 to 7 of Page 9 of 13 Care Homes for Older People Schedule 2 (c) he is satisfied on reasonable ground as to the authernticity of the references referred to in paragraph 5 of schedule 2 in respect of that person. Enhanced Criminal Record Bureau checks must be obtained first in respect of that person and checked against the vulnerable adults register. This is to ensure that only suitable people work in the care home and individuals are not put at risk. 6 30 18 The registered person shall, 08/02/2009 having regard to the size of the care home, the statement of purpose and the number and needs of service users (a) ensure that at all times suitabley qauified, competent and experienced persons are working at the care home in such numbers as are appropriate for the health and welfare of service users. As this is a home with dementia people living in it all staff must receive training in this area of care. Care Homes for Older People Page 10 of 13 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 1 1 4 The registered person shall 10/04/2009 compile in relation to the care home a written statement in these regulations referred to as the statement of purpose which shall consist of a) a statement of the aims and objectives of the care home; b) a statement as to the facilities and services which are to be provided by the registered person for service users; and c) statement as to the matters listed in Schedule 1. The registered provider must further consider how the needs of people with dementia are to be met and service users with physical disabilities especially now that the four steps have been identified as being unsuitable for people within that category. The Statement of Purpose and Service User Guide must reflect how these needs are to be met. 2 19 23 Where a time scale has been 10/04/2009 Page 11 of 13 Care Homes for Older People set for compliance with any standard relating to the physical environemt of the home, a plan and programme for acheiving compliance is produced and followed and records kept. The registered provider must consider the safety of people in the home and alternative telephone access should be avialable should this be needed in the case of fire as the current telephone line is linked to the flat within the premises. 3 19 23 The registered person shall 10/04/2009 undertake appropriate consultation with the authority responsible for environmental health in which the care home is situated. Environmental Risk Assessments are in place; although there are currently two files in place, which may confuse staff and pose a risk as staff may not follow the correct information. 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 12 of 13 Reader Information Document Purpose: Author: Audience: Further copies from: Inspection Report CSCI General Public 0870 240 7535 (telephone order line) Our duty to regulate social care services is set out in the Care Standards Act 2000. Copies of the National Minimum Standards –Care Homes for Older People can be found at www.dh.gov.uk or got 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 Helpline: 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 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) Commission for Social Care Inspection (CSCI). 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 CSCI copyright, with the title and date of publication of the document specified. Care Homes for Older People Page 13 of 13 - 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!