Care Home: The Victoria Grand

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What the care home does well Staff offer care in a respectful and encouraging manner and people who use the service spoken to stated that they are treated with respect. The preferred form of address for people who use the service is recorded in the care Plan. A varied and nutritious diet is offered. There is a comfortable sitting room and an accessible garden There is an improved activities programme What has improved since the last inspection? The requirements of the last inspection have been met. Contracts have been reviewed, locks are being fitted to bedroom doors, the laundry has been refurbished and all staff have a Criminal Records Bureau Clearance and POVA check. In addition automatic door closures have been fitted and rooms have been decorated. What the care home could do better: The kitchen flooring needs to be effectively mended or replaced to prevent the spread of infection. All items listed on the medicine administration charts need a signature. CARE HOMES FOR OLDER PEOPLE The Victoria Grand 22 Mill Road Worthing West Sussex BN11 4LF Lead Inspector Sheila Gawley Unannounced Inspection 31st March 2008 09:00 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 The Victoria Grand DS0000058062.V359497.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. The Victoria Grand DS0000058062.V359497.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service The Victoria Grand Address 22 Mill Road Worthing West Sussex BN11 4LF 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) 01903 248048 Victoria Care Elite Ltd Mrs Julie Courtnadge Care Home 26 Category(ies) of Old age, not falling within any other category registration, with number (26) of places The Victoria Grand DS0000058062.V359497.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 27 03 07 Brief Description of the Service: The Victoria Grand is one of a number of homes in the Worthing area owned by Victoria Care Elite Ltd. The home is a large detached Victorian building within it’s own grounds. It is situated on the corner of a busy road close to shops and other facilities, including Worthing seafront. The home is situated on three floors with a passenger lift serving all but three rooms that have a few stairs down to access the mezzanine floor. There is a main lounge overlooking the garden and fishpond, and a smaller, quiet, conservatory, lounge to the eastern side. The home has 20 single bedrooms, 11 with en suites, and 3 shared bedrooms, and is registered to accommodate 26 older persons. Mrs Julie Courtnadge manages the service. The scale of charges varies from - £450.00 to £550.00 per week dependent on the type of bedroom occupied. The Victoria Grand DS0000058062.V359497.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 stars. This means the people who use this service experience good quality outcomes. This site visit as part of the inspection process was carried out on 31/03/08. The Registered Manager facilitated the inspection and any documents required on the day were made available. The proprietors were also available for part of the visit Prior to the visit the service file was reviewed as were any comments or complaints received by the Commission for Social Care Inspection. The home had sent us their Annual Quality Assurance Assessment for the inspection, which gave us the information we needed on the home. We were in receipt of Surveys from six people who use the service, eight family members and 15 staff. The majority of these comments were positive and these are reflected throughout the report Staff and people who use the service spoken to on the day stated that they were happy in the home The home has fully met the requirements of the last inspection. What the service does well: Staff offer care in a respectful and encouraging manner and people who use the service spoken to stated that they are treated with respect. The preferred form of address for people who use the service is recorded in the care Plan. A varied and nutritious diet is offered. There is a comfortable sitting room and an accessible garden There is an improved activities programme The Victoria Grand DS0000058062.V359497.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. The Victoria Grand DS0000058062.V359497.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 The Victoria Grand DS0000058062.V359497.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): 2,3, Standard 6 is not applicable People who use this service experience good outcomes in this area, as there is a clear assessment and admission process. This judgement has been made using available evidence including a visit to this service. EVIDENCE: It was a requirement of the last inspection that contracts and terms and conditions were reviewed. This has been done and contracts were seen to be in place along with up to date terms and conditions. People who use the service have their needs assessed prior to admission. In the care plans inspected these assessments were seen and were comprehensive. People who use the service spoken to confirmed that they had this assessment. Care management plans were also seen in care plans in which social services detailed the care needs they wished to see being met. The Victoria Grand DS0000058062.V359497.R01.S.doc Version 5.2 Page 9 The Victoria Grand DS0000058062.V359497.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): 7-10 People who use this service experience good outcomes in this area because all needs are assessed and met, set out in a plan and residents are treated with respect. Medicines are handled appropriately. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Three people who use the service were case tracked and were also spoken to on the day. All residents had a plan of care. Their care plans were inspected and they contained information on health, personal, nursing and social need. The care plans were drawn up following an assessment of these needs. This included mental, physical and social need, nutritional assessments, mobility, hygiene, continence, and pressure areas, and risk assessments. The risk assessments covered mobility, falls, nutrition and pressure area risk. There was evidence of monthly review and weight is monitored. The Victoria Grand DS0000058062.V359497.R01.S.doc Version 5.2 Page 11 Access to specialist health support is available as required including general practitioner. There was record of a District Nurse checking catheter care. The chiropodist visits six weekly. People who use the service are taken to the optician and dental appointments, although a dentist is available to visit the home. Staff were observed offering care in a respectful and encouraging manner and people who use the service spoken to stated that they are treated with respect. Their preferred form of address was recorded in the care plans. People who use the service and relatives spoken to stated that care is offered as assessed. A relative’s survey commented that communication between the home and relative is very good. Medicines are received, stored, administered and recorded correctly. Medicine administration charts inspected were up to date except for a thickening agent added to drinks. For the one person who uses the service who self medicates, there is a locked space available in the bedroom. The home is supported in the management of their medicines by a local pharmacy. There was a large stock of some medicines. This was discussed with the Registered Manager who will discuss this with the pharmacy and surgery, as there are occasions when a medicine is not ordered but is still sent to the home. The need to sign for all items on the Medicine administration charts was also discussed with the Registered Manager. The Victoria Grand DS0000058062.V359497.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): 12-15 People who use this service experience good outcomes in this area, because lifestyle in the home meets their expectations. Activities and events provided satisfy social, cultural and recreational needs. There is a variety of nutritional food on offer. This judgement has been made using available evidence including a visit to this service. EVIDENCE: There is an activities programme in place, which is listed on the notice boards in the hallway. There is keep fit, movement and dance, and carpet bowls. During the summer months there are weekly mini bus outings giving people who use the service the opportunity to go out to tea. There is piano music with sherry on Sundays, as well as seasonal events such as Christmas and Easter parties and summer garden parties. There is monthly communion and a quarterly newsletter. People who use the service spoken to stated that they were happy with daily life in the home. Birthdays are celebrated. Visitors are welcome in the home and religious needs are met as requested. The Victoria Grand DS0000058062.V359497.R01.S.doc Version 5.2 Page 13 People spoken to also stated that they could receive visitors as they choose. People spoken to stated that they have freedom in daily routines such as when to go to bed and where to take meals. A hairdresser visits the home. The cook was spoken to. There is varied menu in place and choice is offered to people who use the service. People are asked each day what choice the wish for the next day. The menu is discussed at quarterly residents meetings. The meal seen prepared and served today appeared nutritious and people who use the service said they enjoy the food. Relatives are always welcome to have lunch in the home one survey commented “ They have an excellent chef and the meals are always first class, they are always happy for my mother to have a relative or friend for a meal free of charge.” The Victoria Grand DS0000058062.V359497.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 People who use this service experience good outcomes in this area, as there are policies and procedures in place for complaints and safeguarding adults. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Surveys received and people spoken to on the day of the visit all commented that complaints would be addressed if the need to complain arose. One survey from a person who uses the service commented “would speak to the manager”. There are complaints and safeguarding procedures in place and staff spoken to are aware of the processes to follow. The complaints procedure needs to be updated with the new CSCI contact details. There is training in safeguarding adults in place supplied by an external company and training records were up to date. Staff spoken to confirmed they receive this training. The Victoria Grand DS0000058062.V359497.R01.S.doc Version 5.2 Page 15 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 People who use this service experience good outcomes in this area because they live in a safe and well-maintained environment although there is damage to the kitchen flooring. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home externally and internally was decorated to a good standard. It was neat, clean and free from offensive odours. Automatic door closure devices have been fitted since the last inspection and rooms have been redecorated. A programme for fitting locks to doors is in place. The requirements of a recent environmental health report carried out on 15/05/07 were met but an area of the kitchen floor covering is missing and the The Victoria Grand DS0000058062.V359497.R01.S.doc Version 5.2 Page 16 edges are torn and lifting. This poses a risk of infection to the people who use the service and the proprietor stated he would rectify this and called in a flooring contractor on the day and has subsequently confirmed by telephone that that area of the kitchen will have the floor replaced within the week. The requirement of the last inspection to address shortfalls in the laundry has been carried, a new floor has been fitted and the walls have been painted. One relative surveyed commented, “It’s the most immaculately clean and well kept home that I have ever visited”. The Victoria Grand DS0000058062.V359497.R01.S.doc Version 5.2 Page 17 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): 27-30 People who use this service experience good outcomes in this area because needs are met by a staff trained and qualified to do so. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Staff rota showed staffing levels were sufficient to meet the needs of residents, with three care staff on duty on the day of the visit with the manager, two housekeepers and the chef. The Registered Manager stated that of late the home has not had a kitchen assistant and that carer numbers have been reduced to two in the afternoons but an activities coordinator is on at this time. She did state that the needs of people who use the service are met. There are robust recruitment procedures in place and staff files inspected contained all the documentation required to ensure the protection of people who use the service. There was evidence of application forms with employment history, except for one carer who had been employed directly from school. Criminal Records Bureau Clearance and POVA check, two referenced, identity documentation, and photograph were all in place. There is a staff-training programme in place which staff spoken to confirmed they attend. Training records were seen in staff files. Surveys received from staff commented, “The induction I received was very good and interesting The Victoria Grand DS0000058062.V359497.R01.S.doc Version 5.2 Page 18 letting me know about the job”. “Our manager always ensures there are enough staff to meet clients needs”. This home creates a good living environment for residents and staff and training is good”. One person who uses the service commented “We are Looked after exceedingly well”. A relative survey commented, “The staff are always welcoming to visitors”. Ten carers have National Vocational Qualification Level 2, two carers are completing this at present and four carers are completing National Vocational Qualification Level 3. This meets the minimum 50 recommended in The National Minimum Standards. The Victoria Grand DS0000058062.V359497.R01.S.doc Version 5.2 Page 19 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, 36,38 People who use this service experience good outcomes in this area because the home is run in the best interests of the residents. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The registered manager has many years experience working with older persons, and has been in management for ten years. She has achieved the NVQ level 4 in management qualification. A staff survey received commented, “ the manager is very good and very supportive in all aspects”. “The staff are very friendly and the management is good. Staff spoken to on the day stated The Victoria Grand DS0000058062.V359497.R01.S.doc Version 5.2 Page 20 that it is a happy home to work in and that the people who use the service are well cared for. People who use the service spoken to on the day were very positive with comments such as “ Don’t want for anything. “ Discussion with the registered manage demonstrated that she is committed to ensuring that the best possible services are provided to residents and that residents are fully consulted about the sort of services provided The home provides a staff structure including senior care staff to which the manager can safely delegate. The home does not hold or manage any monies or accounts for people who use the service. There is a staff supervision programme in place and supervision records were seen in staff files and these were up to date. Staff spoken to confirmed they received supervision. There are staff meetings and meetings with people who use the service quarterly. Minutes of these meetings were seen. People who use the service are also surveyed formally and informally. The responses seen in these surveys were mostly “excellent or “very good”. The home is about to commence surveying relatives and professionals. The health, safety and welfare of people who use the service and staff are protected by the provision of mandatory training. Health and safety policies and procedures are in place, and the proprietor is made aware of any maintenance issues that need to be addressed. The Victoria Grand DS0000058062.V359497.R01.S.doc Version 5.2 Page 21 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 3 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 3 3 X X X X X X 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 3 X 3 The Victoria Grand DS0000058062.V359497.R01.S.doc Version 5.2 Page 22 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. Refer to Standard Good Practice Recommendations The Victoria Grand DS0000058062.V359497.R01.S.doc Version 5.2 Page 23 Commission for Social Care Inspection Maidstone Office The Oast Hermitage Court Hermitage Lane Maidstone ME16 9NT 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 Victoria Grand DS0000058062.V359497.R01.S.doc Version 5.2 Page 24 - 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. 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