Care Home: Vicarage House

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What the care home does well The home is run in the best interests of the people living there. People are being consulted about the way the home is managed and their views are taken into account. Anyone thinking of moving into Vicarage House can go and look around to see for themselves if they think the home is suitable for them. If they decide to move in staff from the home will carry out an assessment to make sure that they can meet that persons needs. People living in the home told us that their health and personal care needs are being met. People look well cared for. All the people who live in the home spoke well of staff and they felt that they were kind and caring. There are individual and group activities on offer, including trips out, to keep people stimulated. People can follow their own routines and relatives and friends are welcome to visit at any time. People living at the home all said that the food was good offering choice and variety. If people living at the home and/or relatives are not happy about the service they are getting there is a complaints procedure. People were aware of the procedure and said that they would be able to raise any concerns and that they felt any problems would be resolved. The home is clean, tidy and comfortable. People living at the all said that the home was kept fresh and clean. The staff are friendly and well trained. Staff enjoy working at the home and feel they work well as a team. In the surveys we asked people what they thought the home does well. These are some of the comments we received: `It is a good home and the staff are good.` `People living in the home get individual care and attention. There is a family atmosphere.` `In my opinion Vicarage House is like one big happy family.` `The home seems to run well with the members of staff that are there. People living in the home get the care they need and more from staff.` What has improved since the last inspection? Staff recruitment procedures have improved and people are being properly checked before they start working in the home to make sure they are suitable and safe to work with older people.Staff at the home are telling us about things that happen in the home that we need to know about. This makes sure that we can check they are taking the right action. What the care home could do better: The owner needs to make sure that she writes a report about her visits every month and gives a copy to the manager. This will make sure that discussions and agreements between the owner, people living in the home, staff and the manager are documented and provide information to make sure the home continues to be run in the best interest of the people living there. Key inspection report Care homes for older people Name: Address: Vicarage House 10 Church Street Ravensthorpe Dewsbury West Yorkshire WF13 3LA     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home is meeting the needs of the people who use it. We give a quality rating following a full review of the service. We call this full review a ‘key’ inspection. Lead inspector: Paula McCloy     Date: 0 2 0 3 2 0 1 0 This is a review of quality of outcomes that people experience in this care home. We believe high quality care should • • • • • Be safe Have the right outcomes, including clinical outcomes Be a good experience for the people that use it Help prevent illness, and promote healthy, independent living Be available to those who need it when they need it. The first part of the review gives the overall quality rating for the care home: • • • • 3 2 1 0 stars - excellent stars - good star - adequate star - poor There is also a bar chart that gives a quick way of seeing the quality of care that the home provides under key areas that matter to people. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Care Homes for Older People Page 2 of 24 We review the quality of the service against outcomes from the National Minimum Standards (NMS). Those standards are written by the Department of Health for each type of care service. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The mission of the Care Quality Commission is to make care better for people by: • Regulating health and adult social care services to ensure quality and safety standards, drive improvement and stamp out bad practice • Protecting the rights of people who use services, particularly the most vulnerable and those detained under the Mental Health Act 1983 • Providing accessible, trustworthy information on the quality of care and services so people can make better decisions about their care and so that commissioners and providers of services can improve services. • Providing independent public accountability on how commissioners and providers of services are improving the quality of care and providing value for money. Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report Care Quality Commission General public 0870 240 7535 (telephone order line) Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Care Homes for Older People Page 3 of 24 Information about the care home Name of care home: Address: Vicarage House 10 Church Street Ravensthorpe Dewsbury West Yorkshire WF13 3LA 01924459585 01924459060 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Plus Care Homes Limited care home 20 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 old age, not falling within any other category Additional conditions: The maximum number of service users who can be accommodated is: 20 The registered person may provide the following category of service only: Care home only - Code PC; To service users of the following gender: Either; Whose primary care needs on admission to the home are within the following category: Old age, not falling within any other category - Code OP Date of last inspection Brief description of the care home Vicarage House provides personal care and accommodation for up to twenty older people. The home located in the town centre of Ravensthorpe, near Dewsbury is close to shops and other amenities. The home is arranged on two levels both accessed by a passenger lifts and a stair lift. The home has 18 single and 1 double bedroom. The communal sitting and dining area is well used by people who live at the home. A conservatory to the rear of the property leads out to raised flowerbeds and a pleasant sitting area. Care Homes for Older People Page 4 of 24 Over 65 20 0 Brief description of the care home Information about the home and the services provided are available from the home in the statement of purpose and the service user guide. Care Homes for Older People Page 5 of 24 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: The current weekly charges at the time of our visit on 2 March 2010 ranged from £360 -£400 per week. Additional charges are made for hairdressing and newspapers. This inspection was carried out to assess the quality of care provided to people living at the home. The inspection process included looking at the information we have received about the home since the last key inspection as well as a visit to the home, which lasted approximately 6 hours. During the visit we spoke to 5 people living in the home, 2 members of staff, the manager and the owner. We also observed staff delivering care, looked at various records and looked around the home. Care Homes for Older People Page 6 of 24 Surveys were sent to 10 people living in the home, 10 staff and 5 health care professionals; these cards provide an opportunity for people to share their views of the service with us. Information received in this way is shared with the home without identifying who has provided it. One person using the service one relative and eight members of staff wrote to us with their comments. Their comments have been used in this report. We have reviewed our practice when making requirements, to improve national consistency. Some requirements from previous inspection reports may have been deleted or carried forward into this report as recommendations, but only when it is considered that people who use the service are not being put at significant risk of harm. In future, if a requirement is repeated, it is likely that enforcement action will be taken. Care Homes for Older People Page 7 of 24 What the care home does well: What has improved since the last inspection? Staff recruitment procedures have improved and people are being properly checked before they start working in the home to make sure they are suitable and safe to work with older people. Care Homes for Older People Page 8 of 24 Staff at the home are telling us about things that happen in the home that we need to know about. This makes sure that we can check they are taking the right action. What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line 0870 240 7535. Care Homes for Older People Page 9 of 24 Details of our findings Contents Choice of home (standards 1 - 6) Health and personal care (standards 7 - 11) Daily life and social activities (standards 12 - 15) Complaints and protection (standards 16 - 18) Environment (standards 19 - 26) Staffing (standards 27 - 30) Management and administration (standards 31 - 38) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 10 of 24 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People can go and look around the home to see for themselves if they think it is suitable. Staff assess people before they move in so they are sure they can meet peoples needs. Evidence: Anyone thinking of moving into Vicarage House can go and have a look round to see for themselves if they think it will be suitable. They can also have a copy of the homes Service User Guide to take away with them. This document gives people information about the home and the service it provides. A member of staff from Vicarage House will go and assess anyone thinking of moving into the home. This means that peoples needs are identified and that staff are sure they can meet those needs before people move in. Care Homes for Older People Page 11 of 24 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Peoples health and personal care needs are being met. Evidence: We looked at three care plans because we wanted to see what individual needs had been identified and what action staff have to take to meet these needs. We found that generally the care plans contained some good information, but need to be more detailed. When we talked to staff about peoples care and support they were able to give very detailed accounts of peoples preferences and the way they like to be supported. This level of detail needs to be included in the individual plans. We spoke to the owner and acting manager about this. The owner has a new care planning format that she will be introducing that she is confident will address the current shortfalls. We spoke to five people who all told us that they get the care and support they need. They also told us that staff listen to them and that staff are kind and patient. Care Homes for Older People Page 12 of 24 Evidence: Peoples health care needs are being identified and met. Staff are vigilant and GPs and other health care professionals are being involved as necessary. Details of any visits by health care professionals are documented in the individual care plan and show the advice that has been given. People generally looked well cared for and we saw that men had been shaved, peoples hair brushed or combed, spectacles were clean and peoples personal hygiene was well maintained. The medication system is well managed. We watched part of a medication round. The senior care assistant spent time with each individual, offering encouragement when needed. People are receiving their medication at the prescribed times and records are well maintained. Care Homes for Older People Page 13 of 24 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People can follow their own routines and there are activities on offer to keep people stimulated. Meals are the home are good offering choice and variety. Evidence: People are able to follow their own routines and interests. The care staff have time to sit with people in small groups or individually to provide activities to keep people stimulated. The home have purchased a Wii gaming console, which staff told us provides a lot of entertainment for people. A weekly exercise class and bingo sessions also take place. A very large black and white cart called Beefy also lives at the home. He is very affectionate and people living there like having a pet. The acting manager told us she will be arranging some trips out as soon as the weather improves. Last year people visited the Ponderosa, a local attraction that gives people the opportunity to handle a variety of reptiles and small animals. Some of the people we talked to remembered this visit and told us how much they had enjoyed it. Care Homes for Older People Page 14 of 24 Evidence: Staff at the home are very welcoming and there is a lively atmosphere. Visitors are made to feel welcome and can sit in the lounge, conservatory or peoples bedrooms if they want more privacy. Meals at the home are good offering choice and variety. We talked to the cook who told us that food supplies are obtained from a local farm shop, greengrocers and supermarket. People are offered a choice for every meal and the cook is aware of peoples personal preferences and caters for these. All of the people we spoke to and staff told us that the meals were good. We observed the lunchtime meal. People received their nicely presented meals in a timely fashion and staff were available to assist people as necessary. Care Homes for Older People Page 15 of 24 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Complaints and adult protection issues are being dealt with properly. This means that staff are listening to people and keeping them safe. Evidence: The home has a complaints procedure that is detailed in the Service User Guide. There is a copy of the Service User Guide in every bedroom so people can refer to it if they need to. The home has a complaints log where they write down any complaints that they receive together with the action taken and outcome. They have received one complaint that has been dealt with properly. The safeguarding procedures are on display as are the details of how to contact the safeguarding team in Kirklees. Staff receive regular training about safeguarding, this means that they are aware of the different types of abuse, reporting procedures and understand how to keep people safe. Care Homes for Older People Page 16 of 24 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home is comfortable, clean and tidy. Evidence: Vicarage House is in Ravensthorpe, Dewsbury and the local shops are within walking distance. The home is on a bus route. There is a pleasant garden for people to use in nice weather. The accommodation at the home is arranged over two floors. There is a lounge, dining room and conservatory on the ground floor. There is one double bedroom and all of the rest are singles. They all vary in shape and size. All of the bedrooms we looked at had been personalised with various pieces of furniture, pictures and ornaments. This made them look very homely. The home was very clean and tidy and people told us that this is always the case and there are never any unpleasant odours. At the last inspection by environmental health the kitchen was awarded 3* for hygiene. This means that the standards of cleanliness are good. Staff have completed training so that they are aware of infection control issues and what they have to do to stop the spread of infection. Care Homes for Older People Page 17 of 24 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. There are enough staff on duty to meet peoples needs. Staff are well trained and competent to do their job. Evidence: At the time of our visit there were 19 people living at the home. During the day there are three care staff on duty and at night there are two waking carers. The caring staff are well supported by cooks, a housekeeper and cleaner. This means that they can concentrate on delivering care and support to people and are not taken away to do other duties. The staff we spoke to told us that there are enough staff on duty to meet peoples needs. We looked at some of the records relating to recently recruited staff to see if staff are appropriately checked before they start work at the home. Recruitment procedures are generally good, references are always taken up and checks are always made with the Criminal Records Bureau and against the Protection of Vulnerable Adults register to ensure that new staff are suitable to work with older people. There are fourteen care staff working in the home, seven have completed their NVQ (National Vocational Training) level 2 or 3 in care and four members of staff are in the process of completing this training. This means that staff are trained and have been assessed as competent to do their job. Care Homes for Older People Page 18 of 24 Evidence: There is a training matrix in place for each member of staff, which shows what training staff have received and what training they need to do. Training has also been arranged for staff about the Mental Capacity Act and Deprivation of Liberty Safeguards. This will make sure they fully understand this legislation and can apply it to their everyday working practice. The acting manager told us that staff receive induction training when they first start working in the home and that they work with an experienced member of staff until they feel confident to work alone. There is an induction programme in place for staff to follow. This means that staff are given the training and information they need before they start working alone. Care Homes for Older People Page 19 of 24 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home is being run in the best interests of the people living there. Evidence: The acting manager is in the process of completing the Leadership and Management of Care Services Award and a National Vocational Qualification at level 3 in Business and Administration. She has applied for registration with us and is awaiting an interview. The acting manager and owner talk to people living in the home, relatives and staff to get their views about the service. The acting manager has also sent out surveys as another way to get peoples views and what they think about the home. When these are returned she needs to produce a report that can be given to people telling them about the results and what action is going to be taken to address any issues that have been raised. We wanted to look at the monthly reports that the provider has to write about the conduct and management of the home. There were no reports available. We talked to Care Homes for Older People Page 20 of 24 Evidence: the owner who visits the home every week, she agreed that she will produce a report every month about her findings and discussions. The purpose of these visits and reports is to make sure the home is being manged properly and is run in the best interests of the people living there. The manager should receive copies of these reports so that she knows if there is any action she needs to take as a result of these visits. The acting manager does hold money on behalf of people living there. We looked at the records and found that they were accurate. This means that people are protected from any financial abuse. There is a written Health and Safety policy. Staff receive moving and handling, health and safety, food hygiene, fire safety, first aid and infection control training. One member of staff has particular responsibility for health and safety and works one day a week making sure that all of the necessary checks and documentation are in place. Care Homes for Older People Page 21 of 24 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 22 of 24 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No Refer to Standard Good Practice Recommendations 1 7 The new care planning format should be introduced. Staff should use this as an opportunity to make the care plans more detailed to reflect the actual care and support they provide. This will make sure that anyone could read the care plan and offer appropriate care and support. The area manager must write a monthly report about her visits to the home. This will make sure that the manager gets written details about any action that she needs to take to improve the service. 2 33 Care Homes for Older People Page 23 of 24 Helpline: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. 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