Latest Inspection
This is the latest available inspection report for this service, carried out on 2nd February 2010. CQC found this care home to be providing an Adequate service.
The inspector found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.
For extracts, read the latest CQC inspection for Vicarage Road (62).
What the care home does well 1. The Statement of Purpose and Service Users Guide have been reviewed since the last inspection, and meet the needs of the service. The Service User Guide was updated in December 2009, and is in a pictorial format that the people who live in the home can understand. Everyone has a copy of the Service User Guide in their room. 2. Some care plans have been reviewed and updated. A risk assessment is in place for one person for the use of Warfarin, with clear information and guidelines on managing the risks. All the staff have signed to say that they understand the side effects and management required. 3. The manager consulted the home`s pharmacist for good practice in dealing with tablets of Warfarin that needed to be cut in half. The pharmacist advised that tablets are available in smaller doses, and a new supply in the smaller dose was delivered during our visit to the home. 4. The provider`s action plan stated that missing persons protocols have been updated. Copies of individual protocols were sent to CQC before this inspection. Each person now has their own procedure should they be missing, which addresses their individual needs and risk factors. 5. The provider`s action plan stated that staff who are on full time contracts work 75 hours over two week period. Also that the issue of working long 24 hour shifts due tosleepovers at night has been discussed with Adult Care Services who agree that this is the usual practice in care homes where people sleep in. Granta HR department is looking into issues re sleep-ins and the working time directive and will feed back any necessary adjustments. When we visited the home the current staff rotas showed that no-one worked over 48 hours a week, although all support workers and the manager work one 24 hour shift a week that includes a sleepover. The manager said that they are very rarely disturbed at night, but if they have been needed they can ask for support and leave earlier the next day. This probably complies with the working time directive requirement for compensatory time following a sleepover. But the organisation should be certain that their policies do comply. 6. The provider`s action plan stated that training requests have been completed by all staff for epilepsy and medication where required. Staff will receive relevant training and be able to undertake administration of medication. The manager told us that mandatory training updates slipped due to a misunderstanding, as he had thought this was done automatically by head office. The manager has now updated the training schedule and at the time of our visit staff were completing requests to update mandatory training where required. Medication training for those who required it took place the week before this inspection. 7. Monthly supervision is now taking place. We saw the records seen of January supervisions, which covered cover key working, and training. What the care home could do better: Three of the requirements from the last inspection report have not yet been met. The action plan shows that there are plans in place to address them, and we expect that these will be completed before the next key inspection. 1. The provider`s action plan stated that care plans are checked monthly. A full review was undertaken on 18/01/10, and recommendations made. The action plan stated that all care plans should be updated by the end of February. We saw evidence of this review when we visited the home. Care plans have post-it notes in place where changes are needed. 2. The provider`s action plan stated that residents` contribution to cost of vehicles was agreed with Herts ACS before the home opened, "Therefore no action required at present. To review when implementation of individual budgets. All residents care plans have paragraph re payment for vehicles and this has been agreed." In the care plans that we saw on this occasion, under `My money and support I need to manage it` it states, "I will pay DLA straight to Granta to use for minibus." But there is no signature to confirm this agreement. For one person we saw an agreement for the use of their disability benefit (DLA) signed 19/11/97, and not reviewed since. It states that the person will be given fares for public transport when they wish to use it. The manager told us that this person now has a bus pass, but fares where given to him in the past from the home`s petty cash.Decisions on how each person uses their money need to be taken and reviewed on a regular basis. New legislation has been passed since the home opened, which the home and provider need to ensure that they adhere to and follow. Each person`s capacity for making this decision should be assessed in line with the Mental Capacity Act (MCA), with involvement of an independent advocate (IMCA), if a person does not have the capacity to make this decision. The manager was not clear on the implications of the MCA, and should have training on this to enable him to uphold the independence of the people who live in the home. 3. The manager said that while they waited for a new supply of Warfarin, staff continued to cut tablets in half, and disposed of the half that was not used. But there is no record in the home of the disposal of this medication. 4. The provider`s action plan stated, "If the need arises in future for controlled drugs at scheme that are administered by staff or other professionals then a controlled drugs cabinet would be installed." The manager was not fully aware of the legal requirements for a controlled drugs cabinet. If it is not installed before controlled drugs may be required again, then these should not be supplied for people in the home. Random inspection report
Care homes for adults (18-65 years)
Name: Address: Vicarage Road (62) 62 Vicarage Road Buntingford Hertfordshire SG9 9BA one star adequate service 04/08/2009 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 review of the service. We call this review a ‘key’ inspection. This is a report of a random inspection of this care home. A random inspection is a short, focussed review of the service. 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: Claire Farrier Date: 0 2 0 2 2 0 1 0 Information about the care home
Name of care home: Address: Vicarage Road (62) 62 Vicarage Road Buntingford Hertfordshire SG9 9BA 01763273191 Telephone number: Fax number: Email address: Provider web address: www.grantahousing.org.uk Name of registered provider(s): Type of registration: Number of places registered: Conditions of registration: Category(ies) : Granta Housing Society Limited care home 4 Number of places (if applicable): Under 65 Over 65 4 learning disability Conditions of registration: Date of last inspection Brief description of the care home 4 0 4 0 8 2 0 0 9 62 Vicarage Road is a house that looks like the other houses in the road. It is close to the shops in the town centre. There is a small shop nearby. The home is near to bus routes and the train station. This means that the people who live at the home can get around easily. Everybody who lives at the home has their own bedroom. Nobody has to share a room. Everyone shares the lounge, dining room and kitchen.
Care Homes for Adults (18-65 years) Page 2 of 10 Brief description of the care home The manager can tell people about the accommodation charges for 62 Vicarage Road. The Statement of Purpose and the Service Users Guide tell people about the home. The manager will give a copy of the CQC inspection report to people who want to see it. Care Homes for Adults (18-65 years) Page 3 of 10 What we found:
We did not receive any comments from the home on our report of the last key inspection, and they did not send us an action plan when we requested it, to show what steps they are taking to address the requirements that we made. We sent a letter to the registered Responsible Individual, to warn of possible further actions that we might take, and we received an action plan following this warning letter. The action plan stated, I acknowledge that there are issues that needed to be addressed in care plans, training etc. and this is a priority area. We saw evidence of the actions that are in progress, and we discussed the plans for further improvements with the manager. Although we saw evidence of progress towards meeting all the requirements that we made in the last inspection report, many of the actions were not started in good time, and only started after we sent the warning letter in January 2010, four months after we had sent the draft inspection report. The review of care plans started only on 18th January. New supplies of the correct dosage of Warfarin were only in place on 2nd February. Staff started to complete training requests for mandatory training during January. Medication training only took place in January. The manager has been in post since July 2008. The AQAA sent to us on 27th July 2009 stated that there were plans for the manager to complete registration. The Commission has not yet received an application for registration. What the care home does well:
1. The Statement of Purpose and Service Users Guide have been reviewed since the last inspection, and meet the needs of the service. The Service User Guide was updated in December 2009, and is in a pictorial format that the people who live in the home can understand. Everyone has a copy of the Service User Guide in their room. 2. Some care plans have been reviewed and updated. A risk assessment is in place for one person for the use of Warfarin, with clear information and guidelines on managing the risks. All the staff have signed to say that they understand the side effects and management required. 3. The manager consulted the homes pharmacist for good practice in dealing with tablets of Warfarin that needed to be cut in half. The pharmacist advised that tablets are available in smaller doses, and a new supply in the smaller dose was delivered during our visit to the home. 4. The providers action plan stated that missing persons protocols have been updated. Copies of individual protocols were sent to CQC before this inspection. Each person now has their own procedure should they be missing, which addresses their individual needs and risk factors. 5. The providers action plan stated that staff who are on full time contracts work 75 hours over two week period. Also that the issue of working long 24 hour shifts due to
Care Homes for Adults (18-65 years) Page 4 of 10 sleepovers at night has been discussed with Adult Care Services who agree that this is the usual practice in care homes where people sleep in. Granta HR department is looking into issues re sleep-ins and the working time directive and will feed back any necessary adjustments. When we visited the home the current staff rotas showed that no-one worked over 48 hours a week, although all support workers and the manager work one 24 hour shift a week that includes a sleepover. The manager said that they are very rarely disturbed at night, but if they have been needed they can ask for support and leave earlier the next day. This probably complies with the working time directive requirement for compensatory time following a sleepover. But the organisation should be certain that their policies do comply. 6. The providers action plan stated that training requests have been completed by all staff for epilepsy and medication where required. Staff will receive relevant training and be able to undertake administration of medication. The manager told us that mandatory training updates slipped due to a misunderstanding, as he had thought this was done automatically by head office. The manager has now updated the training schedule and at the time of our visit staff were completing requests to update mandatory training where required. Medication training for those who required it took place the week before this inspection. 7. Monthly supervision is now taking place. We saw the records seen of January supervisions, which covered cover key working, and training. What they could do better:
Three of the requirements from the last inspection report have not yet been met. The action plan shows that there are plans in place to address them, and we expect that these will be completed before the next key inspection. 1. The providers action plan stated that care plans are checked monthly. A full review was undertaken on 18/01/10, and recommendations made. The action plan stated that all care plans should be updated by the end of February. We saw evidence of this review when we visited the home. Care plans have post-it notes in place where changes are needed. 2. The providers action plan stated that residents contribution to cost of vehicles was agreed with Herts ACS before the home opened, Therefore no action required at present. To review when implementation of individual budgets. All residents care plans have paragraph re payment for vehicles and this has been agreed. In the care plans that we saw on this occasion, under My money and support I need to manage it it states, I will pay DLA straight to Granta to use for minibus. But there is no signature to confirm this agreement. For one person we saw an agreement for the use of their disability benefit (DLA) signed 19/11/97, and not reviewed since. It states that the person will be given fares for public transport when they wish to use it. The manager told us that this person now has a bus pass, but fares where given to him in the past from the homes petty cash. Care Homes for Adults (18-65 years) Page 5 of 10 Decisions on how each person uses their money need to be taken and reviewed on a regular basis. New legislation has been passed since the home opened, which the home and provider need to ensure that they adhere to and follow. Each persons capacity for making this decision should be assessed in line with the Mental Capacity Act (MCA), with involvement of an independent advocate (IMCA), if a person does not have the capacity to make this decision. The manager was not clear on the implications of the MCA, and should have training on this to enable him to uphold the independence of the people who live in the home. 3. The manager said that while they waited for a new supply of Warfarin, staff continued to cut tablets in half, and disposed of the half that was not used. But there is no record in the home of the disposal of this medication. 4. The providers action plan stated, If the need arises in future for controlled drugs at scheme that are administered by staff or other professionals then a controlled drugs cabinet would be installed. The manager was not fully aware of the legal requirements for a controlled drugs cabinet. If it is not installed before controlled drugs may be required again, then these should not be supplied for people in the home. 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 Adults (18-65 years) Page 6 of 10 Are there any outstanding requirements from the last inspection? Yes R No £ 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, Regulations 2001 and the National Minimum Standards.
No. Standard Regulation Requirement Timescale for action 1 6 15 Measures must be put in place to ensure that care plans are reviewed and updated following changes. Care plans should provide up to date and appropriate details of each persons needs, so that the staff have the information that they need to be able to meet their needs. 21/11/2009 2 7 20 The people in the home are 21/11/2009 not fully consulted on the decision that they should contribute their disability benefits towards the running costs of the homes vehicle. All decisions that are made on behalf of a person in the home must comply with the Mental Capacity Acts codes of practice. 3 20 13 Controlled drugs must be stored and recorded in accordance with the Misuse of Drugs (Safe Custody) (Amendment) Regulations 2007, and with Royal Pharmaceutical Society guidelines. This will make sure that 21/11/2009 Care Homes for Adults (18-65 years) Page 7 of 10 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, Regulations 2001 and the National Minimum Standards.
No. Standard Regulation Requirement Timescale for action everyone has the care and medication that they need in a safe and effective way. Care Homes for Adults (18-65 years) Page 8 of 10 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, 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 Care Homes for Adults (18-65 years) Page 9 of 10 Reader Information
Document Purpose: Author: Audience: Further copies from: Inspection Report Care Quality Commission 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 Adults (18-65 years) 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: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.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) 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. Care Homes for Adults (18-65 years) Page 10 of 10 - 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!
