Care Home: Victoria House

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What the care home does well 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 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. 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. 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.Each person is treated as an individual, they are part of their local community, and they are supported to follow personal interests and activities. People`s health, personal and social care needs are well met by staff at the home, and each person has a very detailed plan of care that the person, or someone close to them, has been involved in making. 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 people working at the home all about them and the support they need. Victoria House does not provide intermediate care. What has improved since the last inspection? The issues that were found at the last visit in relation to incorporating social care plans in with the existing care plans have been dealt with. The feedback from people living and working in the home is supported by the records held by the manager which shows that there are a number of strengths in the way the home is operating, and the improvement seen over the last year has been maintained. CARE HOMES FOR OLDER PEOPLE Victoria House 2 Nostell Lane Ryhill Wakefield West Yorks WF4 2DB Lead Inspector Gillian Walsh Key Unannounced Inspection 14 December 2007 09:30a 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 Victoria House DS0000066614.V343163.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. Victoria House DS0000066614.V343163.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Victoria House Address 2 Nostell Lane Ryhill Wakefield West Yorks WF4 2DB 01226 727179 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) Helpcare Ltd Mrs Tina Rowley Care Home 30 Category(ies) of Dementia - over 65 years of age (30), Mental registration, with number Disorder, excluding learning disability or of places dementia - over 65 years of age (30), Old age, not falling within any other category (30), Terminally ill (2), Terminally ill over 65 years of age (2) Victoria House DS0000066614.V343163.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 2nd November 2006 Brief Description of the Service: Victoria House, located in the village of Ryhill, is a former vicarage which was converted and was originally registered as a nursing home in 1989. The home was registered again under new ownership in 2006 but retained the existing manager and staff team. It is situated next to the church and within easy walking distance of local shops and amenities. The home provides care, including nursing, for up to 30 older people. The home is on two levels with two separate lounges, dining room and conservatory to the front of the home, which extends the lounge area. There is another conservatory built on to the back of the building, extending the dining room area. There is a car park at the rear of the building. The majority of the bedrooms are single occupancy, service users are encouraged to personalise their rooms and are able to bring with them small items of furniture and personal possessions. Service users enjoy activities provided by care staff as time allows, outside entertainers, trips out and input from the local churches. Information about the home is available within the Statement of Purpose and Service User Guide, both of which are available on request from the home. All new people are provided with a copy of the Service User Guide immediately prior to, or on, admission. A copy of the summary of the last inspection report is also included in the Service User Guide. At the time of the inspection the manager said that fees for care at the home ranged from £359 to £492 depending on the needs of the person. Victoria House DS0000066614.V343163.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced visit started at 9:30 am and ended at 12:30 pm. This was a very positive and enjoyable visit. There was the opportunity to speak to people living at the home as well as the registered manager, registered providers and care staff. The care plan files of people living at the home were seen and included assessments, care plans, daily and medical records and the record of activities. Staff records were also seen and included application forms, references, police checks, training and supervision records. Other information considered was the home’s returned Annual Quality Assurance document and surveys that were returned to the Commission for Social Care Inspection. A good number of people responded to our survey, and the feedback received was positive. The inspector would like to take the opportunity to thank the manager and her staff team for their hospitality, and people using the service and their relatives for their patience and co-operation throughout the visit. What the service does well: 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 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. 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. 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. Victoria House DS0000066614.V343163.R01.S.doc Version 5.2 Page 6 Each person is treated as an individual, they are part of their local community, and they are supported to follow personal interests and activities. People’s health, personal and social care needs are well met by staff at the home, and each person has a very detailed plan of care that the person, or someone close to them, has been involved in making. 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 people working at the home all about them and the support they need. Victoria House does not provide intermediate care. 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. Victoria House DS0000066614.V343163.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 Victoria House DS0000066614.V343163.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 3 and 6 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. 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 people working at the home all about them and the support they need. Victoria House does not provide intermediate care. EVIDENCE: All of the people’s files seen included the pre-admission assessment completed by the home prior to the person being admitted. The assessments were found to be based on the activities of daily living and included good information in each area. The manager explained that the findings from the pre-admission assessment are then used to formulate an initial care plan on admission to the Victoria House DS0000066614.V343163.R01.S.doc Version 5.2 Page 9 home. She added that all prospective new people are visited and assessed prior to admission by either herself or one of the home’s staff nurses and that, wherever possible, they and their families visit the home to have a look around and meet other people and staff. Feedback from people who completed our survey showed that they had found the initial visit to the home very helpful and that staff had been very welcoming and supportive. Victoria House DS0000066614.V343163.R01.S.doc Version 5.2 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 7 8 9 10 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People’s health, personal and social care needs are well met by staff at the home, and each person has a very detailed plan of care that the person, or someone close to them, has been involved in making. EVIDENCE: During the visit, two people’s care plan files were examined. All of the files contained a range of assessments and risk assessments relevant to the individual, all of which had been properly completed and reviewed. The manager explained that, where an assessment had indicated the need for a specific care plan to be formulated, this had been done. The records confirmed this. The manager explained that the care plans are developed based on the activities of daily living, with additional specific plans in place for specific and individual health care needs. All of the care plans were found to be well written and gave clear instructions to staff about how individuals’ physical needs Victoria House DS0000066614.V343163.R01.S.doc Version 5.2 Page 11 should be met, taking into account their personal preferences and need for privacy and dignity. Discussion took place with the manager about how an improvement had been made in relation to the inclusion in the care plans outlining people’s social care needs. The manager explained that the staff do consider social needs to be as important as physical needs. It was seen that, wherever possible, care plans had been signed by either the person or their representative. People living at the home, and people who responded to our survey, said that they are made aware of their care plan or their relative’s care plans and are involved when changes are made. The daily records and professional visitors’ records show that staff at the home ensure that people’s health care needs are met, either through visits to the home or through people attending local hospital clinics. All of the people spoken with said that they were treated with respect and that staff ensured that their needs for privacy and dignity were respected. Records and systems relating to medication were checked and found to be in good order. Victoria House DS0000066614.V343163.R01.S.doc Version 5.2 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12 13 14 15 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Each person is treated as an individual, they are part of their local community, and they are supported to follow personal interests and activities. EVIDENCE: The manager said that the home employs an activities person to work approximately twenty hours on a flexible basis each week within the home. The activities programme includes things like movement to music, regular coffee mornings and Bingo. People living at the home said that parties, outings and other activities are planned on a regular basis. Photographs of a recent event showed how staff and people at the home had taken part and enjoyed the event. All of the people spoken with said they were supported to make choices and decisions about how they lived their lives within the home. More reference about social activities is now included in care plans and daily records. All of the people spoken with about the food at the home said it was very good. The lunchtime meal on the day of the visit was very appetising, well presented and the manager explained that it could be taken either in the Victoria House DS0000066614.V343163.R01.S.doc Version 5.2 Page 13 dining area which extends into a conservatory, or wherever the person felt most comfortable. Victoria House DS0000066614.V343163.R01.S.doc Version 5.2 Page 14 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): 16 18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. 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. EVIDENCE: The records show that no complaints have been received since the last inspection and no complaints have been received by the Commission about the home. The manager explained that she does document where people or visitors have made suggestions or have expressed minor concerns. The records confirmed this. People said that they would discuss any worries or concerns with staff. The manager said that all staff have recently had update training in protection of vulnerable adults. The records confirmed this. Staff spoken with were able to say what they would do, in line with local procedures, should there be any suggestion of abuse within the home. Victoria House DS0000066614.V343163.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 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. 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. EVIDENCE: A tour of the home, and discussion with people living there, confirmed that the home is well maintained and that staff, particularly domestic staff, work hard to keep the home clean and tidy. Communal areas have a homely and comfortable feel and bedrooms are nicely personalised. People living at the Victoria House DS0000066614.V343163.R01.S.doc Version 5.2 Page 16 home said that the way that it is set out helps them get round the place, and that the staff are very helpful in helping them move around the home safely. Victoria House DS0000066614.V343163.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 28 29 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People 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. EVIDENCE: People living at the home that were spoken with said that staff were always available when they needed them. People who responded to our survey said that staff were always available when they need them. Evidence available during the visit was that staff are available in sufficient numbers at the moment and the manager said that she keeps this under review, taking into account the changing needs of people and any new admissions that are made to the home. Information from the manager, and staff training and supervision records, showed that over 50 of care staff hold the NVQ level 2 (in care) award. The manager explained that mandatory training is up to date. A look at the records confirmed this. The records also showed that new staff follow the Skills for Care induction process along with the home’s own induction Victoria House DS0000066614.V343163.R01.S.doc Version 5.2 Page 18 programme. The manager explained the recruitment procedure, which was found to be in good order and supported by the home’s personnel records. Victoria House DS0000066614.V343163.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 38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. 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. EVIDENCE: The home’s manager is a registered nurse who has been managing the home for many years. The manager explained that, as well as undertaking mandatory and other training, she has also completed NVQ level 4 in Victoria House DS0000066614.V343163.R01.S.doc Version 5.2 Page 20 management and is about to complete the registered managers award. The manager explained that regular meetings are held with the people living at the home and their relatives, and these are minuted. A look at the records confirmed this, and this was supported by feedback from people living at the home. The manager explained that there is a system is in place for quality monitoring within which questionnaires are sent to people living at the home and their relatives and any health and social care professionals who visit the home. A look at the records confirmed this, and this was supported by feedback from people living at the home. The manager explained that monitoring visits to the home are made by the homeowner’s representative. A look at the records confirmed this. It was noted that there is a system is in place at the home for people to have small amounts cash held on their behalf in the home’s safe. A look at the records confirmed that all was in good order. The manager gave information within the pre-inspection questionnaire that appropriate checks and servicing of equipment and systems in the home have taken place as required by the regulations. Records of fire drills and training were seen and evidenced that these are being done appropriately. The manager has produced risk assessments for all areas within the home and has sought input from other agencies, such as the fire authority, to ensure that the risk assessments are appropriate. A discussion took place with the manager regarding the finances available to her for food, equipment and any other supplies. She explained that, whenever people in the home need new or extra equipment, if it is found to be appropriate to their needs, then it is bought. She explained that food is purchased over the Internet, and that there is always a good stock of food and supplies. A look at the records confirmed this, and this was supported by feedback from people living at the home. The manager added that she does not have any problems with paying the bills for the service, and is confident that she can discuss the purchasing of equipment and supplies with the owners who, in her opinion, are more than happy to supply the finances for the effective running of the business. Victoria House DS0000066614.V343163.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 X 3 X X 3 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 X X 3 Victoria House DS0000066614.V343163.R01.S.doc Version 5.2 Page 22 Are there any outstanding requirements from the last inspection? 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 Victoria House DS0000066614.V343163.R01.S.doc Version 5.2 Page 23 Commission for Social Care Inspection Brighouse Area Team First Floor St Pauls House 23 Park Square Leeds LS1 2ND 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. 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