Care Home: Victoria Residential Care Home

What the care home does well Care plans are prepared in sufficient detail to enable the staff to identify the specific needs and preferences of each service user. All checks are made on staff prior to them commencing work at the home to ensure that service users are protected. The home employs a well trained staff team who are committed and enthusiastic about the care they give. The decor and furnishings throughout the home provide a warm, homely and comfortable environment. A high number of activities are offered to service users, including trips out to local shops and places of interest. The home is managed to a high standard and staff are supportive of the management team. What has improved since the last inspection? Additional information has been included in the care plans to provide staff with greater information about service users needs. The decor and lighting has been improved to brighten the home. Work is taking place to provide a garden area with seating for service users. The exterior of the home has been rendered and repainted. What the care home could do better: Care should be taken to ensure that handwritten entries in the MAR sheets are witnessed and signed by two persons to ensure accuracy. The training programme and updates should continue to further increase staffs knowledge and understanding. Inspecting for better lives Key inspection report Care homes for older people Name: Address: Victoria Residential Care Home 166 Church Street Wallasey Wirral CH44 8AL     The quality rating for this care home is:   three star excellent service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Jeanette Fielding     Date: 1 6 0 4 2 0 0 9 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. 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. 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 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 Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Older People Page 2 of 26 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Care Homes for Older People Page 3 of 26 Information about the care home Name of care home: Address: Victoria Residential Care Home 166 Church Street Wallasey Wirral CH44 8AL 01516387863 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Conditions of registration: Category(ies) : Dr David Charles Downward care home 56 Number of places (if applicable): Under 65 Over 65 56 old age, not falling within any other category Additional conditions: 0 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 categories: Old age, not falling within any other category - Code OP. The maximum number of service users who can be accommodated is: 56. Date of last inspection Brief description of the care home Victoria Care Home is a large, three storey building situated in Wallasey, Wirral. The building was originally the nurses home for Victoria Central Hospital. The home provides care for 56 residents. All rooms are comfortably furnished and for single occupancy. There are no en-suite facilities. The home has two large lounges, one with a conservatory, and two dining rooms, a smokers lounge is also provided. The home is well maintained and in good decorative order. Victoria Care Home has many aids and adaptations to meet the needs of residents and there are two passenger lifts. Care Homes for Older People Page 4 of 26 Brief description of the care home The home is currently developing a garden at the rear of the home; there is a small car park to the front of the premises. The home has a mini bus, which is used for many outings. The home is situated near to local amenities in Liscard, which has a park, shops, pubs and churches. The home is on the bus route to Birkenhead. The fees charged are 352.24 pounds per week. Care Homes for Older People Page 5 of 26 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: three star excellent 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: This unannounced inspection took place on 16th April 2009 and a total of seven hours were spent in the home. As part of the inspection process, records relating to the care of the service users were viewed to evaluate the level of care required by and afforded to them. Staff files were viewed to ensure that all safety checks had been made on them prior to them commencing at the home and to evaulate the training that they had undertaken. Safety certificates were viewed to ensure that all equipment and facilites within the home assured the health, safety and welfare of the staff and service users. A full tour of the building was undertaken, including some of the service users bedrooms to assess the environment in which service users live. Care Homes for Older People Page 6 of 26 Discussions were held with staff to obtain their views of the home and to evaluate their knowledge and understanding of service users needs, the policies and procedures and their individual role and responsibilities. Service users were spoken to to obtain their views and opinions of the home and to gather information regarding their individual lifestyles within Victoria Residential Care Home. What the care home does well: What has improved since the last inspection? 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 set out 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 8 of 26 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 9 of 26 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. Detailed information is gathered prior to service users being admitted to the home to ensure that the staff have full details regarding the care needs and preferences to enable the appropriate level of care to be provided. Evidence: The home has produced a Statement of Purpose and Service User Guide to give current and prospective service users information about the services and facilities offered. The manager explained that these documents are now being reviewed and updated to reflect changes that have taken place within the home. It is expected that the updated version of the service user guide will be available in the next few months. The service user guide is also available in picture format to aid those who have reading difficulties and is displayed in the foyer of the home. Care Homes for Older People Page 10 of 26 Evidence: The manager or deputy manager visit prospective service users in hospital or in their own home to undertake an assessment of their needs. This is to ensure that the staff at the home have the skills and ability to meet those needs and also to identify any necessary equipment required to enable this to be provided in sufficient time for their admission. The pre-admission assess,emts of the two most recently admitted service users were inspected and were found to contain full information regarding the service users needs and preferences. Information is gathered from the service user, their relatives, hospital records and any other person involved in their care. The home also obtains a copy of the assessment undertaken by the Multi Disciplinary Team. Sufficient information is recorded to enable a plan of care to be prepared. The home does not offer intermediate care. Care Homes for Older People Page 11 of 26 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. The health needs of service users are well met with evidence of good multi disciplinary working taking place on a regular basis. Evidence: Individual care plans are prepared for each service user following a detailed assessment of their needs and any risks. Care plans include personal care, continence, manual handling, meals and nutrition, risk of pressure sores and social needs. Risk assessments include falls, fire and an assessment of their room. A separate document entitled My Day identifies individual preferences which includes time or rising and going to bed, meals which includes likes and dislikes, frequency of bathing and hobbies and social activities. These documents are specific to the individual service user to the level that the information about meals also includes preferences regarding tea or coffee and the amount of sugar taken in drinks. The records show that the care plans are reviewed and updated each month and that the risk assessments are updated as the needs and abilities of the service users Care Homes for Older People Page 12 of 26 Evidence: change. Records are also held of visits made to and by other healthcare professionals including GP, dietician, speech and language therapist, physiotherapist, dentist, optitian and district nurse. All records inspected were found to be informative, well maintained and up to date. Staff spoken to during the inspection confirmed that they had full access to the care files to enable them to be kept updated about the needs and wishes of the service users. One member of staff said its good to know about their needs and it must be awful if they had to tell each member of staff how to do something in the way they like it. Cultural and religious needs are identified and systems put in place to ensure that these are respected and met. The home operates a key worker system which means that each service user has a designated member of staff to be responsible for ensuring that the appropriate level of care and support is given, under the supervision of the manager. In the response to the surveys sent out by CSCI, to which an excellent response was received, staff all said that they felt they provided a high level of care to ensure that the service users were comfortable. Aids and adaptations are provided to assist service users who have special needs or mobility difficulties. Assisted bathing facilities are provided together with ramps and rails. The home has a policy and procedure for the administration of medications. The Medication Administration Record (MAR) sheets were signed appropriately to indicate that medications had been administered to the service users. Care should be taken to ensure that medications that arrive in the middle of the monthly cycle are witnessed by two people when handwritten entries are made on the MAR sheets. Medication storage was secure, organised and clean. Regular audits of the medications are undertaken on a regular basis to ensure accuracy and compliance with the homes policy and procedure. Care Homes for Older People Page 13 of 26 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Service users are able to enjoy a full and stimulating lifestyle with a variety of options to choose from to enhance their lives. Evidence: The home employs an activities co-ordinator who works 20 hours each week. The staff gather information about service users individual social needs and preferences and this information is recorded in their care file. The records held in the home provide evidence that the activities and social stimulation provided reflects the service users preferences. Group and individual activities are provided, and on the day of the inspection, a group of service users were going out on the minibus. Trips out on the minibus are provided at least twice each week and service users are encouraged to suggest new venues to visit. Other activities that are provided include Bingo, quizzes including The Price is Right and Deal or No Deal. Armchair exercises have proved popular as have the foot massages. The home provides a library area which contains a wide range of reading material. Jigsaws, board and card games are available. Entertainers visit the home on a regular basis and the home also provides movies and music afternoons. Clergy visit the home on a regular basis and provide services for those who wish to participate. Care Homes for Older People Page 14 of 26 Evidence: Service users were observed to enjoy a homely environment with one service user sitting on a sofa with her feet up to watch television or enjoy an afternoon nap. Staff confirmed that this was what the service user enjoyed when she was at home and continued to enjoy the lifestyle that she preferred. Service users meetings are held regularly and a record of issues discussed is held. Service users are free to offer suggestions about the home and the records show that any requests have been addressed by the manager. The menus are reviewed and changed regularly according to season or requests by service users. Meals are taken in the dining room or the service users own bedroom as they wish. The dining room has been redecorated in pale blue and yellow and is to a very high standard. Attractive curtains have been provided at the windows. The dining tables and sideboards have been painted in a light colour and new dining chairs have been purchased. Tables are attractively laid with tablecloths, place mats, napkins, cutlery and crockery. A good supply of condiments are placed on each table to enable service users to choose the sauces of their preference. The meal served on the day of the inspection looked and smelled appetising. A choice of meals is available and service users spoken to siad that the meals are very good. One service user said that the home provided good basic food that she liked. The cook confirmed that service users did not like rice, pasta or curries and so these would only be provided on request. Special diets are provided on the advice of the GP or dietician or at the request of the service users. The kitchen was clean and organised and a good selection of fresh foods were seen. Some frozen foods are used in the preparation of meals to offer greater choice when these foods are not in season. Visitors are welcome at the home at any time and one visitor said that the staff always made her very welcome. She said that she visited at various times of the day and found that the home was always clean and fresh and that her relative was complimentary about the home and the staff. Care Homes for Older People Page 15 of 26 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. Staff have a good knowledge and understanding of Adult Protection issues to protect service users from abuse. Evidence: The home has a robust complaints procedure which is displayed in the foyer of the home and is also detailed in the service user guide. Information is detailed on who to contact to make a complaint and of the timescales that the home will adhere to in response. Two complaints have been made to the home in the last twelve months and both were dealt with in a professional and timely manner to the satisfaction of the complainants. Service users spoken to confirmed that they would feel comfortable in discussing any areas of concern with the manager or deputy and were confident that issues would be addressed to their satisfaction. All staff have been given training on the protection of vulnerable adults through an external training organisation. Regular updates in this training is given and the manager ensures that all staff are fully aware of the different types of abuse and of the action to be taken in the event of abuse being suspected. Staff spoken to confirmed that they had undertaken training and two said that the updated training had been booked. Care Homes for Older People Page 16 of 26 Care Homes for Older People Page 17 of 26 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Continued investment has improved the home and has created a warm, comfortable and safe environment for those living there and visiting. Evidence: Victoria Care Home is located in a residential area of Wallasey, close to parks, shops and public transport. Single rooms are provided for all service users and there is a range of seating areas within the home to offer service users a choice of where they spend their day. Two dining rooms are provided and both are decorated and furnished to a high standard. The rooms are bright and welcoming and provide a pleasant area to take meals. Three lounges are provided, one being at the front of the home and now provided with a conservatory to offer greater choice of where service users can spend their day. All lounges are homely and are provided with armchairs and sofas. All are decorated and furnished to a high standard. One smaller lounge has been designated for use by service users who smoke to protect other service users. Since the last inspection, the conservatory has been built at the front of the home and has been provided with heating and air conditioning to enable it to be used throughout the year. Blinds are fitted to the conservatory to provide privacy for the service users. The programme of redecoration of bedrooms continues with all those inspected being Care Homes for Older People Page 18 of 26 Evidence: bright and homely. All bedrooms seen were observed to be personalised with pictures, photographs and items of memorabilia to further promote the homely environment. The furnishings within bedrooms are of a good standard. Since the last inspection, access to the home has been improved by the provision of ramps, with handrails to assist service users who require to use a wheelchair or have mobility difficulties. Two passenger lifts provide full access to all areas of the home and ramps and rails are fitted where necessary. Aids and adaptations are provided to assist service users where this has been identified as necessary including hoists and assisted bathing facilities. Staff have been given training in the use of equipment and tests are made on the equipment regularly to ensure safety. All areas of the home were clean and fresh. Improvements are currently being made to the garden area at the rear of the home. A new patio is being built and an area set aside for plants and flowers. An arbour is planned to provide shade from the sun. When completed, this will provide a pleasant and private area for service users to spend their days during the warmer months, away from passers by, and sheltered from winds. The exterior of the home is being rendered and repainted and plans are in place for the replacement of some of the windows. The exterior of the home has improved since the last inspection and is bright and fresh. Parking is available at the front of the home with additional on-street parking available. Care Homes for Older People Page 19 of 26 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home employs and enthusiastic and well trained staff team to provide care and support to the service users. Evidence: The staff rota within the home provides evidence that sufficient staff are employed and deployed to meet the needs of all service users. No agency staff have been required by the home as the staff are happy to cover each other for holidays and sickness which has resulted in a consistent level of care being provided. The staff turnover has been extremely low. A high number of training events have taken place to ehance staffs knowledge and understanding of the care they give. All staff, with the exception of one new member of staff, hold NVQ qualifications. Arrangements are currently being made to ensure that the new member of staff can commence this training in the near future. The staffing is structured and provides a manager, deputy manager, senior care, care, housekeeping, handyman, administrator, activities co-ordinator, cook and kitchen assistant. Staff records for a range of staff showed that a robust recruitment procedure is in Care Homes for Older People Page 20 of 26 Evidence: place. All prospective staff are required to complete an application form prior to being called for interview. Two references are taken and checks are made through the protection of vulnerable adults and the criminal records bureaux to ensure that service users are protected. Induction training is given to all new staff and this evidenced on their training file. Individual training files are kept for the staff and contain certificates and evidence of training undertaken. In the surveys completed by the staff, all confirmed that they were given training appropriate to their role. Staff spoken to said that they enjoyed the training and felt that it helped them to provide a high level of care. Planned training includes nutrition, food hygiene updates and the Mental Capacity Act. Care Homes for Older People Page 21 of 26 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home is managed to a good standard with policies and procedures in place to ensure the health and safety of service users and staff. Evidence: The registered manager, and the deputy manager, hold NVQ in management at level 4 and are qualified and experienced in the management of care services. The manager and deputy work closely together and both were able to demonstrate that the home is run in the best interests of the service users. Both are involved in the day to day care of the service users and the supervision and support of the staff. Staff spoken to said that the management of the home was good and they felt supported. The manager is well supported by the owner who visits the home regularly and prepares reports on the running of the home and the premises. The owner keeps the manager fully informed of proposed improvements and the manager is given the opportunity to make recommendations about the changes that have taken place. Care Homes for Older People Page 22 of 26 Evidence: The manager was able to demonstrate that she has a clear understanding of customer satisfaction and arranges surveys of service users, relatives and other stakeholders to gather their views of the home and to obtain suggestions about the service. The manager meets with service users and relatives on a one to one basis as often as possible and relatives are invited to the service user meetings. A suggestion book is placed at the front of the home to gather comments from service users or visitors but no comments had been written. The home does not hold money for service users and a designated service user bank account is in place for those who wish to use it. Policies and procedures are reviewed on a regular basis and these are accessible to all staff for information or advice. Health and safety issues are addressed as soon as they are identified to ensure that service users and staff are protected at all times. Equipment used within the home is checked on a regular basis and certificates of safety are held. Tests on fire detection equipment are made on a regular basis and a record of the findings is held. All certificates inspected were found to be up to date. Care Homes for Older People Page 23 of 26 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 24 of 26 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 Care Homes for Older People Page 25 of 26 Helpline: Telephone: 03000 616161 or Textphone: or 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) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. Care Homes for Older People Page 26 of 26 - 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!