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Archived: The Old Rectory Inadequate

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Inspection report

Date of Inspection: 26, 27 June 2014
Date of Publication: 9 August 2014
Inspection Report published 09 August 2014 PDF

People should get safe and appropriate care that meets their needs and supports their rights (outcome 4)

Not met this standard

We checked that people who use this service

  • Experience effective, safe and appropriate care, treatment and support that meets their needs and protects their rights.

How this check was done

We looked at the personal care or treatment records of people who use the service, carried out a visit on 26 June 2014 and 27 June 2014, observed how people were being cared for and talked with people who use the service. We talked with carers and / or family members, talked with staff, reviewed information given to us by the provider and reviewed information sent to us by other authorities. We talked with other authorities.

We used the Short Observational Framework for Inspection (SOFI). SOFI is a specific way of observing care to help us understand the experience of people who could not talk with us.

Our judgement

People’s needs were not consistently assessed and care and support was not always planned and delivered in line with their individual care plan.

Reasons for our judgement

People told us that they had lived at the Old Rectory for a long time. Some people had lived there for over 30 years. People told us “I like living here” and “I love it here”. We watched people join in with activities such as arts, watching television, watching films, listening to music, karaoke and bowls. People also had trips out of the home. Two people had visited the local beach on one of the days we inspected. One person’s activity plan in their care file showed that the activities the person had planned had taken place.

People who used the service told us about planned trips and activities. They said that nine people had planned to go to a steam festival at the weekend. People told us that they were looking forward to going to the war and peace show later in the year.

A hairdresser and barber visited the service, staff asked people if they wanted their hair cut and people choose to accept or not. A visiting optician also visited the service during our inspection.

We carried out a short observational framework for inspection (SOFI) during our inspection. During this observation, which took place in one of the lounge areas, we saw that staff provided discreet prompts and reminders to people who used the service. For example, as one person was watching a film with others; the staff member approached the person and quietly asked them whether they would like to use the toilet and then when the person said yes they helped them to leave the room. Staff asked each person in the room whether they would like a drink and gave them a choice of drinks to choose from. Each person communicated in their own way what drink they would like and the staff member returned with each drink.

We saw staff offer reassurance in a kind and caring manner. For example, one person told the staff they were worried about something and so the staff member talked through the person’s concerns and offered reassurance. The person was reassured and hugged the member of staff.

Most of the interactions we observed were good. However, we did see that one staff member asked the head of care if one person who lived in the home wanted their hair cut rather than asking the person directly. Whilst the staff member chatted to the head of care about the person; they ran their fingers through the person’s hair without asking them if this was alright.

Some of the support was inconsistent. We watched one person who used the service repeatedly punch the provider in the arm with force. The provider told us that this person was acting out a part in a film. The provider did not stop the person from doing this. Other staff tried to support the person to move away from the provider when this was happening. An inspector distracted the person from doing this by asking them a question.

Some staff used humour whist interacting with people using the service; sometimes this was not appropriate to the situation. For example, one staff member described a person who lived at the home as their ‘girlfriend’ when describing why the person knew their name which was not appropriate.

Staff told us about the needs of people who lived in the home. This included how they supported people’s needs relating to continence management and equipment. However, we observed that staff did not follow a person’s care plan in relation to promoting their continence. This led to a person indicting that they were in pain. Care plans relating to healthcare needs were not always followed by staff. There was minimal recording by staff in daily notes about site entry wound care with ‘personal care given’ recorded even though some wounds required washing and dressing daily. There was no evidence that wounds were being washed and dressed as required so a risk that wounds may become infected.

There was evidence in care and support plans that people had been referred on to specialists as their health deteriorated. People had support from district nurses, GP’s, dentists, hospital consultants and a hos