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Archived: Vine House Rest Home Good

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Reports


Inspection carried out on 11 January 2017

During a routine inspection

We carried out an announced inspection of Vine House Rest Home on the 11 and 12 January 2017. The first day was unannounced.

Vine House Rest Home provides accommodation and care and support for up to 14 older people. The service does not provide nursing care. There were 14 people accommodated in the home at the time of the inspection.

Vine House Rest Home is an older style detached building with surrounding gardens. The home is situated on a main road in Oswaldtwistle. It is close to the town's facilities and the towns of Accrington and Blackburn.

The service was managed by a registered manager. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons.’ Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

Following the last inspection on 24 and 25 March 2015 we asked the provider to take action to improve the way that people’s medicines were managed. During this inspection we found this action had been completed.

People told us they did not have any concerns about the way they were cared for. They told us they felt safe and well cared for. Staff could describe the action they would take if they witnessed or suspected any abusive or neglectful practice and had an awareness of the Mental Capacity Act (MCA) 2005 and the Deprivation of Liberty Safeguards (DoLS). This meant they had knowledge of the principles associated with the legislation and people’s rights.

People considered there were enough staff to support them when they needed any help and they received support in a timely and unhurried way. The registered manager followed safe recruitment procedures to ensure new staff were suitable to work with vulnerable people. Arrangements were in place to make sure staff were trained and supervised.

Medicines were managed safely and people had their medicines when they needed them. Staff administering medicines had been trained to do this safely.

We found people lived in a clean, comfortable and homely environment. Appropriate aids and adaptations had been provided to help maintain people’s safety, independence and comfort. People had arranged their bedrooms as they wished and had brought personal possessions with them to maintain the homeliness.

Each person had a care plan that was sufficiently detailed to ensure they were at the centre of their care. People’s care and support was kept under review and, where appropriate, they were involved in decisions and discussions about their care. Risks to people’s health and safety had been identified, assessed and managed safely. Relevant health and social care professionals provided advice and support when people’s needs changed.

We found staff were respectful to people, attentive to their needs and treated people with kindness and respect in their day to day care. We observed good relationships between people. The atmosphere in the home was happy and relaxed. From our observations it was clear staff knew people well and were knowledgeable about their individual needs, preferences and personalities.

Suitable activities were available and were appropriate to individual needs. People told us they enjoyed the meals. They were provided with a nutritionally balanced diet that met their dietary needs.

People were encouraged to be involved in the running of the home and were kept up to date with any changes. People had no complaints but were aware of how to raise their concerns and were confident they would be listened to.

People considered the service was managed well and they had confidence in the management team. There were systems in place to monitor the quality of the service to ensure people received a good service that supported their health, welfare and well-being.

Inspection carried out on 24 & 25 March 2015

During a routine inspection

We carried out an unannounced inspection of Vine House Rest Home on 24 & 25 March 2015. Vine House Rest Home is registered to provide accommodation and personal care for 14 older people. The service does not provide nursing care. At the time of the inspection there were 13 people accommodated in the home.

Vine House Rest Home is an older style detached building with surrounding gardens. The home is situated on a main road in Oswaldtwistle. It is close to the town's facilities and the towns of Accrington and Blackburn.

At the previous inspection on 26 October 2013 we found the service was meeting all standards assessed.

There was a registered manager in day to day charge of the home. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

We found one breach of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2010, relating to medicines management. This corresponds to regulation 12 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.

We looked at how the service managed people’s medicines. We found processes were in place for the ordering, receipt, storage, administration and disposal of medicines although policies and procedures were not reflective of current practice. This meant staff did not have clear guidance to refer to. Guidance for ‘when required’ or medicines with a ‘variable’ dose was not clear to make sure these medicines were offered safely and consistently by staff. Codes were recorded for refusal of medicines although the reasons for the omissions were not recorded. Staff had received training to help them to safely administer people’s medicines although regular checks on their practice had not yet been undertaken to ensure they were competent and safe to manage people’s medicines. Medicines for disposal and fridge items were not always stored safely. You can see what action we told the provider to take at the back of the full version of the report.

The home was clean and odour free although we noted an offensive odour in one bedroom. The registered manager and the registered provider were aware of the problem and were taking action to resolve the problem. Appropriate protective clothing, such as gloves and aprons, were available and staff had been provided with training in infection control. People living in the home were happy with the cleanliness of the home. One person told us, “It is a very clean place. They work hard to keep it clean.”

People told us they did not have any concerns about the way they were cared for and during the inspection we did not observe anything to give us cause for concern about people’s wellbeing and safety. Staff had an understanding of abuse and were able to describe the action they would take if they witnessed or suspected any abusive or neglectful practice.

We found there were sufficient numbers of suitable staff to attend to people’s needs and keep them safe. One person said, “Staff are brilliant.” Another said, “Nothing is too much trouble.” Our observations confirmed people received care from staff in a timely and unhurried manner. We found a safe and fair recruitment process had been followed and appropriate checks had been completed. Staff were given training and support to help them look after people properly.

We observed staff being kind, friendly and respectful of people's choices and opinions. The atmosphere was relaxed with friendly banter between staff and people living in the home. Staff spoken with had a good knowledge of the people they supported. People told us they were happy with the approach taken by staff. Comments included, “It’s a good place and the girls are very good and friendly”, “It’s home from home; we are all a big family” and “The staff are very good; we can have a laugh with them.”

Each person who lived at the home had a care plan that was personal to them. The care plans included good information about the support people needed and arrangements were in place to monitor and respond to people’s health and well- being.

The Mental Capacity Act 2005 (MCA 2005) and the Deprivation of Liberty Safeguards (DoLS) set out what must be done to make sure the rights of people who may lack mental capacity to make decisions are protected and receive the care and treatment they need. The registered manager and staff understood their responsibilities in promoting people's choice and decision making. However, people’s capacity to make safe decisions and choices about their lives was not always clearly recorded in the care plans; the registered manager told us she would review this.

People were given the support they needed at mealtimes and were offered alternatives to the menu. The meals served looked nutritious and appetising and the portions were ample. People told us they enjoyed their meals. One person told us, “We have a very good cook who knows what we like. We can have a drink and something to eat when we like; it’s always good.”

People told us about the activities they enjoyed. People told us, “I prefer to stay in my room, I’m not interested in anything like that”, “They ask if we want to do anything. We play dominoes or have a game of bingo” and “I’ve had communion today. Some days we have a good chit chat and a laugh about things”.

The home was warm, comfortable and clean. People were satisfied with their bedrooms and living arrangements. During a tour of the home we noted some areas in need of improvement. We were shown an improvement plan for the home and noted action was being taken to maintain and improve the home.

People told us their privacy was respected. We found some of the bedrooms did not have an appropriate door lock in place. Door locks were necessary to help ensure people's privacy and dignity was protected. We discussed this with the registered manager and registered provider and were given assurances this would be resolved.

People told us they had no complaints about the service and felt confident they could raise any concerns with the staff or managers. One person said, “I have no complaints but I would tell the staff if I was worried about anything.”

There were systems to assess and monitor the quality of the service which would help identify any improvements needed. There were opportunities for people to express their views about the service with evidence their views had been used to improve the service.

Inspection carried out on 31 October 2013

During a routine inspection

During our visit we spoke with three people using the service and asked them to tell us how they felt they were being cared for. Some of their comments included; �Of course they are looking after me� and �It�s a home from home here, I am very happy�.

People were provided with a choice of suitable and nutritious food and hydration to ensure their nutritional needs were met. We asked one person using the service if they liked the food and if they were given enough to eat. We were told; �More than enough, its good food�.

We saw that people�s care records contained enough information to show how they were to be supported and cared for. They also showed that people gave consent to

their care and treatment.

An inspection of the care records showed that the people had access to other health care services. We were also made aware of the systems that were in place to make sure that information was passed on when a person�s care was transferred to another service.

We walked around all areas of the home and saw that it was clean, warm and free from offensive odours. The maintenance of the home ensured that people using the service, staff and visitors were kept safe.

Arrangements were in place to ensure that people using the service were cared for by staff that were safely recruited and were properly trained, supported and supervised.

Inspection carried out on 3 January 2013

During a routine inspection

We spoke with five people living in the home. People felt they were well looked after. One person said, "They (the staff) are very kind" and, "They have been very good to me since I arrived". Someone else said, "It's nice here, the food's good, it's always nice and warm". Another said, "The staff are very good but are rushed sometimes - now there isn't a cleaner". People felt staff were attentive and did 'their best'. Two people commented they sometimes had to wait for attention and thought this was due to the home being short staffed sometimes.

Some felt their care and support needs had been discussed with them since admission but others did not recall this process. One person said they knew they had a care plan but wasn't sure what was in it. However people felt the care and support met their needs and felt their wishes were taken into account. They felt they had some choices of routine. All the people we spoke with relied on staff to give them their medication. Two people told us they felt they were given the right medication at the right time.

The manager told us people had been given a copy of the complaints procedure, but some we spoke with were not aware of how to make a complaint.

A member of staff who spoke to us told us they had sufficient, experience, training and support that enabled them to feel skilled and competent in their work. This person had a good knowledge of the areas discussed with the inspector and assessed through the inspection.

Inspection carried out on 25 January 2012

During a routine inspection

People living in the home that we spoke with on the inspection visit told us that they felt

staff respected them, and that they had sufficient involvement in the planning and

delivery of their care and the service. One person said that personal care was carried

out 'properly and respectfully' and said, "All the staff are very good". When asked if staff treated them properly and respectfully one person said, "Oh gosh, yes".

People told us they had a choice in such matters as the food served, spending time in their rooms and when to get up and go to bed. We were also told that people filled in questionnaires about the service and were able to express choices and preferences to their key worker.

People living in the home told us that they received the care and support they needed promptly and that they felt their needs were met. Two people gave examples of how the care staff met their individual needs in a kind and understanding way. One said, "The staff are brilliant". Another person said, "They (the staff) come right away when I use the buzzer" and, "I am happy enough here - I have no regrets - but it's not like being at home". They also said, "The staff never grumble about whatever they have to do".

Staff told us they had sufficient experience, training and support that enabled them to feel skilled and competent in their work.

Reports under our old system of regulation (including those from before CQC was created)