Archived: Vine House Rest Home

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.