Inspection on 07/07/09 for Huntercombe Hall Care Home

This is the latest available inspection report for this service, carried out on 7th July 2009.

CQC found this care home to be providing an Good service.

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Huntercombe Hall Care Home 30/05/06

Huntercombe Hall Care Home 07/02/06

Huntercombe Hall Care Home 04/08/05

Similar services:

St Vincents

The Cotswold Home

Newbeech House

Winton House

Rush Court

Hillyfield Rest Home

The Maypole Nursing Centre

The Briars

Extracts from inspection reports are licensed from CQC, this page was updated on 16/02/2010.

Inspecting for better lives Key inspection report Care homes for older people Name: Address: Huntercombe Hall Care Home Huntercombe Hall Huntercombe Place Nuffield Henley on Thames Oxfordshire RG9 5SE     The quality rating for this care home is:   two star good 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: Kate Harrison     Date: 0 7 0 7 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 24 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 24 Information about the care home Name of care home: Address: Huntercombe Hall Care Home Huntercombe Place Huntercombe Hall Nuffield Henley on Thames Oxfordshire RG9 5SE 01491641792 01491641761 huntercombe@caringhomes.org 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) : Huntercombe Hall Limited C/o Caring Homes Limited care home 44 Number of places (if applicable): Under 65 Over 65 0 44 dementia old age, not falling within any other category Additional conditions: 10 0 The maximum number of service users who can be accommodated is: 44 The registered person may provide the following category/ies of service only: Care home with nursing - N Dementia (DE) 10 Date of last inspection Brief description of the care home Huntercombe Hall is registered to provide nursing care for up to 44 people aged 60 years and over. The home is in a rural part of Oxfordshire and public transport is limited. There is a country bus service, but the bus stop is some distance from the home. There is a registered manager in charge of the home, with one or more registered nurses on duty 24 hours a day, and a team of carers, housekeeping and kitchen staff. The public rooms are spacious and are on the ground floor. The private rooms are Care Homes for Older People Page 4 of 24 Brief description of the care home situated on the ground and first floors with each room having its own en-suite facilities of toilet and washbasin. Two single rooms have an en-suite shower room suitable for people with physical difficulties. There is one double room and communal assisted bathrooms. The home has extensive grounds, and a patio area with tables and chairs accessible from the conservatory. The fees for this service range from £450 to £900 per week. Care Homes for Older People Page 5 of 24 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: two star good 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 inspection of the home was an unannounced Key Inspection, and was carried out by one inspector between 10.00 and 17.00 during the day. It was a thorough look at how well the service is doing. It took into account detailed information provided by the home through the homes self assessment document, the Annual Quality Assurance Assessment (the AQAA) and any other information we received about the home since the last inspection. The AQAA was completed and received by the expected date and contained much of the information we needed to plan our visit. We looked at records and documents relating to the care of the people living there. We saw recruitment records and information about staff training and looked at how peoples medication was managed. We saw the communal areas of the home and some private rooms used by people living there. Care Homes for Older People Page 6 of 24 We asked the views of the people who live in the home, through questionnaires we had sent out. We also sent surveys to healthcare professionals involved with the home and to staff members. Altogether we received 14 completed surveys from staff, two healthcare professionals and from people living in the home, and their views are reflected in this report. We observed how staff interact with people and we spoke to several people about their lives in the home during our visit. We spoke to the registered manager, some staff members, to visiting relatives and to a senior manager from the company, and discussed the running of the home with them. This inspection was a thorough look at how well the home is meeting the standards set by the government and in this report we make judgements about the outcomes for the people living in the home. The date of our last key inspection was 23 July 2007. 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 24 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 24 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. People admitted to the home have their needs assessed before admission, and they and their relatives are assured that the home can meet their needs. Evidence: We discussed how people are admitted to the home with the registered manager. She told us that usually she receives information about people wishing to come to the home from relatives or from a care manager, and visits the individual to carry out a pre-admission assessment. When the individual lives too far away the local care manager from the local authority carries out the assessment, and discusses the information with the manager so that a decision can be made about how suitable the home would be for the individual. Individuals or their relatives receive information about the home, and there is a copy of the homes guide in every private room. We saw the pre-admission assessments for three people, completed on the organisations paperwork, and saw that enough information was available to decide if the home was Care Homes for Older People Page 10 of 24 Evidence: suitable to meet the individuals needs. We observed individuals in the home and saw that their needs were being met. The home does not provide intermediate care. Care Homes for Older People Page 11 of 24 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. People living in the home have their health and personal care needs met, in a respectful way. Evidence: The format and content of the homes care plans is being improved, and the work is proceeding to make sure that all the care plans are updated. The manager is considering how the format of the care plans for people with dementia can be made more suitable, so that information about an individuals past is used to understand their behaviour and the individual can be better cared for by the staff team. We saw the care records of three people, and note that risk assessments were carried out to identify the individuals care needs. We saw that care plans were developed to address any issues, such as moving about safely, skin damage, falls prevention and nutrition. We saw that the home uses a form to record peoples preferences about daily life choices, for example times for getting up and going to bed. We saw no record of how often people wanted to bathe or shower, and individuals told us that they could not always have a bath or shower when they wanted. When we discussed this with the Care Homes for Older People Page 12 of 24 Evidence: manager she said that one bathroom was being renovated so that it would be more accessible, and people would have more choice when the work was completed. The majority of people living at the home who responded to our survey said that they always receive the care and support they need, and that they receive the medical care they need. Two healthcare professionals told us through our survey that the home usually seeks advice and acts on it, to meet peoples health care needs and improve their well-being. We saw how the home manages medication, and noted that there is a system in place to record what happens to all the medication received into the home, so that it is easy to account for all the medication. Some individuals apply their own prescribed creams and gels, and the home is improving the way it records this, by completing self administering forms. The majority of people living in the home who responded to our survey said that the staff always or usually listen and act on what they say. We saw staff members address individuals courteously and attend to their needs promptly. One couple has chosen to have a shared room, and their individual needs are documented in care plans, so each can live as they want. Care Homes for Older People Page 13 of 24 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People living in the home are supported to live as they want to, to make their choices daily and to have good communication with their relatives. Evidence: The home holds residents meetings regularly, and we saw from the minutes of a recent meeting that people can give their views about life in the home, and can expect issues to be resolved. We noted that people complained that they had to wait to use the toilet, and one person told us that this remained a problem. The manager explained that this was more to do with the allocation of staff than a lack of staff, and that it is being addressed. People told us through our survey that the home provides activities that they can take part in. There is an activity coordinator and an activity schedule, showing daily activities such as bingo, reading group and word games, and we saw that the care team are involved in the activity programme. The home is looking to improve the activities provided for people with dementia, so that individuals can enjoy life in the home. A new garden area is nearing completion, so that people with dementia can safely enjoy the garden. People told us that they would like more outings, such as for shopping or to the pub. The manager explained that there had been difficulties Care Homes for Older People Page 14 of 24 Evidence: arranging outings, but that one was arranged for the near future to the nearby pub. The home has grounds suitable for people to use, and people told us that they enjoy going out in good weather. Since our last inspection the Church of England vicar has made arangements to visit the home regularly, and was conducting a service on the day of our visit. Other church ministers also visit, to meet the spiritual needs of the people living in the home. Visitors are welcome at the home, and some told us that they are able to see their relative in private if they want to. They said they were able to eat with their relative at times, were able to make their own drinks at the visitors kitchenette and that the home communicates very well with them about important issues affecting their relative. The majority of people who responded to our survey told us through that they like the food provided at the home. We saw the menu for the day, showing a choice of dishes, and we saw that the food was well presented. One person told us that that the chef makes sure her dietary needs and preferences are met, and we saw the chef discuss the evening meal with her. We noted in one individuals care plan that finger foods are to be provided, in response to the persons changing needs. The manager told us that the home started providing more snacks recently, as well as drinks at all times, so that people can eat little and often as they want. Care Homes for Older People Page 15 of 24 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. People living in the home know how to make a complaint, and they are protected from harm through the homes procedures. Evidence: The homes complaints procedure has recently been updated and now is more user friendly, so that people can easily read it and know whom to complain to. It shows that the home will investigate complaints and respond to complainants within 28 days. The home keeps a record of complaints and four complaints were responded to within the last year. People told us that they know whom to complain to if they need to. The home has a safeguarding procedure and all new staff members receive training during their induction. The majority of staff members have received the extra safeguarding training at Level 2. The home liaises with the local Oxfordshire safeguarding team when issues of abuse are suspected, and made two referrals to the team in the past year. This means that people living in the home can rely on the home to take the right action if necessary. Care Homes for Older People Page 16 of 24 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People live in a welcoming, safe and well maintained environment. Evidence: We met with the person responsible for the general maintenance of the home, and we saw that there is a system in place for identifying and responding to day to day maintenance issues. The home has a decorating schedule and involves people living in the home in decorating decisions, for example in choosing the colour of the dining room. The home has make efforts to make sure that people living in the dementia care area have enough clues from their environment to be able to find their way around easily, for example by using pictures and colour on doors to identify bathrooms and toilets and their own rooms. The majority of people living in the home told us through our survey that the home is always fresh and clean. There is a housekeeping team responsible for the cleanliness and laundry, and there is a system in place to make sure that laundry is managed in a way that minimises the spread of infection, including staff training about infection control. Care Homes for Older People Page 17 of 24 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People have their needs met by trained friendly staff. Evidence: We checked the homes recruitment procedure by looking at three staff members records. We noted that the home recruits some staff from Poland, and the manager said that the home uses an agency to manage the recruitment process there. We noted that the references are translated, but there was no evidence on record to show that the references were authentic. The manager said that the agency is responsible to the organisation for this, but the organisation is planning to manage the overseas recruitment process themselves, and will make sure that all the necessary information is recorded. The home has a staffing rota, showing that there is a mix of qualified nurses and carers on duty over the twenty four hours. Usually there are two nurses on duty during the day and one at night, with the number of carers varying during times of the day. We received responses from our survey to the staff team saying that there were usually enough staff available to meet the needs of the people living in the home. Several staff members commented that the layout of the home had an impact on the availability of staff, as the numbers of staff available were in different locations, throughout the home. The majority of people living at the home who responded to our survey said that they always receive the care and support they need, though some Care Homes for Older People Page 18 of 24 Evidence: individuals reported having to wait to use the toilet. We discussed this with the manager, and she will look at the allocation of staff at particular times of the day, to make sure that the needs of the people living in the home are met. Comments about the staff from people living at the home and visitors included: very friendly and good staff who are capable and friendly. The home uses the organisations training department to manage staff training, and uses a variety of methods to deliver the training, including group, coursework and internet learning. There is an induction programme to the Common Induction standards, and further training detailed on the homes training matrix. We noted that there is ongoing training on key issues, and a system in place to make sure staff have update training as needed. The home is working towards the national minimum standard of having 50 of staff trained to National Vocational Qualification Level 2 in Care. Care Homes for Older People Page 19 of 24 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home is run in the best interests of the people living there, as the manager makes sure that their views are listened to and acted upon. Evidence: The homes manager is a registered nurse and has experience of working in the National Health Service at a senior level. She has management training and was registered this year to be the homes manager. She has an open management style, and makes herself available for people living in the home, their relatives, and staff. Results from our staff survey show that staff feel they get enough support from the manager, and comments about her included very approachable from relatives, and excellent from a staff member. The home carries out a quality assurance exercise about the quality of the services provided annually, and has completed this years survey including surveys to people living in the home, relatives and other health and social care professionals. The results are in the process of being collated, and the home intends to publish the results in the Care Homes for Older People Page 20 of 24 Evidence: homes newsletter. Regular quality audits are carried out about health and safety topics, including care planning and management of medication. People living in the home have opportunities though monthly meetings to comment on any issues affecting their care at the home, and we saw from the minutes of meetings that the home responded to address any issues arising. The home manages small amounts of cash for some people living in the home who cannot manage it themselves. We saw that records are kept of transactions, including receipts from the hairdresser, and that individuals can see their records when they wish. We saw that the homes health and safety policy statement is displayed, and we noted that there is a health and safety committee at the home to monitor and address issues arising. We spoke to the individual responsible for the health and safety checks in the home, and there is a system in place to make sure that regular safety checks on water temperatures, emergency lighting and other topics are made. The home has a fire risk assessment in place, staff receive fire safety training and several staff members have first aid training so that there is always a first aid trained individual on duty at the home. Care Homes for Older People Page 21 of 24 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 22 of 24 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 23 of 24 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 24 of 24 - 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!