Inspection on 19/10/06 for Culworth House Nursing Home

This inspection was carried out on 19th October 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

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

Culworth House Nursing Home 09/10/08

Culworth House Nursing Home 22/11/05

Culworth House Nursing Home 12/05/05

Culworth House Nursing Home 25/10/04

Culworth House Nursing Home 29/06/04

Extracts from inspection reports are licensed from CQC, this page was updated on 08/07/2008.

CARE HOMES FOR OLDER PEOPLE Culworth House Nursing Home Queens Street Culworth Banbury Oxfordshire OX17 2AT Lead Inspector Mrs Linda Preen Unannounced Inspection 10:00 19 October 2006 th X10015.doc Version 1.40 Page 1 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 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Culworth House Nursing Home DS0000012610.V315253.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Culworth House Nursing Home DS0000012610.V315253.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Culworth House Nursing Home Address Queens Street Culworth Banbury Oxfordshire OX17 2AT 08453 455744 01295 768201 Telephone number Fax number Email address Provider Web address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Culworth House Partnership Martha Aletta Cromhout Care Home 35 Category(ies) of Old age, not falling within any other category registration, with number (35), Physical disability over 65 years of age of places (35) Culworth House Nursing Home DS0000012610.V315253.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. A maximum of 35 residents may be accommodated in the home at any one time. No more residents in the category of OP may be admitted to the home when there are already 35 residents in this category accommodated. No more residents in the category of PD (E) may be admitted to the home when there are already 35 residents in this category accommodated. 22nd November 2005 Date of last inspection Brief Description of the Service: The Home is situated in 4 acres of secluded gardens in the centre of a rural village. It provides accommodation for up to 35 elderly residents. The accommodation is provided in mainly single rooms with two companion rooms available for those who wish to share. It provides 24 hour nursing and personal care. Fees range from £300 to £680 per week according to the assessed needs of the resident. Culworth House Nursing Home DS0000012610.V315253.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. Two hours were spent prior to the inspection reviewing previous requirements and recommendations and collating information provided by the service. The Commission sent comment cards out to a random selection of residents and to General Practices providing a service to the home. 2 comment cards had been received from residents, 4 comment cards from relatives and 2 from General Practitioners. These comments were all complimentary except that relatives expressed the opinion that there were not always enough staff on duty. The inspection took place over a period of five hours as part of the statutory inspection programme, which requires all homes to be inspected at least once a year. Four residents were chosen in order that their experience in the home could be assessed. The method used was “Case Tracking”. This involved looking at their records, talking to them and also to the staff concerning the care received. In addition to this staff rotas and medication records were seen. Information was available from a questionnaire completed by the providers of the service. Fees range from £300 to £680 according to resident’s assessed needs. What the service does well: What has improved since the last inspection? Culworth House Nursing Home DS0000012610.V315253.R01.S.doc Version 5.2 Page 6 Staff have received additional training to enable them to provide adequate care plans for all residents in order that all are aware of how the resident’s needs may be met. Care plans are now comprehensive, individual, regularly reviewed, and where possible signed by the resident concerned. Some staff have received training in meeting the specialist needs of those residents who have developed dementia type illnesses since admission and the Registered Manager is currently undertaking an extended course in the care of this group. Additional support staff in the form of Laundry Assistant, maintenance person, activities co-ordinator and increased catering staff hours have been provided to enable care staff to concentrate on the care needs of residents. Monitoring systems are in place to ensure residents are not at risk of scalding when accessing baths and showers and that storage and circulating temperatures of hot water are sufficient to prevent Legionella. What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Culworth House Nursing Home DS0000012610.V315253.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR 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) Scoring of Outcomes Statutory Requirements Identified During the Inspection Culworth House Nursing Home DS0000012610.V315253.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 2, 3 and 4 Quality in this outcome group is good. This judgement has been made using available evidence, including a visit to the service. Residents have the information required to enable them to make an informed choice concerning admission to the home EVIDENCE: The Statement of Purpose and Service User Guide, which set out the services offered in the home, have been updated this year. The Registered Manager stated that residents were issued with Terms and Conditions, but that copies of these were kept at head office and not in the home. Comprehensive assessments of need were available in the resident files seen. Culworth House Nursing Home DS0000012610.V315253.R01.S.doc Version 5.2 Page 9 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 and 10 Quality in this outcome group is good. This judgement has been made using available evidence, including a visit to the service. Good systems are in place to ensure that all aspects of resident need are identified and documented for staff guidance, to ensure that these needs may be met in the home. EVIDENCE: Four residents were chosen in order that their experience in the home could be assessed. This was done using the “case tracking” method, which involves looking at their records, talking to them and to the staff concerning the care provided. All four residents had excellent, detailed care plans in place to guide staff in how their individual needs should be met. These were up to date and regularly reviewed. Where possible the resident had signed the care plan to indicate their consent. All residents seen appeared well groomed and well cared for and those spoken to expressed their satisfaction with the care provided. All relatives and residents who returned comment cards were complimentary concerning the care provided. One resident stated, “I would recommend Culworth House, and I have, to others as you are treated with Culworth House Nursing Home DS0000012610.V315253.R01.S.doc Version 5.2 Page 10 respect and dignity that you expect when you are older and unable to look after yourself.” Medication records were inspected and found to be satisfactory. Systems are in place for the ordering, recording, administration and disposal of medication in the home. There was evidence in individual files that residents had been offered locks to their rooms in order to maintain privacy but none of the residents monitored had availed themselves of this facility. Outside doors to the home are kept locked and visitors have to ring the bell for admission in order to further protect residents from strangers wandering into their private space. Culworth House Nursing Home DS0000012610.V315253.R01.S.doc Version 5.2 Page 11 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome group is good. This judgement has been made using available evidence, including a visit to the service. Social Activities and meals are both well managed, creative and provide daily interest and variation for people living in the home. EVIDENCE: An activities co-ordinator is employed three days a week. Evidence of craftwork produced by the residents was seen in the home, and photographs were on the notice board depicting a recent flower arranging session that the residents had enjoyed. An activities programme was on display on the notice board. The registered manager reported that a hot dog and fancy dress party was planned for the week following the inspection and that a Christmas party for residents and their families was planned for December. Records of resident’s previous lifestyle and interests were available and these records included preferences for times of rising and retiring, food and clothing. Visitors are welcome at any time and one who was visiting her mother during the inspection, complimented staff on the care and attention provided. Culworth House Nursing Home DS0000012610.V315253.R01.S.doc Version 5.2 Page 12 Residents were sitting in the various lounge areas or in their rooms according to personal choice. Lunch was served either in their rooms or in the pleasant dining room. Menus provided as part of the pre-inspection questionnaire completed by the provider, demonstrated that a nutritious, varied diet is provided. Residents are offered choice for each meal, with daily choices being offered at breakfast time each day. The cook has changed her hours in order to be available to prepare the evening meal, taking this responsibility away from the carers. Both she and her deputy have completed food hygiene training. Culworth House Nursing Home DS0000012610.V315253.R01.S.doc Version 5.2 Page 13 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome group is good. This judgement has been made using available evidence, including a visit to the service. Residents may be confident that their concerns will be addressed and that they will be protected from abuse. EVIDENCE: Two complaints have been received by the Commission for Social care inspection concerning individuals care issues. These were forwarded to the company for investigation using their own complaints procedures. Records of the investigation of these and three other complaints were seen in the home and found to be satisfactory. An abuse policy is available for staff guidance and staff training records demonstrate that all staff have received training in the recognition and prevention of abuse. Culworth House Nursing Home DS0000012610.V315253.R01.S.doc Version 5.2 Page 14 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 20, 23, 24, 25 and 26 Quality in this outcome group is good. This judgement has been made using available evidence, including a visit to the service. Residents live in homely surroundings, which are well maintained and clean. EVIDENCE: A limited tour of the environment was undertaken. Some resident’s rooms, corridors and toilet facilities have been decorated since the last inspection. A smoking lounge has been provided as a new resident admitted to the home wished to continue smoking and the hairdressing room has been refurbished making this a very pleasant room for residents to enjoy this service. Pictures of the ladies with their newly styled hair were on display. One resident room has been provided with new floor covering and the registered Manager stated that floor covering for a second room was currently on order. All areas of the home were clean, tidy, bright and airy. Separate housekeeping staff are employed to help maintain this standard. Culworth House Nursing Home DS0000012610.V315253.R01.S.doc Version 5.2 Page 15 A new full time handyman and a laundry assistant have been employed since the last inspection and the Registered Manager stated that these had been a great help in maintaining standards in the home. Culworth House Nursing Home DS0000012610.V315253.R01.S.doc Version 5.2 Page 16 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome group is adequate. This judgement has been made using available evidence, including a visit to the service. Procedures for the recruitment of staff provide safeguards necessary to offer protection to the people living in the home. Staff are provided with training to meet the needs of the residents. EVIDENCE: The Registered Manager stated that staffing levels had recently been increased to allow for the increased numbers of residents to be cared for. Although it was felt that the numbers of staff on duty were adequate to meet the needs of the residents currently in the home, and care staff had reduced the number of hours worked in a week, day care staff still work 66hours a week and night staff 72 hours a week. Although it is acknowledged that these staff have signed an opt out clause from the European Working Time directive, these long hours may put a strain on the health of the carers and may have an adverse effect on residents who are being cared for by very tired staff. Staff records are not kept in the home, and information concerning recruitment practices was requested from the company office during the inspection and was provided from head office via the computer. This and information provided as part of the pre-inspection questionnaire completed by the provider, demonstrated that recruitment procedures are in place to protect residents from potential harm, with Criminal records Bureau checks and references being Culworth House Nursing Home DS0000012610.V315253.R01.S.doc Version 5.2 Page 17 obtained prior to employment. An equal opportunities policy is in place with staff from several different ethnic backgrounds, both sexes and a wide age range being employed in the home. The staff training matrix was seen. This demonstrated that statutory training is provided. A training officer is employed by the company to provide training and updates. New staff are required to complete a three day induction course at head office followed by a twelve week induction in the home. Records of this induction process were seen, and staff spoken to confirmed that they had completed this programme. The majority of carers in the home are qualified nurses from overseas and are therefore considered to be trained to National Vocational Qualification equivalents to ensure they have a basic understanding of care needs already. Some staff members have received training in meeting the needs of residents with a diagnosis of dementia since the last inspection, and the Registered Manager is currently doing a “Person Centred Care for People with Dementia” course to assist them in meeting the needs of those residents who have developed dementias since admission. Culworth House Nursing Home DS0000012610.V315253.R01.S.doc Version 5.2 Page 18 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome group is good. This judgement has been made using available evidence, including a visit to the service. The Registered Manager ensures that the home is run efficiently, in a way that serves the best interests of the residents. EVIDENCE: The Registered Manager is a First Level Registered Nurse who also holds a management qualification. Residents and staff appeared relaxed in her presence and visitors approached her freely during the inspection. Health and safety information was on display in the home. Records of the testing of fire alarms and emergency lighting as well as the temperature of the water were seen and found to be in order. Hot water temperatures to bath and shower facilities are maintained at the required levels to reduce the risk of residents being scalded. Culworth House Nursing Home DS0000012610.V315253.R01.S.doc Version 5.2 Page 19 Records of resident pocket money accounts were seen at the last inspection and found to be satisfactory. Chiropody and hairdressing are charged direct to the relatives and not dealt with by the home. Culworth House Nursing Home DS0000012610.V315253.R01.S.doc Version 5.2 Page 20 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 3 3 3 3 X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 3 X X 3 3 3 3 STAFFING Standard No Score 27 3 28 2 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 3 X 3 X X 3 Culworth House Nursing Home DS0000012610.V315253.R01.S.doc Version 5.2 Page 21 Are there any outstanding requirements from the last inspection? No STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 Refer to Standard OP27 Good Practice Recommendations The number of hours worked by staff should be monitored to ensure they are not becoming overtired and therefore putting residents at risk. Culworth House Nursing Home DS0000012610.V315253.R01.S.doc Version 5.2 Page 22 Commission for Social Care Inspection Northamptonshire Area Office 1st Floor Newland House Campbell Square Northampton NN1 3EB National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Culworth House Nursing Home DS0000012610.V315253.R01.S.doc Version 5.2 Page 23 - 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. 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