Inspection on 22/12/05 for Fewcott House Nursing Home

This inspection was carried out on 22nd December 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. 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

Fewcott House Nursing Home 25/09/07

Fewcott House Nursing Home 09/05/06

Fewcott House Nursing Home 02/06/05

Fewcott House Nursing Home 27/01/05

Fewcott House Nursing Home 22/06/04

Fewcott House Nursing Home 18/02/04

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 08/07/2008.

CARE HOMES FOR OLDER PEOPLE Fewcott House Nursing Home Fritwell Road Fewcott OX27 7NZ Lead Inspector Delia Styles Announced Inspection 5th and 22nd December 2005 09:30 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 Fewcott House Nursing Home DS0000043201.V252768.R01.S.doc Version 5.0 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. Fewcott House Nursing Home DS0000043201.V252768.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Fewcott House Nursing Home Address Fritwell Road Fewcott OX27 7NZ 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) 01869 345501 01869 345502 admin@fewcott.com Fewcott Healthcare Limited Mrs Fairus Harrison Care Home 35 Category(ies) of Dementia - over 65 years of age (8), Mental registration, with number Disorder, excluding learning disability or of places dementia - over 65 years of age (4), Old age, not falling within any other category (35) Fewcott House Nursing Home DS0000043201.V252768.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. The total number of persons that may be accommodated at any one time must not exceed 35. Admittance of two named service users under the age of 65. Date of last inspection 2nd June 2005 Brief Description of the Service: Fewcott House is a small manor house (the original building dates from 1680), set in 2½ acres of gardens, with an ornamental lake. Situated in the small village of Fewcott, in an attractive rural setting, it is conveniently accessible from the motorway and major road routes from Bicester, Oxford and Banbury. The home was originally registered as a nursing home in 1985, with 14 beds. A purpose built extension was added and the home was registered to accommodate a total of 37 residents in 1987. The present registered owner and co-directors - Ms Neeru Harrison, Mr Neeraj Harrison and their parents, Mr H and Mrs F Harrison - bought Fewcott House in March 2003. The home offers care to physically and mentally frail older people with nursing needs. There are nine single rooms and 13 shared rooms. First floor rooms are served by a passenger lift and two stairways. Most rooms are equipped with small en-suite shower/toilet cubicles. There are four communal bathrooms, two of which have bath hoists, and 3 communal toilets. Fewcott House Nursing Home DS0000043201.V252768.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This announced inspection lasted 6 hours and was undertaken by the lead CSCI inspector for the home, accompanied by a nurse employed by a Primary Care Trust who wanted to look at the way in which CSCI conducts inspections. Key standards not assessed on this occasion were looked at during the unannounced inspection in June 2005. The home’s manager, and responsible individual were unable to be present at the inspection, but a co-director of this family-owned business and the home’s administrator were present and the inspector’s observations and recommendations were discussed with them at the end of the day. The inspectors would like to thank the staff and residents of the home for their welcome and assistance. The inspector spoke to residents, nurses and care staff on duty. A sample of residents’ care records was looked at. A tour of the premises was undertaken. Some pre-inspection information was e-mailed, and some was given to the inspector on the day. Information not accessible to staff on the day was requested on the manager’s return. Two comment cards were received about the home – one from a general practitioner and one from a care manager/placements officer. A further meeting was held with the manager, the responsible individual and administrator at the home on 22/12/05 to complete the assessment of some standards and discuss the outcome of a complaint investigation. Recommendations made following the complaint have been incorporated into the recommendations section at the end of this report. What the service does well: The home is clean, warm and homely. There is an ongoing programme of redecoration and the standard of furnishing and décor is good. The gardens and grounds are well maintained and attractive. The nurses and care staff are professional, caring and friendly in their approach to residents. Comment cards indicate that health and social care professionals are satisfied with the standard of care provided by the home. Fewcott House Nursing Home DS0000043201.V252768.R01.S.doc Version 5.0 Page 6 What has improved since the last inspection? What they could do better: The home should have more daily activities for residents to give them more opportunities to share time together and to enjoy different types of individual and group activities that suit them. Assessment of residents’ needs and care planning should be improved to ensure that staff are able to know what to do for each person and for the records to show that the care has been carried out satisfactorily. The care assessments should include detailed information about each person’s physical, mental and social care needs. The home should adhere to the recent new regulations about the collection and safe disposal of unwanted or unused medications from the home, by using a specialist waste disposal contractor and should maintain accurate records of the medications awaiting disposal. Additional training for staff should be provided so that they have the skills to meet the specific needs of those residents with dementia. The system for recording and receipts of residents’ personal property should be improved. The home should be aware of any items of equipment or electrical goods brought into the home by family or friends, so that the electrical and fire safety can be checked. There should be a signed record of any personal property or valuables returned to family members. The home manager and directors should improve the way in which they consult with residents and relatives about how the home is run and should publish the results of any surveys and questionnaires that are used as part of this process. Residents and relatives meetings, and regular newsletters are other ways in which the home could invite feedback about the home and care provided. Fewcott House Nursing Home DS0000043201.V252768.R01.S.doc Version 5.0 Page 7 Formal staff supervision meetings have only taken place once in the past year. All care staff should have regular planned meetings (at least 6 times a year) with senior staff, to discuss their progress, training requirements and any suggestions or concerns about their individual work role. 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. Fewcott House Nursing Home DS0000043201.V252768.R01.S.doc Version 5.0 Page 8 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 Fewcott House Nursing Home DS0000043201.V252768.R01.S.doc Version 5.0 Page 9 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): Standards not assessed on this occasion. Standard 6 is not applicable, as the home does not provide intermediate care. EVIDENCE: Fewcott House Nursing Home DS0000043201.V252768.R01.S.doc Version 5.0 Page 10 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 & 10 The care planning system does not provide the level of detail in order that staff can fully meet residents’ care needs. The health needs of residents are satisfactorily met with evidence of multi disciplinary working with medical practitioners and other health and social care professionals. The procedures in place for the storage, administration and records of medicines are satisfactory and safe. The home should use a specialist waste disposal company to collect and dispose of any unwanted or unused medication, in line with the recently implemented legislation for disposal of medicines for care homes with nursing. Staff have a good understanding of residents’ care needs and offer assistance in a way that protects residents’ dignity. There is some evidence that staff ‘routines’ of care giving may not promote residents’ independence. EVIDENCE: Six care records were examined. There has been no significant improvement to the care record system used in the home since the last inspection. There Fewcott House Nursing Home DS0000043201.V252768.R01.S.doc Version 5.0 Page 11 are no care plans as such, but a computer-generated ‘care needs’ and ‘action’ list. The ‘care needs’ are mainly about the residents’ physical care, with very little about their psychological or social care needs. There is insufficient comment in the written records showing that care has been reviewed and evaluated. Entries to the ‘daily statement’ record are not cross-referenced to the numbered care ‘needs’, and so are still non-specific. The care plan folders are kept in a locked cupboard, to which the registered nurses have a key. This does not encourage care staff to access and read the care plans or to contribute to information about the care they have provided for residents. There was some evidence of additional interim care plans being written if residents’ care needs alter and the monthly printed care record is not due for re-printing. Some handwritten alterations made by nurses to the printed care record had not been signed by the nurse making the changes. There was no evidence that those residents who are able (or their relatives) had been involved in drawing up their care records. A care manager pointed out that during a review of two clients in the home, s/he had found that their care plans were not up to date and were not relevant to the clients’ current situation. This had been discussed with the nurse in charge at the time. The residents’ care records should be sufficiently detailed to provide the information about their health, personal and social care needs and the actions needed to meet those needs. Recommendations for improving the care planning system were discussed with the nurses, co-director and administrator. In particular, the care records for those residents with dementia did not show that staff had enough information about the best ways to help confused and ‘wandering’ residents or to divert them from possible conflict with others. Nurses on duty were not aware of any specific training provided in the home for care staff in caring for people with dementia; however, there are regular contact visits from community mental health nurses to advise and guide the home’s staff. There were records of regular medical, optical and chiropody appointments for residents. A doctor’s comment card response showed overall satisfaction with the care provided to residents in the home and the way in which the home’s staff communicate with the GPs and community nursing team. The systems in place for the safe storage and records of medicine administration were satisfactory. The senior nurse was not aware of the recent legal changes to the arrangements for the collection and disposal of unwanted or unused medicines from the home. Information was given to the nurse in charge and a recommendation made that the home’s manager ensures that the home complies with the current legislation. Fewcott House Nursing Home DS0000043201.V252768.R01.S.doc Version 5.0 Page 12 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): 12, 13, 14 & 15 Organised social activities for residents are limited, but appear to meet the needs of those more able residents currently. There is a need for further development of suitable daily activities that involve residents who are mentally frail. Family, friends and residents’ representatives are able to visit and maintain contact with residents. Residents who are able to express their choices about their care are able to influence the way in which care is given, and about the pattern of their day. The menus are varied and provide a balanced diet for residents. EVIDENCE: Organised activities take place on two weekday afternoons for residents who wish to be involved. On the afternoon of the inspection, residents were playing Bingo, with the activities organiser and her helper. The activities take place in the dining room, which is kept locked between mealtimes, to prevent more confused residents accessing the tables set up for meals. Fewcott House Nursing Home DS0000043201.V252768.R01.S.doc Version 5.0 Page 13 There was little evidence of ad hoc activities or individual time spent by staff with confused residents. There are regular summer outings to places of interest and an annual Church fete is held in the grounds of Fewcott House. The home has an unrestricted visiting policy. The home is situated on the outskirts of a small village and public transport is limited, so visitors without their own cars need to use taxis. An adapted bus is hired for taking residents on outings to places of interest. Residents spoken with who were able to express an opinion about how they spend their days, were satisfied that they were able to do as they wished and had their television, radio and reading materials in their rooms or could join others in the ground floor communal sitting rooms. There was some evidence that residents with mental health have less opportunity to actively make choices: task lists for staff showed a routine of physical care. Residents’ assessment and care plans did not indicate in any detail their former interests and abilities and how recreational and social life in the home could help meet their current needs. The menus were inspected and looked balanced and varied. Mealtime arrangements are flexible so that residents can eat in the main dining room, smaller sitting rooms, or their own rooms, as they prefer. The menus are on display on a notice board in the corridor opposite the dining room but the print size is small; larger print menus would be easier for residents to read and copies of the menu could be provided in the dining room, so that residents are aware of the choices on offer. Residents spoken with before lunch said they did not know what the meal choices were that day, but said that the food is always good, so they would be content to have whatever was served. A whiteboard in the dining room lists individual residents’ breakfast preferences. There were ‘special diet’ sheets available in the staff room to show the type of meals, size of portion and whether help with eating was required for each resident. Fewcott House Nursing Home DS0000043201.V252768.R01.S.doc Version 5.0 Page 14 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): 16, 17 & 18 The home has a satisfactory complaints system though there was some evidence that residents are not always clear about who to go to with any concerns. Residents are able to exercise their right to vote at election times. The home provides training and has policies covering adult protection topics. EVIDENCE: The CSCI has received one complaint about the home since the last inspection in June 2005. The home’s manager and directors responded to the Commission with information and staff statements about the concerns raised about alleged poor care practices in relation to managing a resident’s continence and behavioural problems, and failure to seek medical advice promptly after the resident had fallen. Concerns were also raised about the failure of the home to return property provided for the resident by family members to the resident’s family representative. The inspector has been unable to resolve the elements of the complaint, but made a number of recommendations as a result of the investigation. These include recommendations about improving the standard of written records of care, and the receipt and return of property records. Staff should all be made aware of the systems for reporting any concerns raised by residents and relatives to the home manager or directors so that the manager can ensure that they are investigated thoroughly and resolved satisfactorily. Staff should have regular supervision of their practice and formal supervision interviews where they can discuss their work and progress with a senior member of staff. Fewcott House Nursing Home DS0000043201.V252768.R01.S.doc Version 5.0 Page 15 Most residents have family, friends, or social services care managers and reviewing officers to visit them and ensure that the home is providing satisfactory care that meets their assessed needs. The home ensures that residents are included on the electoral roll and can exercise their right to vote. The home provides training and information for staff about protection of vulnerable adults from abuse, as part of their induction and as part of a regular programme of training. Fewcott House Nursing Home DS0000043201.V252768.R01.S.doc Version 5.0 Page 16 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 & 26 The décor and furnishings of the home are of a good standard and provide a comfortable and pleasant environment for residents to live in. The home is clean and free from unpleasant smells. Outside, the grounds and gardens are well maintained and attractive. EVIDENCE: By walking around the home and talking to residents in their own rooms, it was evident that a high standard of cleanliness is maintained. There were no unpleasant smells. Residents’ individual rooms were homely, attractively decorated and clean. Many residents have wooden stair gates across their room doorways. This is to deter other confused residents who may wander into others’ rooms, and is a positive decision by individual residents to protect their privacy and property. Residents confirmed to inspectors that this was the case. The stair gates are of an ‘easy release’ design and the local fire officer has raised no objection to their use by residents who wish to have them. Fewcott House Nursing Home DS0000043201.V252768.R01.S.doc Version 5.0 Page 17 The proprietor has fitted an automatic disinfecting sluice machine in the small first floor sluice room. This follows the recommendations and infection control guidance for all care homes that provide nursing care. The laundry is in a small basement room, accessed via steep steps. It is clean, tidy and adequate to process laundry work for residents. The home has dedicated laundry staff. There were supplies of protective clothing and hand washing facilities for staff to support good practice in protecting residents from cross-infection. Fewcott House Nursing Home DS0000043201.V252768.R01.S.doc Version 5.0 Page 18 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): 27 & 30 Staffing numbers meet the levels considered adequate to meet the care needs for the current residents. There is evidence of a planned programme of training in place for staff. EVIDENCE: The home employs four staff through an agency: these staff live in a house owned by the proprietors and are familiar with the home and residents. There was evidence that agency staff have appropriate training in health and safety topics. Twelve of the current care staff are undergoing, or have already achieved the equivalent of National Vocational Qualifications (NVQ) Level 2 training in care. The activities worker is part-time and works for two afternoons per week. Care staff have not had specific training in caring for people with dementia. Many of the residents have dementia-type illnesses and staff should have additional training to further develop their abilities to care for this client group. As noted at previous inspections, many of the care staff, particularly the agency staff, work long hours and undertake a range of care and domestic work in the home. There is a risk that staff who work long hours and a variety of day and night shifts, will become overtired and put themselves and residents at risk because they are more likely to make mistakes or have accidents. This was discussed with the administrator and a director, who said Fewcott House Nursing Home DS0000043201.V252768.R01.S.doc Version 5.0 Page 19 they do monitor the duty rosters and would limit staff member’s hours if it was apparent that they were working excessively. Fewcott House Nursing Home DS0000043201.V252768.R01.S.doc Version 5.0 Page 20 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): 31, 33, 35, 36 & 38. The registered manager has long experience of managing a care home and although has had periods of ill health, is supported in her role by her family who are co-directors of the company. The home does not actively seek feedback from residents and their representatives about the extent to which the home meets the aims and objectives and Statement of Purpose. There has been very limited progress in putting in place the programme of formal supervision of all care staff. The systems in place for record keeping and accounts of residents’ personal allowances are sound. Written records and receipts for personal property held on behalf of residents in the home should be improved to provide more detailed description of items and should be countersigned by the resident or their representative. Fewcott House Nursing Home DS0000043201.V252768.R01.S.doc Version 5.0 Page 21 The home has a programme of training for staff in health and safety matters and has systems in place for regular maintenance and safety checks for equipment. EVIDENCE: Mrs Harrison is undertaking the Registered Manager Award course, with a view to completing this by the summer of 2006. She attends a handover report in the home daily and she and other family directors are available to staff at the office in their house next door to the care home. The home does not hold regular formal meetings with residents or relatives currently, but Mrs Harrison said that they do meet informally with residents and their visitors so that she is always available to hear any suggestions or concerns. The home does not use any formal means of gaining feedback from residents or relatives about the facilities and care provided by the home, such as questionnaires. It is recommended that the systems for consulting with residents and their representatives are improved so that residents’ views are actively sought and acted upon and the proprietors can share their ideas and information about the home with residents, staff and relatives. Care staff have had only one formal supervision session this year. Ms Harrison said that she intends to re-start the programme so that all care staff have at least 6 supervision meetings in a 12-month period – the recommended frequency for supervision. The home has produced supervision contracts and a written form for recording topics and agreed actions, so that employees will have a copy of their supervision meeting notes. Records were seen of residents’ expenditure from their personal allowances for additional services, such as chiropody and hairdressing; these costs are itemised and invoiced with their fees. The home runs a small ‘shop’ service, selling toiletries and sweets at cost price to residents. As part of the outcome of the investigation of a complaint, it is recommended that the system in place for recording receipt of resident’s own property (including any additional equipment or electrical goods brought in by the resident’s family) should be improved. The home’s manager should be aware of all additional furniture or equipment not provided by the home, so that the proprietor can check the electrical and fire safety of items before they are used in a resident’s room. The resident or their representative should countersign any amendments made to the property list and on receipt of any items taken away from the home. The home did not have a maintenance worker at the time of the inspection. One of the domestic staff had temporarily taken on the responsibility for Fewcott House Nursing Home DS0000043201.V252768.R01.S.doc Version 5.0 Page 22 checking the fire alarm and emergency lighting, and hot water temperatures in the home: the records for these routine checks were complete and up to date. The temperature of the hot water was checked at several outlets and was within the ‘safe’ range of ‘close to’43°C’, with one exception: the ground floor bath hot water measured 46°C when tested by the inspector in the early afternoon. The temperature had been checked in the early morning by the staff member and was satisfactory then. The temperature control valve should be checked and adjusted to ensure that the hot water is consistently at the recommended safe temperature, to reduce the risk of accidental scalding of residents. Fewcott House Nursing Home DS0000043201.V252768.R01.S.doc Version 5.0 Page 23 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 X X X X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 2 17 3 18 3 3 X X X X X X 3 STAFFING Standard No Score 27 3 28 X 29 X 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 2 X 2 1 X 3 Fewcott House Nursing Home DS0000043201.V252768.R01.S.doc Version 5.0 Page 24 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 OP7 Good Practice Recommendations Ensure that residents care plans are sufficiently detailed, updated to show their current care needs, and evaluated to show whether the care given has been appropriate to meet their needs. Unwanted or unused medications should be disposed of safely using a licensed waste contractor, and the home should retain records of the transactions under the terms of the Special Waste Regulations 1996. Increase the opportunities for residents to be involved in individual and group activities both inside and outside the home, to suit their needs, preferences and capacities. Provide menus in larger print and on dining tables, so that residents are aware of the choices on offer. Consider ‘picture’ menus to assist residents with confusion or communication difficulties to make their choices more independently. Ensure that all staff are aware of the need to bring DS0000043201.V252768.R01.S.doc Version 5.0 Page 25 2 OP9 3 4 OP12 OP15 5 OP16 Fewcott House Nursing Home 6 OP30 7 OP33 8 OP35 9 10 OP36 OP38 residents’ complaints or concerns to the notice of senior staff and the home manager, and maintain a record of the follow-up, outcome and response made to the resident or their representative. Ensure that the services for residents with dementia are based on current good practice and that staff individually and as a team have the skills and experience to deliver care to this client group. Hold residents and relatives meetings, use questionnaires and newsletters to improve the communication between the home’s managers and residents and their relatives, and to get regular feedback about the home’s services. Publish the outcome of quality assurance surveys for service users. Ensure accurate records and receipts are maintained for items held for safe-keeping, or any equipment, furniture or other valuables provided by third parties for use by residents in their own rooms. An accurate record should be kept of all such items returned to residents and/or their relatives at the end of the resident’s stay. Implement the programme of formal staff supervision so that all care staff have at least 6 supervision sessions in any 12-month period. Monitor and adjust the temperature of the hot water in the ground floor bathroom to ensure that it is consistently within the recommended safe range. Fewcott House Nursing Home DS0000043201.V252768.R01.S.doc Version 5.0 Page 26 Commission for Social Care Inspection Oxford Area Office Burgner House 4630 Kingsgate, Cascade Way Oxford Business Park South Cowley Oxford OX4 2SU 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 Fewcott House Nursing Home DS0000043201.V252768.R01.S.doc Version 5.0 Page 27 - 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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