Inspection on 25/09/07 for Fewcott House Nursing Home

This inspection was carried out on 25th September 2007.

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

Fewcott House Nursing Home 09/05/06

Fewcott House Nursing Home 22/12/05

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 Kate Harrison Unannounced Inspection 25th September 2007 10:00 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.V344701.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. Fewcott House Nursing Home DS0000043201.V344701.R01.S.doc Version 5.2 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 Vacant 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.V344701.R01.S.doc Version 5.2 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 7th August 2006 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 home came under new management earlier this year. 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. The registered manager and a team of nurses, carers and housekeeping staff manage the home. Fees range from £660 to £765 per week, and more information about fees is available from the home. Fewcott House Nursing Home DS0000043201.V344701.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection of the service was an unannounced ‘Key Inspection’. The inspector arrived at the service at 09.45 hours and was in the service for 6 hours. This inspection was a thorough look at how well the service is doing. It took into account detailed information provided by the service’s manager, and any information that CSCI has received about the home since the last inspection. The inspector saw all areas of the home and looked at records and documents relating to the care of the residents. The inspector asked the views of the people who use the services and other people seen during the inspection or who responded to questionnaires that the Commission had sent out. Altogether 11 replies were received, and their views are included in this report. From the evidence seen by the inspector and comments received, the inspector considers that this service would be able to provide a service to meet the needs of individuals of various religious, racial or cultural needs. No complainant has contacted the Commission with information concerning a complaint made to the service since the last inspection. What the service does well: What has improved since the last inspection? Several major improvements have been made to the communal and private areas of the home, and are continuing. The improvements have resulted in a cleaner, safer, brighter, more comfortable home, and people living at the home appreciate it. The provision of adjustable beds has improved safety for staff members and individuals living at the home. Fewcott House Nursing Home DS0000043201.V344701.R01.S.doc Version 5.2 Page 6 Staff training has improved and there is a commitment to good induction and continuing training for staff. More ways to improve the running of the home are in hand, such as moving the nurse station to the ground floor. The individual needs of the people living at the home are considered, and this has meant that their daily lives are better. 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. The summary of this inspection report can be made available in other formats on request. Fewcott House Nursing Home DS0000043201.V344701.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 Fewcott House Nursing Home DS0000043201.V344701.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. JUDGEMENT – we looked at outcomes for the following standard(s): 3 and 6. The home does not provide intermediate care. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People coming to stay at the home know that their needs can be met. EVIDENCE: The registered manager usually carries out the pre-admission assessment visit, and gathers all the available information from the care manager, health care professional or from the family before the visit. The pre-admission assessment forms seen by the inspector contained all the information necessary for the manager to make a decision about admitting the individual. The admission system has recently been amended to include a letter to the individual or the individual’s representative confirming that the home can meet the individual’s needs at the time of admission. Fewcott House Nursing Home DS0000043201.V344701.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. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 and 10. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People at the home have their health care needs met in a respectful way. EVIDENCE: Through the Commission’s questionnaire people at the home said that they ‘always’ or ‘usually’ received the care and support they need, and the healthcare professionals who responded to the Commission’s questionnaire said that the health care needs of individuals were ‘always’ or ‘usually’ met by the home. Several staff members were seen during the day managing difficult situations in a sensitive respectful way. The new management has introduced new care plan documentation and is working to move more towards person centred care planning. The inspector saw the care planning documentation for three people living at the home, and was satisfied that their personal, health and welfare needs were recognised and met. Fewcott House Nursing Home DS0000043201.V344701.R01.S.doc Version 5.2 Page 10 At present some of the risk assessments and assessment tools are duplicated and some of the assessment tools are not clearly evidence-based. The registered manager is reviewing the documentation so that only the necessary forms are used, and is implementing the nationally evidence-based nutrition assessment tool, and the risk assessment documentation recommended by the Primary Care Trust’s Falls Service. Only nurses manage the medication in the home and policies and procedures are available to help staff members. The inspector saw the records of some of the people living at the home, and was satisfied that all the medication administered is recorded appropriately, including controlled drugs. Medication refused by individuals is also recorded appropriately. Medication is supplied by three surgeries, and comes into the home at different times of the month. The system of recording the receipt of the medication is different depending on the supplying pharmacy, is hand written and time consuming, and this can lead to errors by staff members. The registered manager is reviewing the existing arrangements and it is recommended that she arrange for the community pharmacist to be part of the review, with a view to making the arrangements simpler. Fewcott House Nursing Home DS0000043201.V344701.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. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 and 15. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Improvements have been made to improve the choices available to people at the home. EVIDENCE: People at the home said that there are ‘always’ or ‘usually’ activities available that they can take part in, though several said that they choose not to take part. The preferences of individuals regarding activities are known and staff are looking at ways of improving the recording of information. There is an activities timetable and group and individual activities are provided. Two activities organisers manage the activities at the home during the week, and staff members arrange activities over the weekends. A volunteer comes regularly to the home, and is able to spend time chatting with individuals. The manager is aware of the need to provide more opportunities for individuals to use the grounds, and is working to make the area safe. Representatives from the local churches visit the home regularly to care for the spiritual needs of individuals, and staff are aware of the need to know and met the individual needs of the people living at the home. The majority of relatives Fewcott House Nursing Home DS0000043201.V344701.R01.S.doc Version 5.2 Page 12 who replied to the Commission’s survey said that the home ‘always’ kept them informed of important matters affecting their relative. The cook has a system of getting information about the food preferences of new individuals admitted to the home, and is able to source local fresh produce. The dining room has been much improved, with fresh tablecloths and serviettes, and the improvements show respect for the people living at the home. A relative said that one individual was not able to have a private room, as the local social services department was unable to fund it, and the individual had to share a room because of cost. Fewcott House Nursing Home DS0000043201.V344701.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. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People living at the home know that their complaints will be listened to, and staff members know how to protect them from harm. EVIDENCE: The complaints procedure is displayed in the home, and it is easy for individuals to follow if they want to make a complaint. No complaints have been made to the home since the new management took over. The majority of people living at the home who responded to the Commission’s survey said that they knew how to make a complaint. No complainant has contacted the Commission with information about a complaint made to the service since the last inspection. The home has policies and procedures about safeguarding vulnerable adults, linked to local multi-agency codes of practice, and staff members receive information about the subject during induction. All staff members attend the ‘Alert to Abuse’ training. Fewcott House Nursing Home DS0000043201.V344701.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. JUDGEMENT – we looked at outcomes for the following standard(s): 19 and 26. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People living at the home are safe from hazards and live in an increasingly comfortable environment. EVIDENCE: The environment is homely, comfortable and clean. Systems are in place to make sure that daily maintenance issues are managed in a timely way, and that regular procedures are carried out to maintain safety. The new management has begun a considerable refurbishment programme, and the people living at the home and their relatives appreciate this. Most of the recommendations from the last inspection report about the environment have been implemented. The refitting of the kitchen is planned and is due to be started soon. Major improvements include the installation of a new nurse call system, the redecoration and new furniture in the dining room and other communal areas, and new furniture and redecoration in private rooms. Fewcott House Nursing Home DS0000043201.V344701.R01.S.doc Version 5.2 Page 15 The laundry room is housed in the basement area, with keypad access for safety. The basement environment presents difficulties, especially regarding infection control, as there is no lift access. Procedures are in place to minimize the spread of infection, and staff members are aware of how to work safely. To improve the management of the laundry, arrangements are in hand for the home’s laundry to be contracted out, so that only personal laundry is managed at the home. As part of the planned improvements, a new nurses station is to be constructed on the ground floor, and this will make life easier for care staff and for people living at the home. The inspector noted that some private rooms had gates fitted across the entrance. The registered manager stated that this was at the request of individuals and their families, and that risk assessments were in place, and they were not fitted to prevent individuals leaving their rooms. Plans are in hand to improve safety in the grounds of the home, so that more people living there can enjoy the outdoors. Plans include making the lake area safe, and protecting individuals from traffic. Fewcott House Nursing Home DS0000043201.V344701.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. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 and 30. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. People living at the home are confident that they will be looked after by safe staff members. EVIDENCE: People living at the home have confidence in the staff who care for them, and the majority who responded to the Commission’s survey said that staff are ‘always’ or ‘usually’ available when they were needed. The new management has taken action to support staff members enrol on the National Vocational Qualification (NVQ) training programme, and two carers are currently doing the course. This means that at present the national minimum standard of 50 trained care staff members is not met, although several of the care team are nurses in their country of origin, and are skilled carers. The registered manager is developing the home’s induction programme to the Skills for Care standards, and manages the staff training programme. Training is arranged to meet the needs of the people living there and includes care of people with dementia. The manager is aware that some overseas staff members may not fully understand all that is said to them, and in an effort to improve communication has arranged for English classes to be provided for overseas staff members. The home’s recruitment procedures are robust, and the files seen show that the procedures are followed. Fewcott House Nursing Home DS0000043201.V344701.R01.S.doc Version 5.2 Page 17 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. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35 and 38. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The best interests of people living at the home are protected through the home’s procedures, and through the work of the registered manager. EVIDENCE: The manager is qualified to run the home, and has made major improvements in the environment and ethos of the home. She has clear plans to continue the improvements, with a focus on improving the quality of life for people living there through staff training and continued environmental improvements. The home has a policy of conducting quality surveys every six months, and in July 2007 sent out questionnaires to relatives of the people living at the home. The results are being collated and it is planned to feed back the learning points through the proposed home newsletter. Fewcott House Nursing Home DS0000043201.V344701.R01.S.doc Version 5.2 Page 18 Small amounts of petty cash are kept securely for some individuals and receipts and records are kept. The registered manager is responsible for the implementation of the home’s health and safety procedures. The home has a health and safety policy statement, and training is provided so that staff are aware of their responsibilities to work safely. The home’s fire risk assessment is being reviewed, so that safety is improved. Fewcott House Nursing Home DS0000043201.V344701.R01.S.doc Version 5.2 Page 19 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 3 X 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 X X X X X X 2 STAFFING Standard No Score 27 3 28 2 29 3 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X X 3 Fewcott House Nursing Home DS0000043201.V344701.R01.S.doc Version 5.2 Page 20 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 Good Practice Recommendations It is recommended that the registered manager arrange for the community pharmacist to be part of the medication review, with a view to making the arrangements simpler. Fewcott House Nursing Home DS0000043201.V344701.R01.S.doc Version 5.2 Page 21 Commission for Social Care Inspection Oxford Office 4630 Kingsgate Oxford Business Park South Cowley Oxford OX4 2SU National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 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.V344701.R01.S.doc Version 5.2 Page 22 - 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. 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