Inspection on 04/08/05 for Huntercombe Hall Care Home

This inspection was carried out on 4th August 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

Huntercombe Hall Care Home 23/07/07

Huntercombe Hall Care Home 30/05/06

Huntercombe Hall Care Home 07/02/06

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 09/07/2008.

CARE HOMES FOR OLDER PEOPLE Huntercombe Hall Care Home Huntercombe Place, Nuffield, Henley-on-Thames, Oxfordshire RG9 5SE Lead Inspector Philippa MacMahon Announced 04 August 2005 09:30 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 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. Huntercombe Hall Care Home v231552 h57-h08 s63474 huntercombe hall v231552 040805 stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Huntercombe Hall Care Home Address Huntercombe Place, Nuffield, Henley-on-Thames, Oxfordshire, RG9 5SE Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) 01491 641 792 01491 641 761 marketing@caringhomes.org Huntercombe Hall Limited Care Home with Nursing 48 Category(ies) of Old age, not falling within any other category registration, with number (48) of places Huntercombe Hall Care Home v231552 h57-h08 s63474 huntercombe hall v231552 040805 stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: 1. The admittance of one named under age resident. Date of last inspection 29 November 2004 Brief Description of the Service: Huntercombe Hall is registered to provide nursing care for up to 48 male and female service users aged 60 years and over. Registered nurses are on duty 24 hours a day. The home is situated in the Oxfordshire countryside in an isolated situation. Public transport is limited and visitors may need to rely on private transport when visiting the home, as the nearest bus stop is situated some distance from the home at the end of a long driveway. The public rooms are spacious and are situated on the ground floor. There are 40 single bedrooms and 4 double rooms 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 suitable for infirm service users, as well as a toilet and washbasin. The home has recently undergone major refurbishment and the standard of décor and furnishings is good. The programme of recreational activities is displayed on notice boards in the home and a copy is also given to every service user to keep. The activities organiser occasionally arranges trips out in the home’s mini-bus. The home is set in extensive grounds, although the large expanse of lawn to the side of the home is on a slope, making it unsuitable for many of the service users to walk on. There is a pleasant patio with garden tables and chairs accessible from the conservatory. Huntercombe Hall Care Home v231552 h57-h08 s63474 huntercombe hall v231552 040805 stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an announced inspection that commenced at 9.30 am and finished at 3pm. The home has recently changed ownership to a company called Caring Homes, and the manager has only been in post for a few months. Two inspectors carried out the inspection and spent a good deal of the time in talking to the residents, staff, relatives and other visitors to the home to gain their impression of life at Huntercombe Hall. Care plans were examined, and this activity was followed up by meeting the individual residents to ascertain if the care needs were being met. All areas of the home were inspected, and records required by regulation were examined. The medication systems were examined, and the home’s policies and procedures to support these. Comment cards provided by the Commission for Social Care Inspection were received from 6 relatives and residents, and 6 from health care professionals. What the service does well: Huntercombe Hall provides a comfortable, friendly, and homely place for the residents to live in. Residents spoken to were very appreciative of the service provided and this was expressed in comments such as “The staff are so kind”, “The staff are gentle”. Others commented on the environment with words such as “the rooms are comfortable,” and “the grounds are beautiful”. The comment cards from the health care professionals were also complimentary one commented “A new manager has made significant positive changes, paper work and care plans are up to date, professional, caring and clear, reliable communication.” Another said, “I believe under new professional management, this has had a very positive effect on the residents”. The appointment of a new chef who is very much in consultation with the residents and is making every effort to find out what their likes and dislikes are and how the meals can be made more interesting. The environment is very well appointed and the furnishings and décor are of a high standard. The staff are friendly and helpful, and were consistently welcoming to any visitors to the home. Huntercombe Hall Care Home v231552 h57-h08 s63474 huntercombe hall v231552 040805 stage 4.doc Version 1.40 Page 6 What has improved since the last inspection? 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. Huntercombe Hall Care Home v231552 h57-h08 s63474 huntercombe hall v231552 040805 stage 4.doc Version 1.40 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 Standards Statutory Requirements Identified During the Inspection Huntercombe Hall Care Home v231552 h57-h08 s63474 huntercombe hall v231552 040805 stage 4.doc Version 1.40 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 standard(s) 3 Nobody is admitted to the home without first having had an assessment of their care needs made, and been assured that the home will meet those needs. EVIDENCE: The inspector examined a sample of care plans and each one had a detailed assessment record that had been carried out prior to admission, and this formed the basis on which the care plans were developed. Huntercombe Hall Care Home v231552 h57-h08 s63474 huntercombe hall v231552 040805 stage 4.doc Version 1.40 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 standard(s) 7,8,9,10,11. The present care planning system is not clear and easy to use. It is recommended that a review of the whole system should take place and consideration made to set up a way to archive old or irrelevant records. This review should include the risk assessment tools that are used within the home. One of the residents did not have a care plan. It is a requirement that all residents in the home whether it is for a short or long stay must have a care plan. It is recommended that if a resident requires a specialist assessment such as for appropriate seating, this should be provided. EVIDENCE: The inspector examined a sample of care plans, including the most recently admitted residents, and some of residents who have lived at the home for some time. The more recent plans are in a more “user friendly” format that makes it easier to find out the relevant information quickly. However one of the resident’s documentation did not include a care plan even though the assessment and daily record clearly showed that there were care needs. No risk assessments Huntercombe Hall Care Home v231552 h57-h08 s63474 huntercombe hall v231552 040805 stage 4.doc Version 1.40 Page 10 had been completed for moving and handling purposes, and falls, and the nutritional assessment had not been completed. The resident was sitting in an inappropriate chair where the person was unable to place both feet on the floor, and the wooden armrest was causing the shoulders to be raised in an uncomfortable way. A small footstool had been provided but this was placing the person’s posture into a poor position. The care plans were not complete, in that on a number of occasions the daily record gave an indication of changes and these had not been transferred into the care plan. The home uses “core” care plans and the more recent ones have been personalised to the individual concerned. However a resident who has been in the home for a number of years has a number of “core” care plans which are not applicable to her care needs at this time. The home does not appear to have a system of archiving old records in a different folder and filed securely, and as a consequence the care plan record is very full and it is difficult to find out what the care issues are at this time. Huntercombe Hall Care Home v231552 h57-h08 s63474 huntercombe hall v231552 040805 stage 4.doc Version 1.40 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 standard(s) 15 Every effort is made to ensure that residents enjoy their meals and mealtimes. EVIDENCE: Residents spoken to were not entirely happy with the menus and comments such as “food is reasonable,” last chef not so good,” “Suppers boring,” were made. The inspector discussed the home’s food arrangements with the new chef and he is keen to introduce new menus and keen to change the existing supper menus, which has mostly consisted of soup and sandwiches. He prefers to use fresh vegetables wherever possible and make his own fresh soups. Menus are decided the day before and there is ample choice and alternatives to the main dishes if the resident is not happy with the menu of the day. Each day there are three meals offered to residents, hot and cold snacks, and drinks are also available throughout the day. Lunchtime was observed and residents were seen to be enjoying a nutritious lunch of roast beef or Cornish pasties in a pleasant dining room with staff being attentive to those residents less able to help themselves. Huntercombe Hall Care Home v231552 h57-h08 s63474 huntercombe hall v231552 040805 stage 4.doc Version 1.40 Page 12 Those residents not able or not wishing to have their lunch in the communal dining room were seen receiving their lunch on trays in their individual bedrooms and the food arrived hot, having been served from hot trolleys onto hot plates. Huntercombe Hall Care Home v231552 h57-h08 s63474 huntercombe hall v231552 040805 stage 4.doc Version 1.40 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 standard(s) The inspector did not make a judgement about this outcome as none of the outcomes were inspected. EVIDENCE: None of these standards were assessed on this occasion. Huntercombe Hall Care Home v231552 h57-h08 s63474 huntercombe hall v231552 040805 stage 4.doc Version 1.40 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 standard(s) 19,20,21,22,23,24,25,26. The home is clean, safe and well maintained and residents have access to safe comfortable indoor and outdoor facilities with specialist equipment to maximise independence where necessary. All of the residents’ rooms are well furnished and equipped to assure comfort and privacy, and provide the residents with an attractive and homely place to live. EVIDENCE: Cleaning was underway throughout the inspection and everywhere was clean, tidy and reasonably pleasant smelling. There was one bin without a lid in an upstairs corridor, which needs replacing. The laundry was well organised and staff adhere to the health and safety requirements within this setting. Huntercombe Hall Care Home v231552 h57-h08 s63474 huntercombe hall v231552 040805 stage 4.doc Version 1.40 Page 15 The communal areas of the home are large and comfortable; there are two large sitting rooms and a smaller sitting room leading out into a large conservatory providing ample space for residents to make choices about where to spend their day. All bedrooms are individually styled with residents’ personal possessions and those residents spoken to were completely satisfied with their rooms and surroundings. One resident spoken to praised the staff for keeping her room clean and tidy. The home has sufficient toilet and bathroom facilities close to bedrooms and communal areas in addition to the en-suite facilities in all rooms. Aids such as a passenger lift, hoists and assisted baths and toilets are provided and residents can use wheelchairs to enable them to have access to all areas of the home. The grounds are extensive with splendid views of the countryside beyond and a patio with chairs and umbrellas provide opportunities for those residents who wish to spend time enjoying the garden. Huntercombe Hall Care Home v231552 h57-h08 s63474 huntercombe hall v231552 040805 stage 4.doc Version 1.40 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 considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) The inspectors did not make a judgement about this outcome as none of the outcomes were inspected. EVIDENCE: None of these standards were assessed on this occasion. Huntercombe Hall Care Home v231552 h57-h08 s63474 huntercombe hall v231552 040805 stage 4.doc Version 1.40 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 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31,32,34,35,37,38 The home is well managed and the staff team work very well together. The financial and accounting systems in place are appropriate in safeguarding the residents’ interests. The records required by regulation were found to be complete, up to date and stored appropriately. The health, safety and welfare of residents are considered to be a high priority at Huntercombe Hall. EVIDENCE: There are clear lines of accountability and the inspector observed good professional interaction between the staff at all levels. The manager had to deal with a critical situation just before the inspections arrived, and she was Huntercombe Hall Care Home v231552 h57-h08 s63474 huntercombe hall v231552 040805 stage 4.doc Version 1.40 Page 18 observed to cope with it in a most appropriate manner, and to communicate with other professionals in a very clear calm manner. The GP visiting the home said that he was very pleased with the improvement that had occurred at Huntercombe in recent times and in particular the good communication between the nursing staff and the surgery, and the standard of care provided. The inspector discussed accounts and finance arrangements with the administrator and the manager, and was informed that all invoicing, payment of fees etc. was dealt with by Caring Homes, head office. Those residents who wished to have money kept for sundry items are able to keep it in the home’s safe. The inspector examined the individual pockets containing the money and the accompanying records kept. These were found to be in good order. The accident and incident book was inspected and clearly all staff are aware of the importance of recording such incidents and the correct procedure to follow. The fire log, servicing records, water temperatures, gas and electrical tests were all found to be up to date and complete and stored safely. The environmental health inspection report on the kitchen was seen and most of the requirements from that visit have been completed. The one outstanding requirement was the provision of a new extractor fan and this according to the manager is in hand. The inspector would like notification when this extractor fan has been fitted. Staff spoken to confirmed that they had received Manual-handling training thus ensuring the safety of residents and staff. Huntercombe Hall Care Home v231552 h57-h08 s63474 huntercombe hall v231552 040805 stage 4.doc Version 1.40 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score x x 3 x x N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 2 9 2 10 3 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 x 13 x 14 x 15 3 COMPLAINTS AND PROTECTION 3 3 3 3 3 3 3 3 STAFFING Standard No Score 27 x 28 x 29 x 30 x MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score x x x 3 3 x 3 3 3 3 3 Huntercombe Hall Care Home v231552 h57-h08 s63474 huntercombe hall v231552 040805 stage 4.doc Version 1.40 Page 20 No Are there any outstanding requirements from the last inspection? 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. 1. Standard 7 Regulation 15 Requirement It is a requirement that all residents in the home, whether it is for a short or long stay, must have a care plan. Timescale for action 11.08.05 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 7 Good Practice Recommendations It is recommended that a review of the whole system should take place and consideration made to set up a way to archive old or irrelevant records. This review should include the risk assessment tools that are used within the home. It is recommended that if a resident requires a specialist assessment such as for appropriate seating, this should be provided. 2. 8 Huntercombe Hall Care Home v231552 h57-h08 s63474 huntercombe hall v231552 040805 stage 4.doc Version 1.40 Page 21 Commission for Social Care Inspection 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 Huntercombe Hall Care Home v231552 h57-h08 s63474 huntercombe hall v231552 040805 stage 4.doc Version 1.40 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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