Inspection on 23/06/05 for Puttenham Hill House

This inspection was carried out on 23rd June 2005.

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

Puttenham Hill House 28/06/07

Puttenham Hill House 28/11/05

Puttenham Hill House 15/11/04

Puttenham Hill House 30/06/04

Similar services:

Springfield House

Sutton Lodge Nursing Home

The Shelley

St Helier`s Residential Hotel

St Joseph`s

Ridgemount

Wingham Court

Old Hastings House

Extracts from inspection reports are licensed from CQC, this page was updated on 09/07/2008.

CARE HOMES FOR OLDER PEOPLE Puttenham Hill House Puttenham Hill Puttenham Guildford Surrey. GU3 1AH Lead Inspector Miss Marianne Barham Announced Inspection 23 June 2005 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. Puttenham Hill House H58 H09 s17634 Puttenham Hill House v223792 230605 Stage 4 ann.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Puttenham Hill House Address Puttenham Hill, Puttenham, Guildford, Surrey. GU3 1AH 0113 381 6100 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) BUPA Care Homes Ltd, Bridge House, Outwood Lane, Horsforth, Leeds, LS18 4UP Mrs Jayne Mannion CRH (N) 36 Category(ies) of Old age, not falling within any other category registration, with number (OP) 36 one of whom may have dementia. of places Puttenham Hill House H58 H09 s17634 Puttenham Hill House v223792 230605 Stage 4 ann.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: 36 beds providing nursing care for elderley people from the age of 60 years. To include one bed for a person from the age of 48 years. To include one named person over the age of 65 years with dementia. Date of last inspection 15 November 2004 Brief Description of the Service: Puttenham Hill House is large property located in a rural setting just outside Guildford off of the A31. The home provides nursing care and accommodation to up to 36 older people, 1 of whom may have dementia. It is owned and managed by BUPA Care Homes Ltd. The home has ample communal space including two lounge areas, a large dining room and an activities room that incorporates hairdressing facilities. There are 28 single occupancy rooms and 4 double rooms, most of which have en-suite facilities. the bedrooms are arranged mostly on the ground floor with only 8 being located on the first floor. The home has adapted bathing and toilet facilities on both floors. The first floor can reached by passenger lift or stairs. The home has access to a vehicle for trips out and has ample parking to the front and side of the building. There are attractive enclosed gardens that are accessible to the service users. Puttenham Hill House H58 H09 s17634 Puttenham Hill House v223792 230605 Stage 4 ann.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an announced inspection carried out at 10.30am by Marianne Barham, lead inspector for the service. The inspection was undertaken over a period of five and a half hours and was the first inspection in the Commission for Social Care Inspection (CSCI) year April 2005 to March 2006. During this inspection the manager had an interview as part of her application to be the registered manager under the CSCI and this how now been approved. The manager, Mrs Jayne Mannion was present and a total of eight service users and seven members of staff were spoken with during this inspection. Several comment cards from service users, relatives and health professionals were received prior to this inspection and records relating to care of service users and the management of the home were examined. What the service does well: What has improved since the last inspection? The home has introduced new service user contracts that have been produced with the Office of Fair Trading. These give very clear information about the terms and conditions of living in the home to service users and their families. The temperatures are now taken and recorded for all fridges and freezers in the home, the plant room is kept locked and there is a keypad entry system on the sluice room doors. These meet requirements made at the last inspection on 15th November 2004. Puttenham Hill House H58 H09 s17634 Puttenham Hill House v223792 230605 Stage 4 ann.doc Version 1.30 Page 6 All service users now have a lockable facility in their rooms in which to store valuables and personal items securely, again meeting a requirement made at 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. Puttenham Hill House H58 H09 s17634 Puttenham Hill House v223792 230605 Stage 4 ann.doc Version 1.30 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 Puttenham Hill House H58 H09 s17634 Puttenham Hill House v223792 230605 Stage 4 ann.doc Version 1.30 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) 2 and 3 Service users have a written contract with the home and are only admitted if the home is able to meet their assessed needs. EVIDENCE: Each service user has a written contract stating the terms and conditions of residence in the home. These are signed either by the service user or a representative. BUPA Care Homes Ltd have recently introduced a new contract format that has been produced in consultation with the Office of Fair Trading and gives very clear information on what is and what is not included in the fees paid. All existing service users now have this type of contract. The manager carries out a pre-admission assessment on prospective service users, using a recognised assessment system. The assessment covers all aspects of the persons needs from physical needs to social and emotional needs. The manager stated that she would not admit a service user unless she was sure the home could meet their needs. Puttenham Hill House H58 H09 s17634 Puttenham Hill House v223792 230605 Stage 4 ann.doc Version 1.30 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, 10 and 11 Each service user in the home has a plan detailing their individual health, personal and social care needs. Service users right to privacy is respected and they and their families can be sure they will be treated with care and sensitivity at the time of their death. EVIDENCE: The home has clearly written, detailed care plans for all service users. A number of these were examined. The care plans are generated from the preadmission assessment and those seen reflected the needs identified in the assessment. Risk assessments have been carried out and guidelines for managing risks put into place. All care plans seen had been signed by, the service user or a representative. Care plans are reviewed monthly and this is recorded. Staff members were observed to relate positively to service users and were seen to carry out care duties in a dignified and respectful manner. Service users spoken with commented on the polite and respectful manner in which members of staff treated them. Puttenham Hill House H58 H09 s17634 Puttenham Hill House v223792 230605 Stage 4 ann.doc Version 1.30 Page 10 The home has a policy and procedure in place for care of the dying and death of the service user. Staff members are made aware of this at induction and through training sessions. The receptionist has been trained in bereavement counselling, as she is often the first person to speak to grieving families and friends. The home also provides booklets with details on coping with bereavement and useful contact numbers for relatives and friends and also allows visiting at any time day or night. Puttenham Hill House H58 H09 s17634 Puttenham Hill House v223792 230605 Stage 4 ann.doc Version 1.30 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) 12 and 15 The lifestyle experienced in the home reflects the individual interests and preferences of the service users. The meals provided are nutritious and appealing and taken in pleasant surroundings. EVIDENCE: The home employs an activities co-ordinator throughout the week and offers a wide range of activities to service users. These include bingo, shuffleboard, reminiscence groups, crosswords and carpet bowls. The home also brings in outside entertainment such as travelling theatre groups, singers and visiting dogs. A timetable of activities is posted weekly around the home and service users are asked if they want to take part. Service users religious and cultural needs are recorded in their care plans and they are supported to take part in services or celebrations as and when they wish to. The menus in the home have been produced in consultation with service users through their residents meetings. There is always a choice of two main meals and a variety of desserts, supper items and breakfasts. Service users are given a card with the following days menu on to choose their meals, however they are able to change their mind if they wish. Puttenham Hill House H58 H09 s17634 Puttenham Hill House v223792 230605 Stage 4 ann.doc Version 1.30 Page 12 Service users spoken with were complimentary about the food they receive and confirmed that they are able to choose their meals. The dining area is pleasant and the tables were nicely laid. The food served at lunchtime during the inspection appeared appetising and nutritious. Temperatures are now recorded for all fridges and freezers, meeting a requirement made at the last inspection on 15th November 2004. Puttenham Hill House H58 H09 s17634 Puttenham Hill House v223792 230605 Stage 4 ann.doc Version 1.30 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) 18 The manager and staff team in the home are aware of their responsibilities to protect service users from abuse. EVIDENCE: The home has a copy of the Surrey Multi-Agency Procedures and the manager has attended the training. BUPA also has its own procedures on protecting service users from abuse. All other members of staff have received training from BUPA. The manager plans to send senior staff on the Surrey training as soon as places become available. Puttenham Hill House H58 H09 s17634 Puttenham Hill House v223792 230605 Stage 4 ann.doc Version 1.30 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, 24 and 26 The environment is generally safe and well maintained with some areas in the home needing attention. The home is clean, pleasant and hygienic. EVIDENCE: The home has a programme in place for routine maintenance and repairs. It is generally well maintained and decorated, with a few areas needing attention as detailed below. Service users bedrooms are clean and comfortably furnished with their own belongings in evidence, all now have a lockable facility, meeting a requirement made at the last inspection. The home was very clean and tidy throughout. The tiles behind the toilet in the en-suite bathroom of room 33 need to be repaired or replaced. The toilet opposite room 43 is in a very poor state of decoration and this needs to be addressed. The toilet opposite room 31 has a hole in the plaster stuffed with paper and this needs to be repaired and made good. The terrace door of room 38 needs to have a safety barrier fitted when the door is open as the terrace is not safe to walk on. Requirements have been made to address the issues above. Puttenham Hill House H58 H09 s17634 Puttenham Hill House v223792 230605 Stage 4 ann.doc Version 1.30 Page 15 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) 27 The numbers and skill mix of the staff team meets the needs of the service users. EVIDENCE: Staffing rosters were examined and show that the home is meeting the staffing levels notice issued by the local authority. The manager and deputy are both supernumerary and there is always a registered nurse on duty. There are two registered nurses and five carers in the morning, one registered nurse and four carers in the afternoon and one registered nurse and three carers at night. At present the home has seven vacant beds and the manager plans to increase the staff number by one in the afternoon once these are filled. The manager is currently recruiting care staff. Staff spoken with reported that they receive training and supervision and that they enjoy working at the home. Many staff members have worked at the home for several years. Service users spoken with were complimentary about the care and support they receive from the staff team and made comments such as caring, kind and respectful when describing the staff. Puttenham Hill House H58 H09 s17634 Puttenham Hill House v223792 230605 Stage 4 ann.doc Version 1.30 Page 16 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, 35 and 38 The home is run by, a competent and experienced manager, the financial interests of service users are safeguarded and their health, safety and welfare is promoted and protected. EVIDENCE: The manager is a registered general nurse and has many years experience of working in the care setting. Prior to working in the home she was registered with CSCI as manager of a large care home for older people with mental disorders. The manager has completed the registered managers award qualification and is awaiting external verification. The manager had her ‘fit person’ interview as part of the process of becoming the registered manager, at the end of this inspection and her application has now been approved. Staff and service users spoke highly of the manager stating that she was approachable and that she was making improvements in the home. Puttenham Hill House H58 H09 s17634 Puttenham Hill House v223792 230605 Stage 4 ann.doc Version 1.30 Page 17 The home is not involved in service users finances. Any extra services or purchases are invoiced directly to the service user or a representative. A small amount of money is kept at the home for personal spending for each service user and robust procedures are followed to deal with this. The home has a health and safety committee that meets quarterly to discuss health and safety issues. The manager meets with heads of departments daily to address problems promptly. Staff members receive training on all areas of health and safety and the manager has just completed the two days health and safety course. The door to the plant room is now kept locked and the doors to the sluice rooms now have a keypad entry system to ensure the safety of service users, meeting requirements made at the last inspection. Puttenham Hill House H58 H09 s17634 Puttenham Hill House v223792 230605 Stage 4 ann.doc Version 1.30 Page 18 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 4 3 x x x HEALTH AND PERSONAL CARE Standard No Score 7 3 8 x 9 x 10 3 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 x 14 x 15 3 COMPLAINTS AND PROTECTION 2 x x x x 3 x 3 STAFFING Standard No Score 27 3 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 3 3 x x x 3 x x 3 Puttenham Hill House H58 H09 s17634 Puttenham Hill House v223792 230605 Stage 4 ann.doc Version 1.30 Page 19 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. 2. 3. 4. 19 19 19 23 (2) (b) 23 (2) (b) 23 (2) (b) The tiles behind the toilet in the en-suite of bedroom 33 must be repaired or replaced. The toilet opposite room43 is in a very poor state of decoration and must be re-decorated. The hole in the plaster by the sink in the toilet opposite room 31 must be repaired and made good. The door to the roof terrace in room 38 must have a safety barrier fitted when the door is open owing to the terrace being unsafe. 23/07/05 23/08/05 23/07/05 Standard Regulation Requirement Timescale for action 5. 19, 38 13 (4) (a) (c) 23/07/05 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 Good Practice Recommendations Puttenham Hill House H58 H09 s17634 Puttenham Hill House v223792 230605 Stage 4 ann.doc Version 1.30 Page 20 Commission for Social Care Inspection The Wharf Abbey Mill Business Park Eashing Surrey. GU7 2QN 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 Puttenham Hill House H58 H09 s17634 Puttenham Hill House v223792 230605 Stage 4 ann.doc Version 1.30 Page 21 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!