Inspection on 19/01/06 for Ramping Cat House Nursing Home

This inspection was carried out on 19th January 2006.

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

Ramping Cat House Nursing Home 14/10/08

Ramping Cat House Nursing Home 09/08/07

Ramping Cat House Nursing Home 04/07/06

Ramping Cat House Nursing Home 10/10/05

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

CARE HOMES FOR OLDER PEOPLE Ramping Cat House Nursing Home White Hill Burford Oxfordshire OX18 4EX Lead Inspector Kate Harrison Unannounced Inspection 19th January 2006 12:15p 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 Ramping Cat House Nursing Home DS0000064639.V280332.R01.S.doc Version 5.1 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. Ramping Cat House Nursing Home DS0000064639.V280332.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Ramping Cat House Nursing Home Address White Hill Burford Oxfordshire OX18 4EX 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) 020 8440 4666 Atlantis Healthcare Ltd Jane Pocock Care Home 15 Category(ies) of Old age, not falling within any other category registration, with number (15) of places Ramping Cat House Nursing Home DS0000064639.V280332.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. On admission persons should be aged 60 years and over Date of last inspection 10th October 2005 Brief Description of the Service: The Ramping Cat House is a care home with nursing, registered with CSCI to provide accommodation and services to 15 individuals. The home is situated in open countryside on the edge of the Cotswolds, near to Burford. Accommodation is provided in a mix of single and double rooms over two floors, with a stair lift providing access to the first floor. The manager and a team of nursing, care and household staff provide care. The present owner home acquired the home in July 2005, visits regularly, and has plans to improve and extend the accommodation. Ramping Cat House Nursing Home DS0000064639.V280332.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was not expected and the inspector arrived in the home at lunchtime when the residents and staff were in the dining room. The inspector met with residents, friends and relatives, and assessed records and documents. The inspector also discussed care and the management of the home with the registered manager, and saw all areas of the home. Only those key standards not assessed at the announced inspection on October 10th were assessed at this inspection. What the service does well: What has improved since the last inspection? What they could do better: All medication coming into the home must be properly recorded. To improve communication the daily progress notes and the care plans need to be used together. Residents’ views about the timing of meals need to be sought. The registered manager should take action to minimise the security risks arising from the home’s ‘open door’ policy. The laundry walls and floor need to be better finished. A quality assurance system based on the views of residents needs to be developed. All staff need to attend the fire lectures. The home should develop a safe working practices policy as soon as possible. The outstanding recommendations made at the announced inspection on 10th October 2005 need to be implemented. Ramping Cat House Nursing Home DS0000064639.V280332.R01.S.doc Version 5.1 Page 6 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. Ramping Cat House Nursing Home DS0000064639.V280332.R01.S.doc Version 5.1 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 Ramping Cat House Nursing Home DS0000064639.V280332.R01.S.doc Version 5.1 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): EVIDENCE: The key standards were assessed at the last inspection and were not assessed at this inspection. Ramping Cat House Nursing Home DS0000064639.V280332.R01.S.doc Version 5.1 Page 9 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8 and 9. Residents’ needs are recorded and health and welfare needs are met. Medication is generally well managed, but record keeping needs to be improved to meet legislation. EVIDENCE: The inspector saw care plan records and discussed care with some residents. All residents had care plans and those assessed contained sufficient detail for care staff to appropriately meet the needs of the residents. The daily progress notes are recorded separately from the care plans and to improve integration and communication, the inspector recommends that both be kept together in the resident’s own room where possible. The inspector discussed health needs with two residents, and both were satisfied that their needs were met. The inspector checked records, and noted that appropriate referrals were made and followed up so that residents received care in a timely way. Only nurses dispense medication at the home, and medication is safely stored. The inspector noted that medication coming into the home is not recorded, and requires that the receipt of all medication into the home must be recorded. Ramping Cat House Nursing Home DS0000064639.V280332.R01.S.doc Version 5.1 Page 10 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): 15. Good food is available in pleasant surroundings, but residents’ views about the timing of meals should be sought. EVIDENCE: The inspector saw the dining room and discussed food and mealtimes with the cook and residents, who said that the quality of the food was good. Some said that the food was homely and suited them, and that the afternoon cakes were very good. Others said that they would appreciate more food in the evening, a good lunch was served at 12 mid day, but as there was no cook present in the evenings, usually soup and sandwiches were served around tea time. The inspector recommends that the registered manager formally seek the views of residents and relatives about the timings of mealtimes, prepare an action plan based on the results and inform the inspector about the findings. The dining room is well presented, with tables for small groups of residents to use. Ramping Cat House Nursing Home DS0000064639.V280332.R01.S.doc Version 5.1 Page 11 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): EVIDENCE: The key standards were assessed at the last inspection and were not assessed at this inspection. Ramping Cat House Nursing Home DS0000064639.V280332.R01.S.doc Version 5.1 Page 12 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 and 26. The home is clean and hygienic, but action to assess the security of the home has not been carried out. EVIDENCE: The home was clean and fresh, and maintenance is carried out as necessary. At the last inspection the inspector was concerned about the lack of security at the front door, and at this inspection noted that the recommendation to carry out a risk assessment on security had not been carried out. After discussion with the registered manager it was agreed that the recommendation be carried out very soon. The registered manager should inform the inspector of the results and action plan arising from the front door security risk assessment. The laundry is located in the basement of the building with access from outside. The floor and walls are not easily kept clean, as neither have an appropriate finish. The inspector is aware that the proprietor intends to improve and extend the home, and he should inform the inspector how he intends to meet the national minimum standard regarding the laundry. Ramping Cat House Nursing Home DS0000064639.V280332.R01.S.doc Version 5.1 Page 13 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): EVIDENCE: The key standards were assessed at the last inspection and were not assessed at this inspection. Ramping Cat House Nursing Home DS0000064639.V280332.R01.S.doc Version 5.1 Page 14 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 and 38. The registered manager is an experienced nurse and needs to complete the appropriate management course. A quality assurance system needs to be developed. Residents’ finances are appropriately managed. It is not clear that health and safety legislation is being met. EVIDENCE: The registered manager has worked for many years at the home and recently completed the registration process with the Commission. She is a registered nurse and intends to start soon on the Registered Manager’s Award. There is no formal quality assurance process at the home, such as quality questionnaires or residents and relatives meetings, though the registered manager is regularly available for residents and relatives. During the inspection one resident said that his Sunday newspaper did not always arrive, and a system needs to be developed to ensure that quality and reliability issues are monitored and addressed. The inspector recommends that a formal Ramping Cat House Nursing Home DS0000064639.V280332.R01.S.doc Version 5.1 Page 15 quality assurance system, based on the views of residents and relatives, be introduced to the home. Relatives or care managers usually manage the finances of those residents unable to manage. The home does not have a safe working practices policy, and this should be developed as soon as possible. The inspector checked the fire safety records and noted that safety checks are regularly performed. However it was not clear that all staff have attended the appropriate number of fire lectures, and the registered manager should inform the inspector what action is being taken to remedy the current situation. Ramping Cat House Nursing Home DS0000064639.V280332.R01.S.doc Version 5.1 Page 16 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 X HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 2 10 X 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 X 13 X 14 X 15 2 COMPLAINTS AND PROTECTION Standard No Score 16 X 17 X 18 X 2 X X X X X X 2 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 2 X 2 X 3 X X 2 Ramping Cat House Nursing Home DS0000064639.V280332.R01.S.doc Version 5.1 Page 17 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. 1. Standard OP9 Regulation 13 Requirement The receipt of all medication into the home must be recorded. Timescale for action 26/01/06 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. 2. Refer to Standard OP7 OP15 Good Practice Recommendations To improve integration and communication the daily progress notes and the care plans should be kept together. The registered manager should formally seek the views of residents and relatives about the timings of meals, prepare an action plan based on the results and inform the inspector about the findings. (a) The inspector recommends that life stories be developed for each resident, so that appropriate interests be identified and offered at the home. (b) A care plan should be developed for each resident to combat boredom, with reference to life stories and available resources. (c) Activities provided should be a mix of group and Ramping Cat House Nursing Home DS0000064639.V280332.R01.S.doc Version 5.1 Page 18 3. OP12 individual activities, and should reflect the views of residents. (d) Appropriate resources should be made available to meet the needs of the residents. This recommendation is outstanding from the announced inspection on October 10th 2005. The inspector recommends that a risk assessment be carried out regarding the home’s ‘open door’ policy to determine if any further action is needed to protect residents and staff. This recommendation is outstanding from the announced inspection on October 10th 2005. The registered manager should inform the inspector of the results and action plan arising from the front door security risk assessment. The proprietor should inform the inspector how he intends to meet the national minimum standard regarding the laundry. A formal quality assurance system, based on the views of residents and relatives, should be introduced to the home. The inspector recommends that appropriate members of staff should attend supervision training. This recommendation is outstanding from the announced inspection on October 10th 2005. Formal supervision should be implemented for all staff as soon as possible. This recommendation is outstanding from the announced inspection on October 10th 2005. Designated staff should be responsible for the provision of activities at the home. This recommendation is outstanding from the announced inspection on October 10th 2005. The home should develop a safe working practices policy as soon as possible. The registered manager should inform the inspector what action is being taken to make sure that all staff attend the appropriate number of fire lectures. 4. OP18 5 6 7 8. OP19 OP26 OP33 OP36 9. OP36 10. OP27 11. 12. OP38 OP38 Ramping Cat House Nursing Home DS0000064639.V280332.R01.S.doc Version 5.1 Page 19 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 Ramping Cat House Nursing Home DS0000064639.V280332.R01.S.doc Version 5.1 Page 20 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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