CARE HOMES FOR OLDER PEOPLE
Sotwell Hill House Brightwell Cum Sotwell Wallingford Oxfordshire OX10 0PS Lead Inspector
Carole Moore Announced Inspection 30th September 2005 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 Sotwell Hill House DS0000013135.V250411.R01.S.doc Version 5.0 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Sotwell Hill House DS0000013135.V250411.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION
Name of service Sotwell Hill House Address Brightwell Cum Sotwell Wallingford Oxfordshire OX10 0PS 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) 01491 836685 Mr John Edmund Butterfield Mrs Joy Patricia Butterfield Mr John Edmund Butterfield Care Home 36 Category(ies) of Old age, not falling within any other category registration, with number (36) of places Sotwell Hill House DS0000013135.V250411.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION
Conditions of registration: 1. Condition 1 The overall number of registered beds is 36, however 3 of the registered beds cannot be used to accommodate service users until such time as Building Control have passed them, a further site visit has taken place and the Commission for Social Care Inspection are satisfied that they are fit for the purpose. 25th January 2005 Date of last inspection Brief Description of the Service: Sotwell Hill House is a late Victorian converted country house set in attractive and extensive grounds and provides accommodation for those older people who require day-to-day supervision and care. The home does not provide nursing care. Independence is encouraged and the layout of the grounds enables service users to take exercise in safety. Service users are able to visit the nearby town of Wallingford and other outings are arranged on an occasional basis. Sotwell Hill House DS0000013135.V250411.R01.S.doc Version 5.0 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This was an announced inspection and took place on Friday 30th September 2005. The inspector was made to feel very welcome by both staff and residents and was appreciative of the full cooperation of all the staff who were on duty that day. The inspector toured the building looking at all of the communal areas and visited some bedrooms with the permission of the residents. A majority of the time was spent talking to residents and individual time was spent talking to the carers who were on duty that day. Time was also spent with the manager and her deputy. The inspector spent some time in the kitchen with the chef and joined the residents for lunch. Three residents’ care records were examined and three staff files were looked at in detail as well as paperwork relating to the health and safety of residents. Very favourable comments were received from a number of GPs. There were a number of very positive comments from residents and relatives. ”A very caring family atmosphere”, “The staff are caring and well trained”. “I am very happy with care they give my mother”. ” A friendly and fantastic place”. Some comments were geared towards the fact that staff spend more time with the less able and that those residents who are independent do not receive the same level of attention. The manager and her deputy will be looking at this area of practice. What the service does well:
There is a very homely environment and caring family atmosphere and the home takes pride in its robust housekeeping and cleanliness. All residents enjoy spacious single bedrooms and have access to spacious communal settings and enjoy the views of the surrounding extensive grounds. All visitors to the home are made to feel very welcome and this was evidenced in the feedback received. All staff spoken to had a personal knowledge of their residents and are committed to providing their residents with the best care possible. Residents spoken to had nothing but praise for the staff team. The home present a monthly newsletter which is both informative and
Sotwell Hill House DS0000013135.V250411.R01.S.doc Version 5.0 Page 6 interesting. It provides the residents with up to date news of staff and residents, birthdays of residents and local news. 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. Sotwell Hill House DS0000013135.V250411.R01.S.doc Version 5.0 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 Sotwell Hill House DS0000013135.V250411.R01.S.doc Version 5.0 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): 3,5. All prospective residents have an assessment of their care needs so that the home, the prospective resident and their families are clear that these needs can be met. EVIDENCE: The manager explained how the procedure for admitting residents to the home was carried out and the inspector had sight of the pre-admission assessment. Residents and their families are encouraged to visit the home prior to admission to assess the home as a suitable placement, where they can meet the staff and other residents. Hopefully this will then help to make the transfer to Sotwell Hill more pleasant and personal for the individual. Residents spoken to described how they were made to feel very welcome when they first visited the home, and were given all the relevant information to support their decision to choose a home that was right for them. Sotwell Hill House DS0000013135.V250411.R01.S.doc Version 5.0 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): 7,8,9 &10. The home meets the health; personal and social care needs of the residents. There is a safe system of medicine administration within the home. The staff respect the privacy and dignity of residents. EVIDENCE: Three residents’ care notes were examined and all have their needs clearly identified and how these were being met. Regular reviews of the care plans are now clearly documented. Residents spoken to felt they had the best possible care and that all of their care needs were met. The only area raised was that if a resident was mostly independent, then the time that care staff spent with them was more limited than those whose needs were greater. The inspector spoke with both the manager and her deputy and they have agreed to look at this feedback and speak to the residents concerned. Residents also confirmed that staff were kind and gentle and respected their privacy and dignity. Staff were seen knocking on bedroom doors before entering and being sensitive to residents’ needs.
Sotwell Hill House DS0000013135.V250411.R01.S.doc Version 5.0 Page 10 The inspector examined the medicine administration system in the home and found that it was in good order. The Commission’s pharmacist has approved the new system currently operating. There is only one resident selfadministering. Sotwell Hill House DS0000013135.V250411.R01.S.doc Version 5.0 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 the following standard(s): 12,13,14 &15. Every effort is made to ensure that residents enjoy their meals. Residents are encouraged to maintain contact with family and friends and are assisted to exercise choice over their day. EVIDENCE: The home welcomes all visitors and this was confirmed by the feedback received from family and friends. The home celebrates birthdays if the resident wishes and there were many photographs of a recent 100th birthday, showing residents involved in the birthday celebrations. There is a variety of activities that the staff encourage residents to engage in, but there were a couple of residents who felt there was little to do after lunch. Other residents enjoyed going out to coffee mornings at the local church or social outings with members of staff. Usually, activities are discussed at the residents meetings and decisions are made based on the general agreement from residents. On the day of the inspection one resident was going into the garden to feed the fish, another was taking exercise walking around the grounds and others were sitting in the main
Sotwell Hill House DS0000013135.V250411.R01.S.doc Version 5.0 Page 12 lounge listening to music and some residents were enjoying time in their own rooms. Time was spent with the chef and he explained the dietary arrangements and choices of food available. On the day of the inspection there was fish, chips and peas with an alternative for those who did not like fish. The inspector joined the residents for lunch and it was a pleasant unhurried affair in a pleasant dining room and staff were seen sensitively attending to those residents who needed assistance. The chef is to embark on gaining the “Healthy Choice Award” as discussed with the environmental health officer and he hopes to achieve this before the next inspection. Sotwell Hill House DS0000013135.V250411.R01.S.doc Version 5.0 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 the following standard(s): 16 There is a clear complaints procedure. EVIDENCE: The home has had no complaints since the last inspection. Residents confirmed that they could always speak to the manager or another member of the management team should there be any difficulties. They confirmed that they were confident that any concern would be listened to and acted upon. This was backed up by family members in their feedback to the inspector. Sotwell Hill House DS0000013135.V250411.R01.S.doc Version 5.0 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 the following standard(s): 19 & 26. Residents live in a safe, homely and well-maintained environment. EVIDENCE: Sotwell Hill provides spacious comfortable rooms and the décor and furnishings are of a high standard. A tour of the building showed that the home was clean, well maintained and pleasant smelling. The home have moved their store of medications into a larger room and this has now allowed a specific room for the storage of wheelchairs. The extensive grounds are also well maintained and have wheelchair access. There is an ongoing programme of routine maintenance and the building complies with the requirements of the local fire service and environmental health department.
Sotwell Hill House DS0000013135.V250411.R01.S.doc Version 5.0 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 consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27 & 29 Trained and competent staff care for residents. The home’s recruitment procedures need to be more robust. EVIDENCE: The staffing rota on the day of the inspection showed there was sufficient staff on duty to meet the overall needs of the residents. Staff spoken to were clear about the training they had received and most are enthusiastic about the NVQ training programme. The training manager holds training files for all staff identifying any areas of training that require updating. There are also three assessors in-house. Three new staff records were looked at to ensure that correct recruitment procedures had been followed and there were a few shortfalls on two staff files. The manager is keen to correct this shortfall and has since implemented a front sheet checklist, in order to operate more thorough procedures in recruitment of new staff in the future. Sotwell Hill House DS0000013135.V250411.R01.S.doc Version 5.0 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 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, 36 & 38. The home is run in the best interests of the residents with their health and safety protected. EVIDENCE: The home is family run and well managed. The fire log, servicing records, electrical tests, water temperatures were all found to be up to date and complete and stored safely. The environmental health inspection report on the kitchen was seen and all of the requirements from that visit have been completed. The Environmental health inspector had also asked for risk assessments in relation to different areas of practice and most of these have also been completed. The inspector
Sotwell Hill House DS0000013135.V250411.R01.S.doc Version 5.0 Page 17 has since spoken to the environmental health officer and she has confirmed that all aspects of her visit have been complied with. Staff confirmed that they had regular supervision and this ensures that all areas of practice are being regularly monitored. They also confirmed that they had received training in safe practices, such as moving and handling, food hygiene, fire safety, first aid and safe medication administration. The manager is to implement a visitors comment book to further enhance the quality assurance systems within the home. Sotwell Hill House DS0000013135.V250411.R01.S.doc Version 5.0 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 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 3 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 x 4 x x x x x x 4 STAFFING Standard No Score 27 3 28 x 29 3 30 x MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 x 3 x 3 x x 3 Sotwell Hill House DS0000013135.V250411.R01.S.doc Version 5.0 Page 19 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. Refer to Standard Good Practice Recommendations Sotwell Hill House DS0000013135.V250411.R01.S.doc Version 5.0 Page 20 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
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