Inspection on 29/05/07 for The Old Prebendal House

This inspection was carried out on 29th May 2007.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Excellent. 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

The Old Prebendal House 04/01/06

The Old Prebendal House 19/08/05

The Old Prebendal House 15/03/05

The Old Prebendal House 28/06/04

Similar services:

St Vincents

The Cotswold Home

Newbeech House

Winton House

Rush Court

Hillyfield Rest Home

The Maypole Nursing Centre

The Briars

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

CARE HOMES FOR OLDER PEOPLE The Old Prebendal House Station Road Shipton-under-Wychwood Chipping Norton Oxfordshire OX7 6BQ Lead Inspector Chris Sidwell Unannounced Inspection 29 May 2007 11:00 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 DS0000027180.V331567.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. DS0000027180.V331567.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service The Old Prebendal House Address Station Road Shipton-under-Wychwood Chipping Norton Oxfordshire OX7 6BQ 01993 831888 01993 831800 dora@oldprebendalhouse.com 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) The Old Prebendal House Limited Mrs Dora Watson Gurnett Care Home 45 Category(ies) of Old age, not falling within any other category registration, with number (45) of places DS0000027180.V331567.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. On admission persons should be aged 60 years and over. Maximum of 30 persons with nursing needs. Admittance of one under age category named individual from 23 February 2006 4th January 2006 Date of last inspection Brief Description of the Service: The Old Prebendal House is an elegant Cotswold stone historic building set in extensive grounds in the village of Shipton-under-Wychwood in the west of Oxfordshire. It is close to the Cotswold towns of Stow-on-the-Wold and Burford. The home offers comfortable accommodation to a very high standard for 45 persons, with the maximum of 21 places for persons requiring nursing care. The communal areas include a library, drawing room and a large, spacious dining room that has been created in a beautiful barn conversion. The service users are offered choice in every aspect of their daily lives, from the large and varied choice of well-prepared meals to the range of activities available. The care provided is tailored to individual needs and preferences. The emphasis within the home is very much one of enabling the service users to live their lives as they wish, and to do so with dignity. The fees range from £795 to £960 per week. There are additional costs for hairdressing, chiropody, newspapers and telephone calls. DS0000027180.V331567.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection was conducted over the course of three days and included a one day unannounced visit to the home. The key standards for older people’s services were covered. Information received about the home since the last inspection was taken into account in the planning of the visit. Prior to the visit a questionnaire was sent to the manager with comment cards for distribution to service users, relatives and visiting professionals. Five residents and one general practitioner returned the questionnaires. Residents and families were also spoken to on the day of the unannounced visit. Discussions took place with the manager, nursing, care and ancillary staff. Care practice was observed. A tour of the premises and examination of some of the required records was also undertaken. The homes approach to equality and diversity was considered throughout. What the service does well: The care needs of potential residents are identified with them, prior to their move to the home, to ensure that they can be met. Potential residents have the opportunity to visit the home and to stay before they decide to move in on a permanent basis. Residents’ personal, healthcare and medication needs are met in a manner which protects their autonomy and dignity. One lady commented ‘the staff are superb and cannot do enough for you’. The home offers a lifestyle which matches residents’ expectations and preferences and supports their autonomy. There is a range of activities from which residents choose those which, if any, they wish to take partake in. The meals are of a very high standard and met residents’ nutritional and social expectations. The complaints and protection policies and procedures work well, giving residents and their families confidence that their concerns will be addressed. The Commission for Social Care Inspection has not received any complaints about the home and has not been notified of any allegations made to the local authority. The home’s facilities are of a high standard and residents live in a comfortable and well-maintained environment. The building is attractive and adapted to its present use in keeping with the original design. Residents’ rooms are spacious and they are encouraged to bring personal possessions to make them more homely. DS0000027180.V331567.R01.S.doc Version 5.2 Page 6 There are sufficient, well qualified staff to meet residents’ needs in a timely and competent manner. The staffing levels are good and there is a good training programme in place. The residents were complimentary about the skills of staff and their attitudes. The home is well managed and residents’ views about the quality of the service offered are listened to and acted upon. The health and safety procedures are thorough and residents’ safety is protected. The residents spoke highly of the manager and said that she regularly met with them as individuals or in a group. 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. The summary of this inspection report can be made available in other formats on request. DS0000027180.V331567.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection DS0000027180.V331567.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 3 and 6 People who use the service experience good quality outcomes in this area. This judgement has been made using available evidence, including a visit to this service. The care needs of potential residents are identified with them, prior to their move to the home, to ensure that they can be met. EVIDENCE: The files of four residents were examined. All had evidence that the manager or senior nurse had visited them prior to their move to the home and their needs had been assessed. The residents spoken to said that they had received enough information about the home before they moved and had had the opportunity to visit or stay for a short period prior to moving. Most said that friends or their doctor had recommended the home. They were happy with the information that they had been given and said that the staff had worked hard to make the move as easy and comfortable as possible. The documentation used to guide the assessment of potential residents who are self funding is comprehensive. There is reference to potential residents’ religious and cultural needs. The home does not offer intermediate care. DS0000027180.V331567.R01.S.doc Version 5.2 Page 9 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 and 10 People who use the service experience excellent quality outcomes in this area. This judgement has been made using available evidence, including a visit to this service. Residents’ personal, healthcare and medication needs are met in a manner which protects their autonomy and dignity. EVIDENCE: The care of four residents was followed through. Their files contained comprehensive care plans and the staff spoken to were knowledgeable about their care. The care plans had been reviewed regularly and updated when appropriate. The residents who returned the questionnaires and those spoken to on the day of the unannounced visit said that they were involved in planning their care and that the staff were responsive to their wishes. The risk of residents acquiring pressure damage due to immobility is assessed and the appropriate equipment is made available. Nutritional risk assessments had been undertaken. The staff and chef were aware of residents’ dietary needs and could provide special diets when necessary. Continence assessments are undertaken and appropriate aids are provided by the Primary Care Trust, (PCT). DS0000027180.V331567.R01.S.doc Version 5.2 Page 10 Residents register with the local general practitioner who visits the home weekly. He returned the questionnaire and said that the home communicated clearly with him and that any specialist advice was incorporated into the residents’ care plans. There was evidence that falls assessments are undertaken and the advice of the local Primary Care Trust specialist falls prevention team is taken where necessary. Residents have access to additional private physiotherapy. Medication is managed well. There are medication policies in place. Storage facilities are satisfactory. Records are kept of medication entering and leaving the home. The medication administration records were accurately completed. Controlled drugs were stored satisfactorily and all entries to the controlled register were signed. A contract is held for the safe disposal of unused medication. The registered nurse spoken to said that medication was not administered covertly. If a resident refused medication this would be recorded. If the medication was essential and the resident lacked the capacity to make to the decision, the doctor and family would be informed and a way forward agreed. The staff were observed to be treating the residents with respect and their dignity was protected. All care is given in residents’ rooms. The general practitioner said that he saw residents in their rooms. Residents said that they enjoyed the privacy of the home and the fact that they could use the facilities, for instance the library or lounge, when they wished. DS0000027180.V331567.R01.S.doc Version 5.2 Page 11 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 and 15 People who use the service experience excellent quality outcomes in this area. This judgement has been made using available evidence, including a visit to this service. The home offers a lifestyle that matches residents’ expectations and preferences and supports their autonomy. The meals are of a very high standard and met residents’ nutritional and social expectations. EVIDENCE: There is a range of activities which residents said they enjoyed very much. One said, ‘There is plenty of choice and I can choose whether to take part or not’. One commented, ‘I was persuaded to join the art class on Fridays and now really look forward to it’. The home has a minibus and arranges four regular outings a week to local towns for shopping and for country drives in the Cotswolds. Concerts, theatre trips, pub lunches and visits to garden centres have all been arranged. Regular scrabble mornings are held. Not all residents choose to join group activities and there is an activities co-ordinator who will work with residents on a one-to-one basis. Residents exercise a high level of autonomy and choose who they wish to see. They may see friends and family in their rooms or in the lounges or library. There are no restrictions on visiting. DS0000027180.V331567.R01.S.doc Version 5.2 Page 12 The quality of the meals is of a very high standard. Two three-course meals are provided daily, with lighter options available at both lunch and dinner. This gives residents the choice of taking their main meal at lunchtime or in the evening. A sub committee of the residents’ committee meets regularly with the chef who is very responsive to residents’ wishes. The dining room is attractive and meals were a sociable and pleasant time for residents. One resident said, ‘The food here is excellent’. The chef was knowledgeable about special diets to meet residents’ healthcare and cultural needs. DS0000027180.V331567.R01.S.doc Version 5.2 Page 13 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18 People who use the service experience good quality outcomes in this area. This judgement has been made using available evidence, including a visit to this service. The complaints and protection policies and procedures work well, giving residents and their families confidence that their concerns will be addressed. EVIDENCE: There are complaints policies and procedures in place. A complaints log is kept and action was seen to be taken in response to concerns and complaints. All the residents who returned the questionnaires said that they knew who to speak to if they were unhappy. The residents spoken to said that they had never had to make a formal complaint and that if they were unhappy with any aspect of the service it would usually be dealt with immediately. The home is aware of the local multi-agency strategy for the protection of vulnerable adults. The staff have had safeguarding training and those spoken to said that they would have no hesitation in reporting any concerns about residents’ welfare. The Commission for Social Care Inspection has not received any complaints about the home and has not been notified of any allegations made to the local authority. DS0000027180.V331567.R01.S.doc Version 5.2 Page 14 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 22, 24 and 26 People who use the service experience excellent quality outcomes in this area. This judgement has been made using available evidence, including a visit to this service. The home’s facilities are of a high standard and residents are able to live in a comfortable and well-maintained environment. EVIDENCE: The home is an elegant listed building, which has been extended to provide a nursing wing. The extension is in keeping with the original building. All rooms are ensuite and there is an ongoing programme of maintenance to maintain the building to a very high standard. The gardens are attractive and accessible to residents. There are no CCTV cameras although there is outside lighting. There are a number of external doors that are not alarmed in any way. The manager and handyman said that there were regular checks at night. The manager stated that although they endeavoured to meet all residents’ needs, the home was not really suitable for those with cognitive loss who may wander and become lost. DS0000027180.V331567.R01.S.doc Version 5.2 Page 15 The home has adaptations to meet the needs of frail residents. All beds are height adjustable. Residents had chosen to personalise their rooms, all of which had ensuite facilities. Some rooms are large and could accommodate two people. All rooms are currently used as single rooms and the manager said that double rooms would only be used for a married couple if there was a need. There are infection control policies and procedures in place and the home was spotlessly clean on the day of the unannounced visit. DS0000027180.V331567.R01.S.doc Version 5.2 Page 16 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 and 30 People who use the service experience excellent quality outcomes in this area. This judgement has been made using available evidence, including a visit to this service. There are sufficient, well qualified staff to meet residents’ needs in a timely and competent manner. EVIDENCE: There are good staffing levels. On the morning of the unannounced visit there were seven care staff, including two registered nurses. The care team was supported by the housekeeping and catering team and are not expected to undertake any housekeeping or catering tasks. The residents spoken to said that care staff were able to meet their needs in a timely way. Those who returned the questionnaires said that their needs were always met. There are additional staff available in the mornings and the evenings when residents’ care needs are likely to be greater. Seventy-three per cent of care staff hold the National Vocational Qualifications in Care at Level 2 and above. There is a training co-ordinator in place who ensures that staff undertake mandatory training in safe working practices and who organises training in specialised topics. The training records were up to date and staff spoken to said that they enjoyed the training offered and felt it was beneficial. The home offers placement for local nursing students and the learning environment is assessed by the college. DS0000027180.V331567.R01.S.doc Version 5.2 Page 17 The recruitment files of three recently recruited staff members were examined. All had the required documents and had evidence that appropriate checks had been undertaken before the staff member commenced work. There was evidence that the person’s identity had been checked, two references had been obtained and criminal bureau disclosures sought. The training records showed that they had undertaken an induction programme. DS0000027180.V331567.R01.S.doc Version 5.2 Page 18 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35 and 38 People who use the service experience good quality outcomes in this area. This judgement has been made using available evidence, including a visit to this service. The home is well managed and residents’ views about the quality of the service offered are listened to and acted upon. The quality assurance systems could be further developed to include regular audit of services and procedures to ensure that high standards are maintained. EVIDENCE: There is an experienced manager in post who is a registered nurse and holds the National Vocational Qualifications in Care and Management at level 4. She has been in post for five years. The atmosphere in the home is welcoming and open. A start has been made to develop quality assurance systems. Residents’ meetings are held and minutes are kept. The residents spoken to felt that their views were listened to. DS0000027180.V331567.R01.S.doc Version 5.2 Page 19 The proprietor undertakes monthly quality assurance reviews and records are kept. The manager said that she used a proprietary care homes’ advisory package and was considering implementing further audit procedures. This should be further developed. The home does not manage finances on behalf of residents. All residents have locked storage in their rooms if they wish to keep money or valuables in the home. There are health and safety policies and procedures in place. Training records showed that staff had had up to date training in safe working practices, including manual handling, food hygiene and infection control. Infection control policies have been updated since the Department of Health published new guidance in June 2006. The pre-inspection questionnaire showed that regular maintenance of services and equipment is undertaken. The fire records showed that a fire risk assessment had been undertaken and the fire log was fully completed. The staff spoken to understood the fire evacuation procedures. Water temperatures at water outlets were tested regularly to ensure that residents are not at risk of scalding. DS0000027180.V331567.R01.S.doc Version 5.2 Page 20 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 4 9 3 10 4 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 4 13 3 14 3 15 4 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X 3 X 4 X 4 STAFFING Standard No Score 27 4 28 3 29 4 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 4 X 3 X 3 X X 3 DS0000027180.V331567.R01.S.doc Version 5.2 Page 21 Are there any outstanding requirements from the last inspection? No STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 Refer to Standard OP33 Good Practice Recommendations The quality assurance systems should be further developed to include regular audit of all aspects of the homes operations. DS0000027180.V331567.R01.S.doc Version 5.2 Page 22 Commission for Social Care Inspection Oxford Office Burgner House 4630 Kingsgate Oxford Business Park South Cowley, Oxford OX4 2SU National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI DS0000027180.V331567.R01.S.doc Version 5.2 Page 23 - 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. 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