Inspection on 04/01/06 for The Old Prebendal House

This inspection was carried out on 4th 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

The Old Prebendal House 29/05/07

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 Philippa MacMahon Unannounced Inspection 4th January 2006 09:40 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 The Old Prebendal House DS0000027180.V275989.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. The Old Prebendal House DS0000027180.V275989.R01.S.doc Version 5.1 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 The Old Prebendal House DS0000027180.V275989.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. On admission persons should be aged 60 years and over. Maximum of 30 persons with nursing needs. Date of last inspection 19th August 2005 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 the 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 Old Prebendal House DS0000027180.V275989.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced inspection and the second to take place in the inspection year. The inspector was made very welcome by the staff and residents, and all cooperation was given. The inspector examined care plans, and other records required by regulation, and talked to residents and staff, and observed the daily activities within the home, including lunch. What the service does well: What has improved since the last inspection? Every resident has a care plan in which their assessed care needs are identified and the action required to meet those needs. Risk assessment and documentation around the issue of residents taking responsibility for their own medication have been put in place. Appropriate ventilation has been put in place in the laundry. The charging of batteries takes place in a designated area. The water temperatures at all hot water outlets are regulated to be close to 43°C, and are checked on a regular basis. Bath thermometers have been re provided and staff informed of the importance of using them on each occasion of drawing a bath. The Old Prebendal House DS0000027180.V275989.R01.S.doc Version 5.1 Page 6 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 Old Prebendal House DS0000027180.V275989.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 The Old Prebendal House DS0000027180.V275989.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): None of these outcomes were addressed on this occasion as they had been inspected earlier in the inspection year. EVIDENCE: The Old Prebendal House DS0000027180.V275989.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): 7,8,9. Each resident has a care plan in which their assessed care needs are identified and the action required to meet those needs. Nutritional assessments, risk assessments for moving and handling, and those residents at risk of falling are not in place. Policies and procedures are in place to enable residents to be responsible for giving their own medication. EVIDENCE: A sample of care plans was examined and overall they set out the assessed care needs and the action required to meet them. The nutritional assessment tool “MUST” is being used, however one of the care plans did not have a “MUST” score just a weight chart. It is recommended that all the residents should have a nutritional assessment and that this is recorded in the care plans. One of the care plans showed that the resident was subject to falling and accident/incident forms had been correctly filled in. However there was no risk The Old Prebendal House DS0000027180.V275989.R01.S.doc Version 5.1 Page 10 assessment for moving and handling, and falls prevention. It is recommended that all the residents should have a risk assessment carried out for moving and handling and this to be filed in the individual care plans. One of the residents had bed rails put in place to prevent falling out of bed. The care plan did not include a record of the nature of the circumstances or that protectors were in place. It is recommended that whenever bedrails are put in place, a record of the circumstances including the nature of the restraint, and that the relatives have been informed, should be placed in the care plan folder. Those residents who are responsible for giving their own medication have had a risk assessment carried out and this is documented in the care plans. The Old Prebendal House DS0000027180.V275989.R01.S.doc Version 5.1 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. The home provides a lifestyle experience that matches the expectations and preferences of the residents. Relatives and visitors are most welcome at the home at any time. The Old Prebendal House is very much a part of the village life, and the local facilities are readily accessible to anybody wishing to be involved. Meals and mealtimes are of a very high standard, and taken in beautiful surroundings, in a leisurely and gracious manner. EVIDENCE: The inspector met with the activities co-ordinator who works at the home three mornings a week. One day is for group activity and the other two days are for individual or small group outings or activities. The home’s administrator arranges other social and cultural events including poetry reading and lectures on various subjects. An art class takes place on a Friday and is well attended and enjoyed. The Old Prebendal House DS0000027180.V275989.R01.S.doc Version 5.1 Page 12 Discussion with a group of residents revealed that they felt that the quality of life at Prebendal House was marvellous and that this was enhanced by the interaction of the residents in the adjacent close care apartments. The inspector joined the residents for lunch in the beautiful elegant dining room. The residents are individually served and the staff are trained how to serve the food at table. The quality of the meals and choice are exemplary and residents spoken to said that they could not fault the service provided. “Christmas was splendid very well done”, commented one of the residents. Those residents who require assistance take their meals either in their own rooms or in the small sitting room. This is by mutual agreement to provide dignity for everybody. The Old Prebendal House DS0000027180.V275989.R01.S.doc Version 5.1 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): 16,17,18. The home has a complaints procedure that is readily available to the residents, family, visitors, and staff. Those residents wishing to take part in the civic process are assisted to do so. All staff are made aware of issues around the protection of vulnerable adults. EVIDENCE: A copy of the home’s complaints procedure is posted on the notice board in the entrance hall, and is contained in the Service Users Guide. The registered manager informed the inspector that there had been no complaints in the recent months. Residents do take an active interest in the political scene, and are able to vote either by postal vote or attending the polling station locally. Training in the protection of vulnerable adults is included in the induction training for all staff working in the home. For those staff involved in NVQ training in care this subject is also covered within the course. The Old Prebendal House DS0000027180.V275989.R01.S.doc Version 5.1 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): None of these outcomes were inspected on this occasion. EVIDENCE: The Old Prebendal House DS0000027180.V275989.R01.S.doc Version 5.1 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): 27,28,29,30. The home is well staffed and has the necessary skill mix to meet the needs of the residents. The Staff are all competent to carry out their duties. The registered manager is committed to the training and development of all staff. Robust recruitment policies and practices are in place. EVIDENCE: Staff rosters examined showed that there were sufficient numbers and skill mix of staff on duty at all times. One of the senior carers has recently been awarded a national award of Carer of the year 2005. This is a tremendous achievement and the rest of the staff are justly proud of her, and supported her at the awards ceremony in London. A training officer has recently come into post that works three days a week. She is a trained nurse and very experienced in the training and development needs of staff in the care home industry. Progress is being made into drawing up a training and development plan for all staff. The Old Prebendal House DS0000027180.V275989.R01.S.doc Version 5.1 Page 16 The NVQ in care training is gathering pace as the home now has three assessors on the staff. The Old Prebendal House DS0000027180.V275989.R01.S.doc Version 5.1 Page 17 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 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): 33 The home has started to address issues of quality and quality improvement. EVIDENCE: The registered manager produced a questionnaire previously covering such topics as food, housekeeping and care issues, and the feedback from this caused changes to be made. This was some time ago and the registered manager said that it was time to re-submit this. The registered manager told the inspector that they were looking into the Investment in People award scheme with a view to taking this up in the near future. Letters of commendation are shared with all staff. The Old Prebendal House DS0000027180.V275989.R01.S.doc Version 5.1 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 X X X X X HEALTH AND PERSONAL CARE Standard No Score 7 3 8 2 9 3 10 X 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 3 18 3 X X X X X X X X STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score X X 2 X X X X X The Old Prebendal House DS0000027180.V275989.R01.S.doc Version 5.1 Page 19 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. 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. 2. 3. Refer to Standard OP8 OP8 OP8 Good Practice Recommendations It is recommended that all the residents should have a nutritional assessment and that this is recorded in the care plans. It is recommended that all the residents should have a risk assessment carried out for moving and handling and this to be filed in the individual care plans. It is recommended that whenever bedrails are put in place a record of the circumstances including the nature of the restraint, and that the relatives have been informed, should be placed in the care plan folder. The Old Prebendal House DS0000027180.V275989.R01.S.doc Version 5.1 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 © 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 The Old Prebendal House DS0000027180.V275989.R01.S.doc Version 5.1 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. 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