Care Home: Fewcott House Nursing Home

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What the care home does well There is a pace of life in the home which seems suited to the care of people with dementia. The home provides a comfortable and safe environment for its residents. The spacious grounds provide a very pleasant environment for residents. The home offers a diverse range of activities. Staff are well supported and managers facilitate access to a range of training and development opportunities for staff. A number of staff subscribe to the NHS `Dignity in Care` programme which supports improvements in the care of people with dementia. Families report a good level of satisfaction with the quality of care provided in the home. What the care home could do better: This home continues to provide a good standard of service. Random inspection report Care homes for older people Name: Address: Fewcott House Nursing Home Fritwell Road Fewcott Bicester Oxfordshire OX27 7NZ two star good service The quality rating for this care home is: The rating was made on: A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full review of the service. We call this review a ‘key’ inspection. This is a report of a random inspection of this care home. A random inspection is a short, focussed review of the service. Details of how to get other inspection reports for this care home, including the last key inspection report, can be found on the last page of this report. Lead inspector: Mike Murphy Date: 0 3 0 6 2 0 1 0 Information about the care home Name of care home: Address: Fewcott House Nursing Home Fritwell Road Fewcott Bicester Oxfordshire OX27 7NZ 01869345501 01869345502 admin@fewcott.com Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Mrs Ruth Bowell Type of registration: Number of places registered: Conditions of registration: Category(ies) : Fewcott Healthcare Ltd care home 35 Number of places (if applicable): Under 65 Over 65 0 0 35 dementia mental disorder, excluding learning disability or dementia old age, not falling within any other category Conditions of registration: 35 35 0 The maximum number of service users to be accommodated is 35. The registered person may provide the following category of service only: Care home with nursing - (N) to service users of the following gender: Either Whose primary care needs on admission to the home are within the following categories: Dementia (DE) Old age, not falling within any other category (OP) Mental disorder, excluding learning disability or dementia (MD). Date of last inspection Care Homes for Older People Page 2 of 10 Brief description of the care home Fewcott House is a small manor house (the original building dates from 1680), set in two acres of gardens, with an ornamental lake. Situated in the small village of Fewcott, in an attractive rural setting, it is conveniently accessible from the M40 motorway (junction 10) and major road routes from Bicester, Oxford and Banbury. The home was originally registered as a nursing home in 1985, with 14 beds. A purpose built extension was added and the home was registered to accommodate a total of 37 residents in 1987. The home offers care to physically and mentally frail older people with nursing needs. There are nine single rooms and 13 shared rooms. First floor rooms are served by a passenger lift and two stairways. Most rooms are equipped with small en-suite shower/toilet cubicles. There are four communal bathrooms, two of which have bath hoists, and 3 communal toilets. The registered manager and a team of nurses, carers, housekeeping and other staff provide the service to people living in the home. Care Homes for Older People Page 3 of 10 What we found: This random inspection was carried out by one inspector in June 2010. The inspection process included an unannounced visit to the home on Thursday 3rd June 2010. The inspection also included consideration of information supplied in advance of the visit by the registered manager, consideration of the results of a survey carried out before the visit, discussion with the registered manager, proprietor, some residents, and staff, observation of practice, brief inspection of some areas of the home and grounds, and examination of records. This was not a key inspection and therefore did not involve a review of the homes quality rating. We conclude that this home continues to provide good quality care to the people living there (the residents). This impression is reinforced in comments by relatives (included towards the end of this report) in the survey forms we received and which have been taken account of as part of the inspection. The homes arrangements for assessing the needs of prospective residents are outlined in its Statement of Purpose. In summary these comprise the assessment of the persons needs by ..a qualified member of staff.., the acquisition of relevant information from other professionals involved with the person, the offer of an invitation to view the home and its facilities, and to have tea or join an activity session. Assessments to date have generally been carried out by the registered manager. Examination of the care records of a person admitted since the start of this year showed evidence that the home has a good assessment process and that it ensures it is able to meet the assessed needs of a person before offering a place. A care plan is in place for each person living in the home. We examined four care plans. Individual assessment, care planning and review processes are co-ordinated by a Named Nurse. Care documents comprise a needs assessment and care plan, a care plan diary (for daily notes), a folder containing notes of the pre-admission assessment, the medicines administration record (MAR sheet), and the notes of the activity co-ordinator. The care plans examined were well completed. Progress is evaluated and reviewed monthly and updated where necessary. One care plan examined related to a resident recently admitted for a brief respite stay. This included a particularly good and concise summary of the person and was a good example of how such a summary can communicate essential information on a person. The registered manager informed us that the format of care plans is due for review in the near future. This will provide the home with an opportunity to review its experience with the current format and to consider whether it wishes any rationalisation of care documents. The home has a pleasant ambience and the pace of activity seemed suited to the needs of residents on the day of our visit. Some people participated in a group activity led by an activity co-ordinator, others observed life in the home, while others walked around, Care Homes for Older People Page 4 of 10 occasionally interacting with staff and other residents. The home has two part-time activities co-ordinators - currently a total of 28 hours a week. The home has a range of games, craft and other activities for residents to participate in. Some residents and staff go out to Bicester for afternoon tea occasionally or for lunch in a local pub. The home had a number of newly hatched chickens which was of interest to a number of people. The home has a visiting Pat-a-Dog. This year one resident, accompanied by two staff, had a holiday in Blackpool. Managers expressed an interest in developing a wider range of complementary therapies which might be of benefit to individual residents. We were told that around four or five times a year the home invites musicians or other performers to put on a show for residents. The programme includes a singer and organ player who leads a singing session with residents. At Christmas the programme has a religious theme and also includes a performance by local Brownies. In the spring the home held a Dignity Day which included converting the nursing station to a pub (the Fewcott Arms). Families are invited to participate on these occasions if they wish. The home had not received any complaints over the course of the year preceding this inspection visit. We have not received any complaints about this service during this time. Staff with whom we spoke during the course of our visit were aware of safeguarding of vulnerable adults arrangements. The staff induction and training programme included training on safeguarding procedures. There have not been any safeguarding referrals concerning residents in this home over the past year. At the time of this inspection the homes staffing consisted of two registered nurses and six care staff in the morning, two registered nurses and four care staff in the afternoon and evening, and one registered nurse and three care staff at night. In addition to nurses and care staff the home employs an administrator, a cook and assistant cook, house keepers, a laundry assistant, and a handyman. We examined the recruitment files of four staff who had been appointed to the home over the last 12 months. There are two stages to the induction of new staff. The first stage, around three days, in which the new staff member is supernumerary and is orientated to the home. The second stage, around three months, in which the new staff member works through the detail of the induction programme. The home maintains comprehensive records of training of nurses and care staff. These encompass induction training, mandatory training, NVQs, and continuing professional development (CPD) for nurses. Recent staff training events have included Adult Safeguarding, the care of people with Dementia, Infection Control, Moving and Handling, Use of Hoists, Food Safety, Infection Control, End of Life Care, Mental Capacity Act 2005, Deprivation of Liberty Safeguards (DOLs), Nutrition (including use of MUST (Malnutrition Universal Screening Tool)), and Care Homes for Older People Page 5 of 10 the Administration of Medicines. Many positive features were noted during the course of the day. The pace of life in the home which seems suited to the needs of people with dementia. The relationship we observed between staff and residents. The imminent installation of a wooden fence to allow vulnerable residents to enjoy the open air without the need to be constantly accompanied by by a member of staff. The involvement of some staff in the NHS Dignity Champion initiative which supports dignity in care. The home acquiring a four star rating in the most recent inspection carried out by an environmental health officer. A recent inspection by the fire authority had made a number of requirements and the home had acted promptly to address those. We carried out a survey in advance of this inspection. Comments from relatives included the following. Question: What does the home do well? Relatives responses. Friendly atmosphere. Caring staff. Provide well cooked appetising meals. The home is extremely well run with resident care that would be difficult to improve on. Everybody in the home are so clean and dressed so well. The home is always warm, welcoming and very clean. The staff are all very friendly and I notice that all the residents look up and smile at the staff, which is a good thought to take home. Treats residents with care and dignity. My father has been at Fewcott for 5 years. He has always been treated with respect and dignity. He is very well looked after which gives me peace of mind. Visitors are always welcome. A loving, caring and friendly home. Question: What could the home do better? Relatives responses. Mother wants more regular meal times - not keen on the food - has requested jacket potatoes but I think this has happened only a couple of times. I have complete faith and confidence in the staff. I couldnt think of anything. It is perfect in my mind. From the evidence above we conclude that this home continues to provide a good standard of service. What the care home does well: What they could do better: This home continues to provide a good standard of service. Care Homes for Older People Page 6 of 10 If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 2. Care Homes for Older People Page 7 of 10 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 8 of 10 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No Refer to Standard Good Practice Recommendations Care Homes for Older People Page 9 of 10 Reader Information Document Purpose: Author: Audience: Further copies from: Inspection Report Care Quality Commission General Public 0870 240 7535 (telephone order line) Our duty to regulate social care services is set out in the Care Standards Act 2000. Copies of the National Minimum Standards –Care Homes for Older People can be found at www.dh.gov.uk or got from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. 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