Care Home: Hunters Care Centre

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Annual service review Name of Service: Hunters Care Centre The quality rating for this care home is: The rating was made on: three star excellent service 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 We do an annual service review when there has been no key inspection of the service in the last 12 months. It does not involve a visit to the service but is a summary of new information given to us, or collected by us, since the last key inspection or annual service review.   Has this annual service review changed our opinion of the service?   No You should read the last key inspection report for this service to get a full picture of how well outcomes for the people using the service are being met. The date by which we will do a key inspection: Name of inspector: Kathryn Silvey Date of this annual service review: 0 2 0 3 2 0 1 0 Annual Service Review Page 1 of 8 Information about the service Address of service: Cherry Tree Lane Cirencester Glos GL7 5DT 01285653707 01285655529 hunters@barchester.com www.barchester.com/oulton Barchester Healthcare Homes Ltd Telephone number: Fax number: Email address: Provider web address:   Name of registered provider(s): Name of registered manager (if applicable) Conditions of registration: Category(ies) : dementia old age, not falling within any other category Conditions of registration: The maximum number of service users who can be accommodated is 93. The registered person may provide the following category of service only: Care home providing nursing or personal care - Code N; To service users of either gender whose primary care needs on admission to the home are within the following categories: Old age, not falling within any other category - Code OP - maximum 60 places, DementiaCode DE- maximum 33 places Have there been any changes in the ownership, management or the Yes service’s registration details in the last 12 months? If yes, what have they been: In January 2010 an additional four bedrooms were registered in the original building. These are four of eight rented rooms where people use the facilities of the home but do not have support with personal care. The registered manager Sue Stannard left the service on the 21/10/2010 and a new manager was appointed, Tracey McDonald. Annual Service Review Page 2 of 8 Number of places (if applicable): Under 65 Over 65 33 0 0 60 Tracy McDonald has moved back to the home from another Barchester service, and was the head of the dementia care unit several years ago at Hunters Care Centre. Date of last key inspection: Date of last annual service review (if applicable): Brief description of the service Hunters Care is a purpose built care home with nursing for older people, which accommodate older people with both general nursing and dementia care needs. The general nursing accommodation is situated on two floors and comprises of both single and double bedrooms with en-suite facilities. There is a large lounge area and dining room on the ground floor with several smaller lounges on both the ground and first floor. The recent additional nineteen-bedded general nursing care unit on the first floor has two spacious lounges and a dining room. Many of the lounges give a view across the surrounding landscape and some smaller ones provide privacy to people and their relatives if they wish to use them. The dementia care Unit provides nursing care and is situated on two floors. It is divided into three separate units with the more able people are accommodated in the ground floor units with access to a large circular `wandering corridor? with seats and a lounge area. An enclosed garden area can be accessed from this corridor, which people can freely use. The accommodation on the first floor has an open lounge area and separate dining room/lounge. A new enclosed garden area has been developed at the side of the unit for people to use with staff support. There are assisted bathrooms and toilets situated in all of the areas used by people living in the home. The kitchen and laundry area is situated on the ground floor. There is a recent new addition of a large activities room providing excellent facilities. The current fees range from 950.00 pounds to 1400.00 pounds dependent upon care needs, the room available and whether nursing care is required. The fee may be less if a companion room is taken. Additional costs include: Chiropody, hairdressing, newspapers and visitors meals. Annual Service Review Page 3 of 8 Service update since the last key inspection or annual service review: What did we do for this annual service review? We looked at all the information that we have received, or asked for, since the last key inspection. This included: The annual quality assurance assessment (AQAA) that was sent to us by the service. The AQAA is a self-assessment that focuses on how well outcomes are being met for people using the service. It should also give us some numerical information (Dataset) about the service. Surveys returned to us by people using the service and from other people with an interest in the service. Information we have about how the service has managed any complaints. What the service has told us about things that have happened in the service, these are called notifications and are a legal requirement. The previous key inspection and the results of any other visits that we have made to the service in the last 12 months. Relevant information from other organisations. What other people have told us about the service. What has this told us about the service? The home sent us their annual quality assurance assessment (AQAA) which gave us the detailed information we asked for. The home does the following to ensure that the views of people who use the service are promoted and incorporated into what they do: People that live in the home and their relatives, where appropriate, are involved in the care planning process every six months to help ensure that their wishes are known and acted upon. The manager operates an open door policy for people, staff, relatives, visitors and professionals to met her. The managers office has moved to a more accessible position, opposite the activity room. The AQAA told us that people visit the manager to discuss the running of the home. Regular meetings are held where people can make requests, and the head chef sometimes attends as people may wish to comment about the catering service. A relatives support group has just started, which is particularly helpful for people in the dementia care unit. The AQAA informed us that the home has made the following changes as a result of listening to people who use their service: The menus were reviewed during October and November 2009, and now offer a wider choice of starters and supper alternatives. The dining service now offers individual table service, which speeds up the time of service to each table and ensures food quality is maintained. The activity programme is wide ranging and includes one to one time with people who spend time in their room. There are two activity rooms and the space for activities in the Memory Lane dementia care unit has improved to carry out activity and meaningful occupation. The activity team has expanded to a team of six, two full time Annual Service Review Page 4 of 8 and four part-time, to also include an increased budget. The activity staff have taken a minibus instruction course, facilitating more frequent use of the homes minibus for visits out. The housekeeper audits the laundry and cleanliness of the home. There are additional paved patio and woodland areas for people to walk, and the home reached the Barchester in Bloom final again in 2009, and one of the people living in the home attended the final presentations in London. There is now a fenced vegetable patch and a green house for propagating plants. A qualified gardener has been employed and is working with people living in the home in the grounds. The AQAA told us the following changes have been made to ensure that equality and diversity are promoted: People are able to visit their church of choice by using the help of local volunteers. Bus tokens have been obtained for people so that they may use a taxi if they wish. There is a careful skill mix of staff on a daily basis to help ensure diverse needs are met, and staff have been trained in the use and maintenance of hearing aids. In the previous twelve months the following changes have been made in the home: Pre-admission assessments are more robust to sometimes include two staff completing them, one from the dementia care unit, when required. The homes information pack has been reviewed. The AQAA informed us that there are new policies and procedures for Deprivation Of Liberty Safeguards (DOLS), to help ensure that peoples rights are protected. We were told that the home has not made any referrals to the local DOLS team. Three staff have been trained by a nurse from the Mental Health Trust, 2gether, in the Department of Health (DoH) Dementia Strategy, which is cascaded to other staff. Forty staff have been trained in the dementia care course Yesterday, Today and Tomorrow, enhancing person centred care. A monthly report to monitor pressure ulcers and nutritional assessments is completed to inform Barchesters clinical development nurse. One nurse has become an infection control link nurse and three care staff attend Barchester continence training meetings, cascading information about new practices and products to other staff. The home has purchased seven profiling beds. A drinks dispenser has been provided in lounges for people and their visitors to use to enhance hydration. The home has created a cafe area for people and the staff to use, and volunteers operate a weekly trolley shop. The activity staff in the dementia unit have created wall art as memory prompters for individual rooms. There have been some thefts in the home and CCTV cameras have been installed on the front and rear of building to provide added security. The main ground floor corridor and the dementia care unit lounge have been redecorated. Two nurses stations have had air conditioning fitted, and the home was scored high for property services by Barchester in September 2009. Annual Service Review Page 5 of 8 The AQAA also told us about the changes in staffing and staff training to include the following: The dementia care unit have additional night staff to meet the needs of the people there. The homes trainer has passed her diploma in Person Centred Care for dementia, and the senior nurse on the dementia care unit has passed a module at the University of the West of England (UWE) in Person Centred Dementia Care. A nurse was trained to provide influenza vaccine, and administered it to people in the home as part of the homes pandemic plan. The head housekeeper and housekeeper have both passed their NVQ in Support Services in Health Care. The AQAA told us that twentyseven care staff have an NVQ 2 or above qualification and that four other staff were working towards an NVQ 2 qualification. The homes trainer is one of the highest performers for completion of courses on Barchester Learning and Development system. The health and safety committee is represented by all departments and continues to improve, incidents are reported and action taken to ensure that a serious incident does not happen. We have been notified of many people falling during the past year, and the home plans to invest in additional assistive technology to help prevent further falls where possible. The AQAA informed us that there have been four complaints in the last year, one complaint was upheld, and one is waiting for an outcome. One safeguarding incident was reported and managed appropriately. We received completed surveys from nine people living in the home, six relatives, one doctor and five staff. The surveys indicated that people always or usually received the care and support they needed, and the medical care they needed. One person living in the home told us they did not know how to make a formal complaint. The following comments were made in the surveys from people in the home and their relatives about What the service does well; nursing care, I am very happy here, warmth, meals and friendship, the staff are very helpful in all ways, everything, the staff are kind and caring, the residents are always greeted by name and are given a high degree of respect, the food is excellent with choices provided, the activity coordinator is very switched on and aware of the specific needs of the clients, the nursing care from trained staff is excellent and staff treat residents suffering from dementia with respect and patience. Comments from people about What the service could do better included the following; general maintenance could be improved, some areas are very cold and windows are continually left open, more financial advice regarding money available form social services and health service, personal care can be variable and attention to detail, for example; teeth cleaning and nails, I have asked for my bathroom to be refurbished without success, thorough cleaning of room not evident, curtains in my room not done for three years and have more carers available between meals and not have to be called away to help with hoisting. Annual Service Review Page 6 of 8 The staff surveys told us that generally most staff are well supported by the manager and that they are appropriately trained. The staff comments included the following; the home could improve the temperature control in the summer, especially upstairs, the dementia care unit does person centred care well, residents have many choices regarding their diet, what time they want to get up and go to bed, there is a good training programme, there is a lack of male activities, could do with construction tasks or similar, we need more bank staff to cover staff sickness, the heating never works properly either too hot or too cold, upstairs gets too hot in summer, the home does training, caring and laundry well, the home looks after staff well, we work well as a team and more communication between nurses and carers, and nurses should help carers more. A doctor commented that the home offers person centred holistic care, and that the standard of care at the home is a shining example to other homes. The home has kept us informed of significant events and incidents through the required notification procedure. The manager informed us that in February 2010 a new Head of Dementia Care was appointed, who was previously the homes trainer, and has a diploma in Person Centred Care for Dementia. A registered nurse employed in the home has also commenced her post as the homes new trainer in February 2010. A new maintenance manager was also appointed in February 2010, and is focusing on the decoration and refurbishment of some bedrooms, and auditing the heating system to look at ways to make improvements. An extra housekeep has been recruited and is implementing new cleaning schedules. Curtains will be laundered every six months and bedrooms deep cleaned every month according to infection control policies. Additional staff have also been recruited to join the bank team. The bank team helps to fill staff vacancies during annual leave and staff sickness periods. We looked at all the information and our judgement is that the home is still providing an excellent service and that they know what further improvements they need to make. What are we going to do as a result of this annual service review? The last key inspection of this service was on the 18/01/2008. Subject to any changes in registration and inspection practice following implementation of the Health and Social Care Act 2008, our current plan is to do a key inspection by 18/01/2011 Annual Service Review Page 7 of 8 Reader Information Document Purpose: Author: Audience: Further copies from: Annual service review CQC General Public 0870 240 7535 (national contact centre) Our duty to regulate social care services is set out in the Care Standards Act 2000. The content of which can be found on our website. Helpline: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. 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