Archived: Culworth House Care Home with Nursing

Culworth House Care Home with Nursing is registered to provide accommodation for people who require nursing and personal care for up to 35 people. At the time of this inspection there were 19 people living at the home.

There was not a registered manager in post as they had recently left the service. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run. The service was being supported by interim managers until a permanent replacement could be recruited.

The provider had not taken sufficient or prompt action to ensure that the home and the environment were safe.

We found that the only lift in the home was out of order and sufficient action had not been taken to maintain people’s mobility and freedom within their home. A majority of people were unable to easily or safely access the ground floor, the communal areas or leave the building unless in an emergency.

We found that roof tiles on the home had been dislodged or were missing. One roof tile was caught in the guttering which posed a risk to people in the outdoor environment. No risk assessment had been made with regards to the state of the roof.

Rain leaked through the roof on the top floor of the home and had caused water damage to a smoke detector. This was a recurrent issue that had not been rectified sufficiently. There had not been a detailed assessment to ensure the integrity of the electrics as a result of this.

The guttering on the roof was inadequate with many parts missing or incorrectly fitted. Plants were growing within the gutters and there was evidence of water damage from the lack of maintenance of the guttering.

The stone chimneys were of a significant age and were in a state of disrepair. No assessments had been made to ensure they did not present a risk to people, or further damage to the building.

The call bell system on the top floor was not fit for purpose as people were unable to call for help from staff that could be nearby.

We relayed our findings on the day of the inspection to the provider. The provider made a decision following our inspection they would close the home, citing that they did not have the finances available to take all the action required. However we required the provider to take a range of actions to protect the safety of people in the home during the closure process.

This was a breach of Regulation 15 (1) (c) (e) and Regulation 17 (2) (b).

Culworth House is registered to provide accommodation for persons who require nursing or personal care support for up to 35 people. On the day of the inspection 24 people were living in the home.

There was a registered manager in post at the time of our inspection. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

Staff had good relationships with the people who lived in the home. There were enough staff to ensure that people received the individual care and support that they required. Appropriate staff recruitment processes were in place; however there were occasions where some staff commenced working in the home, before all necessary checks had been concluded and some of these staff were not consistently supervised in line with their individual risk assessment. There were a range of induction and training programs in place; however training records available in the home were out of date and this made it difficult for the registered manager to assess staff compliance with training. They were taking steps to address the gaps in staff training.

Staff engaged with people in a positive way and people felt safe in the home. Staff understood the need to protect people from harm and abuse and knew what action they should take if they had any concerns. Care records contained individual risk assessments and risk management plans to protect people from identified risks and help to keep them safe. They provided information to staff about action to be taken to minimise any risks whilst allowing people to be as independent as possible.

Care plans were written in a person centred approach and detailed how people wished to be supported and where possible people were involved in making decisions about their care. People were actively involved in decisions about their care and support needs. There were formal systems in place to assess people’s capacity for decision making under the Mental Capacity Act 2005 and Deprivation of Liberty Safeguards (DoLS). People were able to choose where they spent their time and what they did. However there was a need to increase the level of stimulation and activities available to people and a staff member had been recruited with the aim of focusing on this aspects of peoples care and support.

People were supported to take their medicines as prescribed. Records showed that medicines were obtained, stored, administered and disposed of safely. People were supported to maintain good health and had access to healthcare services when needed.

Staff were aware of the importance of managing complaints promptly and in line with the provider’s policy. Staff and people were confident that issues would be addressed and that any concerns they had would be listened to. There were systems in place to assess the quality of service provided however there was a need to improve record keeping and to ensure that the auditing processes considered all aspects of the service provided.

We spoke with one relative of a person using the service, they told us that they were happy with the care their relative received.

We found that people's needs had been assessed and they received the care that had been planned to meet their needs. We found that there were adequate numbers of experienced staff and that the staff knew how to safeguard vulnerable adults from abuse. We saw that the provider knew how to monitor and respond to complaints effectively.

People using the service were asked in a number of ways how they wanted their care to be delivered and their dignity and privacy was promoted and maintained.

Effective, safe and appropriate care was received by people using the service, to meet their needs.

There were systems and procedures in place for the safe administering, storage and disposal of medicines.

Evidence we gathered indicated that staffing levels were adequate and that staff were supported through appropriate training. This included both core and additional. One person said that 'Staff are good, very responsive'.

Systems and processes were in place to monitor the quality of service and to ensure people benefit from the service provided.