Archived: Culliford House

Updated 12 April 2018

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

This comprehensive inspection took place on 9 February and 12 February 2018. The first day was unannounced and the second day was announced.

The inspection team included a lead inspector and a second inspector.

In planning the inspection we used information the provider sent us in the Provider Information Return. This is information we require providers to send us at least once annually to give some key information about the service, what the service does well and improvements they plan to make.

Prior to the inspection we contacted the local safeguarding and quality improvement teams for their views on the home.

During the inspection we spoke with five people using the service and three relatives. We also spoke with the registered manager, deputy manager, quality manager, a head of care and four care staff.

We looked at five people’s care plans. We also looked at records relating to the management of the home including staff rotas, medicine administration records, meeting minutes and the recruitment information for three staff.

After the inspection we contacted the mental capacity act, district nursing and speech and language teams for feedback on their visits and contact with the home.

We pathway tracked two people. Pathway tracking is where we review records and do observations to see if people are supported in line with their assessed needs. We carried out general observations and also used the Short Observational Framework for Inspection (SOFI). SOFI is a way of observing care to help us understand the experience of people who could not talk with us.

Updated 12 April 2018

Culliford House is a residential care home for up to 25 older people aged 65 and above with a range of needs including dementia. At the time of our inspection the home was providing support to 20 people. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection. The home has three floors with the top floor available for relatives or friends who have travelled a long distance to see people or who are wishing to spend more time with them if they are receiving end of life care.

The home had a registered manager. 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.

Culliford House was last inspected on 14 October 2015 and the service was rated Good.

At this inspection we found the service remained Good overall.

The home had safe recruitment practices. Checks had taken place to ensure staff were suitable to support people at the home. Pre-employment and criminal records checks were undertaken. Records included photo identification, interview records and two references. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice.

People’s risks were assessed and staff knew how to manage these without being overly restrictive. For example, where people’s skin was at risk or they had problems swallowing; their care plans noted this and detailed how much support they required from staff and how much they were able to do themselves.

People’s mental capacity and ability to consent to living at the home had been checked as part of the pre-assessment process. Staff were able to tell us when and who they would involve if a person lacked capacity. Best interest meetings had taken place in cases where an assessment had determined that a person lacked capacity. These meetings had involved family members with the authority to make decisions on their relative’s behalf, staff who knew the person concerned and healthcare professionals. When necessary staff sought advice and input from the local mental capacity act team.

Staff received an induction programme which included being assigned a mentor and a probationary period involving shadow shifts with more experienced staff and regular competency checks. New starters were given a learning style questionnaire to help inform training sessions and development plans. Training included health and safety, mental capacity, and dementia care.

Interactions between staff and people were natural and warm and there was a relaxed and happy atmosphere in the home. Staff told us that the rotas gave them enough time to spend with people and help meet their needs in a compassionate and person-centred way. They said they had enough time to get to know people, to listen and to respond to any questions they had.

People’s need for privacy and dignity was respected and upheld. For example, we observed ‘please do not disturb’ signs on people’s doors when they were being supported with personal care.

People’s care plans were detailed and reviewed monthly with their involvement and input from family members and healthcare professionals when required. Care plans included what people had done in the past and what they enjoyed doing now.

People were encouraged to become involved in things affecting their quality of life at the home. For example one person had become the peoples’ health and safety representative and attended staff training sessions. Another person was due to join the health and safety committee. The home told us they were planning to include people in the staff recruitment process.

People spoke highly of the senior management team particularly in terms of the support they provided and their collective vision and overview of the service. The service’s values and vision were embedded within staff meetings and supervision and were shared by care staff. Senior management had a good understanding of their roles and clear lines of responsibility had been established.

The home had introduced an ‘employee of the month’ award. Both people, relatives, staff and healthcare professionals could nominate for this. Winners were displayed in the home and on the provider’s website. The award recognised and rewarded the hard work and dedication of staff. Staff achievements were also acknowledged in staff meeting minutes. This included the home obtaining the Investors in People Silver Award. Investors in People is a standard for people management, offering recognition to organisations that adhere to the Investors in People Standard. Staff told us that they felt motivated, valued and happy working at the home. A number of them had returned to the home after working in other care settings. One staff member said it was the best place they had worked with another saying the staff were “like a big family.”

The home held improvement planning meetings. This had led to joint day and night staff meetings to foster consistency and cohesion across the staff team. Staff meetings included discussion about areas for improvement and how these would be achieved. Staff were encouraged to reflect on their practice for example following incidents or hospital admission. One senior staff member said, “we are supported to question practice.”

Further information is in the detailed findings below: