Archived: Culliford House

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:

People's needs were assessed and care was planned and delivered to meet people's needs. A person told us, 'I have a keyworker. She's very helpful.' People's care was regularly reviewed and their personal information was held securely. A visiting family member told us, "I've seen the care plan.'

We viewed a selection of staff records, and saw that relevant checks had been carried out when the home employed staff. Staff had opportunities to gain appropriate qualifications. A visiting family member told us, 'They don't seem to go through a lot of staff; the staff seem stable.'

We found that medicines were stored securely and were given at the correct time. The home's activities co-ordinator told us that the home had implemented new medication management procedures in the past 12 months. The home also had procedures in place for the management and disposal of controlled drugs.

The home kept records of general maintenance of the building. Records were archived and destroyed in accordance with retention schedules.

Staff were keen to involve people in decisions about the home and held regular meetings. One person had asked to have the 'blinds in their room changed as they let too much sun in the room in the morning'. This had been done.

People could get up or go to bed at a time that suited them. One person chose to have tea at 6 a.m and then stayed in bed till their breakfast at 8 a.m as they wanted to maintain their established routine. The home was happy to respect this decision.

We observed staff chatting to people about the care they received and asked if there were any changes that they needed to make. One staff member said 'because people have the same condition it doesn't mean they are not individuals with their own specific needs'.

Staff reported that they were supervised on a regular basis and that 'they found it useful'. Comprehensive notes were kept of these sessions but the quality of some of them was lacking in any valuable information. The sessions were also used for keeping staff up to date with their appraisal which some reported as being confusing.

People told us they felt involved in the decisions made in the home. They commented on how nicely decorated and maintained the home was and their ability to 'come and go as they pleased'.