Inspection on 20/10/09 for Clarendon Care Home

This is the latest available inspection report for this service, carried out on 20th October 2009.

CQC found this care home to be providing an Good service.

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Clarendon Care Home 25/10/07

Clarendon Care Home 29/03/07

Clarendon Care Home 02/03/06

Clarendon Care Home 21/07/05

Clarendon Care Home 20/12/04

Clarendon Care Home 27/09/04

Clarendon Care Home 20/02/04

Similar services:

St Vincents

The Cotswold Home

Newbeech House

Winton House

Rush Court

Hillyfield Rest Home

The Maypole Nursing Centre

The Briars

Extracts from inspection reports are licensed from CQC, this page was updated on 16/02/2010.

Key inspection report Care homes for older people Name: Address: Clarendon Care Home 64/66 Clarendon Road Southsea Hampshire PO5 2JZ     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home 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 full review a ‘key’ inspection. Lead inspector: Nick Morrison     Date: 2 0 1 0 2 0 0 9 This is a review of quality of outcomes that people experience in this care home. We believe high quality care should • • • • • Be safe Have the right outcomes, including clinical outcomes Be a good experience for the people that use it Help prevent illness, and promote healthy, independent living Be available to those who need it when they need it. The first part of the review gives the overall quality rating for the care home: • • • • 3 2 1 0 stars - excellent stars - good star - adequate star - poor There is also a bar chart that gives a quick way of seeing the quality of care that the home provides under key areas that matter to people. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Care Homes for Older People Page 2 of 25 We review the quality of the service against outcomes from the National Minimum Standards (NMS). Those standards are written by the Department of Health for each type of care service. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The mission of the Care Quality Commission is to make care better for people by: • Regulating health and adult social care services to ensure quality and safety standards, drive improvement and stamp out bad practice • Protecting the rights of people who use services, particularly the most vulnerable and those detained under the Mental Health Act 1983 • Providing accessible, trustworthy information on the quality of care and services so people can make better decisions about their care and so that commissioners and providers of services can improve services. • Providing independent public accountability on how commissioners and providers of services are improving the quality of care and providing value for money. Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report Care Quality Commission General public 0870 240 7535 (telephone order line) Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Care Homes for Older People Page 3 of 25 Information about the care home Name of care home: Address: Clarendon Care Home 64/66 Clarendon Road Southsea Hampshire PO5 2JZ 02392824644 02392824644 siliviapaton@yahoo.co.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Mrs Alice Dunbar care home 20 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia old age, not falling within any other category Additional conditions: The maximum number of service users to be accommodated is 20 The registered person may provide the following category of service only: Care home only (PC) to service users of the following gender: Either whose primary care needs on admission to the home are within the following category: Old age, not falling within any other category (OP) Dementia (DE) Date of last inspection Brief description of the care home Clarendon Rest Home is a large property situated within reasonable walking distance of the town centre of Southsea, and within a few minutes walk of the seafront and pier. Accommodation provided is by way of eight single bedrooms, one of which has an en suite facility and six double bedrooms, four of which have an en suite facility. Day space within the home is provided for by way of two lounges and a separate dining room. Outside the garden has been replaced with a tarmac surface, which is level. The home is registered to accommodate twenty elderly persons, of either sex, in need of Care Homes for Older People Page 4 of 25 Over 65 0 20 20 0 2 3 1 0 2 0 0 8 Brief description of the care home residential care due to old age and related mental health problems. Care Homes for Older People Page 5 of 25 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: This report represents a review of all the evidence and information gathered about the service since the previous inspection. This included a site visit that occurred on 20 October 2009 from 11:30 until 17:30. During this time we looked around the premises, looked at the files of five service users and spoke with six people who live in the home. We also observed the support they were receiving. We met the Manager and the Provider, spoke with three members of staff and observed interaction between staff and service users. During the inspection we also met the Activities Coordinator. All records and relevant documentation referred to in the report was seen on the day of the inspection visit. We also referred to the homes Annual Quality Assurance Assessment, which is a self-assessment they are obliged to provide us with. We received written survey replies from four members of staff, five people who live in the home and two healthcare professionals who are involved with people who live there. Care Homes for Older People Page 6 of 25 What the care home does well: What has improved since the last inspection? What they could do better: 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 on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line 0870 240 7535. Care Homes for Older People Page 7 of 25 Details of our findings Contents Choice of home (standards 1 - 6) Health and personal care (standards 7 - 11) Daily life and social activities (standards 12 - 15) Complaints and protection (standards 16 - 18) Environment (standards 19 - 26) Staffing (standards 27 - 30) Management and administration (standards 31 - 38) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 8 of 25 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Service users benefit from having their needs assessed prior to moving into the home. Evidence: The home requires a full and comprehensive assessment for each person before they move into the home. Assessments are carried out jointly with the agency making the referral and involve relevant professionals and the service user. Assessments include the identification of any religious or cultural needs the service user may have. Records showed that all assessments were in place prior to the person moving in and that service users and their families had been involved in the assessment process. The service has comprehensive information on the needs of people moving into the home and this is then used in the care planning process. Care Homes for Older People Page 9 of 25 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Service users benefit from having their needs identified in a care plan and from having their healthcare needs met. They are protected by the homes medication policies and procedures and are treated with dignity and respect. Evidence: We looked at the care plans of five people who live in the home. All care plans contained clear information on the needs of people living in the home and the actions required of members of staff in addressing those needs. Care plans had information on peoples preferred form of address, religious beliefs, family history, communication skills and dietary preferences. The plans related to the needs identified in each persons initial assessment, as well as to further needs identified while the person had been using the service. Along with the care plans there were risk assessments in place where a particular risk had been identified for the person. While the risk assessments were comprehensive in identifying potential risks for each person, the actions identified to minimise each risk needed to be written more clearly with specific actions. For example, one persons risk assessment identified that they may trip when using the stairs. The action identified to minimise the risk said staff to monitor. The Care Homes for Older People Page 10 of 25 Evidence: Manager and Provider, in discussion, recognised that this was not as specific as it might be and they identified a clearer way of stating the action to be taken. Records showed that all care plans and risk assessments had been reviewed on a monthly basis as well as being updated in between times if the persons needs had changed. With each monthly review was a narrative explaining how the persons needs had been addressed during the month and what significant things had happened for the person in that time. Service users spoken with told us they were aware of their care plans and that the staff in the home consulted with them about their care on a regular basis. Records on service users files showed that they were supported to make regular use of healthcare services, including the Chiropodist, Optician, Community Nurses and the doctor. There was evidence of regular checks as well as appointments being made for specific issues that arose. The records of healthcare visits were clear and summarised the reason for the visit and any outcome from the visit that affected the care the person received. Staff in the home regularly monitored peoples health needs and recorded any concerns. Service users spoken with told us they were always supported by staff if they ever needed to attend any healthcare appointments. There had been a requirement from the previous inspection that the home must ensure the safe administration of medication. We looked at the medication storage and records and observed a member of staff administering medication. All medication in the home was appropriately and safely stored. Clear records were kept of all medication coming into and going out of the home and of all medication administered to people living there. Staff involved in administering medication had all received training and, from observation on the day, were able to administer it safely in line with the homes medication procedures. There had been a requirement from the previous inspection that the home must ensure the privacy and dignity of people living there. Throughout the day we observed staff interacting with people living in the home in a very positive and respectful manner. Staff received training in being respectful towards service users and in ensuring their personal privacy and dignity. Care plans, through use of language and a focus on the rights of service users, also promoted the need to be respectful in providing care to people living in the home. Service users we spoke with told us they thought the staff in the home were always polite and respectful to them. Care Homes for Older People Page 11 of 25 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Service users benefit from being able to exercise choice and control and have stimulating activities. They also benefit from good support in maintaining contact with friends and families and a good, balanced diet. Evidence: The home offers a wide range of activities to people living there. As well as the planned activities in the home led by staff, such as music sessions and bingo, the home also made use of the local dial-a-ride service and taxis to ensure that people living in the home were able to get out as much as possible. Service users who could walk were also taken out for a walk on occasions, usually to the beach which is a short distance from the home. Service users told us they enjoyed trips out such as shopping and going to beach and having fish and chips and ice-creams. The home also buys in a self-employed activities coordinator for two sessions a week. The activities coordinator provides a range of sessions based on the interests of people living in the home. On the afternoon of the inspection visit we observed her taking a quiz session. Each session provided by the activities coordinator had a session plan describing the activity and what benefit service users might get from it. Care Homes for Older People Page 12 of 25 Evidence: There were also records of each session describing what took place and the extent to which people enjoyed the session. The session records need to be improved so that they are individualised. They need to state exactly who took part and what they each got out of the session. At present the records are general for the group of people who were present. However, some people joined in more than others and some people did not appear to participate at all, although they may have got some benefit from being in the room while the activity was taking place. The quiz session we saw was very active and the coordinator was skilled in ensuring that each person took part as much as possible. Service users we observed and spoke with enjoyed the session very much. An entertainer also comes into the home once a fortnight to sing for the people living there. Again service users told us this was a very enjoyable event that they looked forward to. As well as planned activities we observed that staff working in the home were mindful throughout the day of ensuring that people living in the home had something to do and received sufficient stimulation. Staff were good at spending time with people and were always available to attend to their needs. Where people got up and began wandering around the home staff would go with them and talk to them to ensure they were alright and would offer activities if they thought the person was unhappy. The day to day interaction staff had with people living in the home was very positive and consisted of meaningful conversations that were relevant to the person. Service users also told us they valued the opportunity to invite family and friends to birthday and Christmas parties and that they were encouraged and supported to have visitors at any time. The service users we spoke with told us they thought they had control over their own lives in that they were able to make choices about what they did, where they went, what they ate and when they had visitors. Observation throughout the day of the inspection showed that staff were aware of the need to ensure that people exercised choice and control over their own lives and they were skilled in enabling this. Service users were offered choices throughout the day and were supported to do the things they wanted to. The menus showed that the home provided a varied range of nutritious and balanced meals. The meal served on the day of the inspection visit corresponded with what was on the menu. Service users we spoke with told us that food in the home was very good quality and served in adequate portions. On the written surveys we received from service users food was the thing they all consistently identified as something the Care Homes for Older People Page 13 of 25 Evidence: service does well. The mealtime we observed was a positive experience for people. There were sufficient staff available to support those people who needed some help with their food and staff also ensured the mealtime was a socially enjoyable occasion. People living in the home were able to choose where to eat their meal, but most chose to eat in the dining room. Some people chose to eat in the lounge where it was quieter. Throughout the day people living in the home were offered drinks. Records from service user meetings also showed that service users were involved in identifying new items to be put on the homes menus. The home has nutritional risk assessments in place for all the people living there. The Manager thought these were too brief and was in the process of implementing more comprehensive assessments with input from the Nutritionist. There were also plans to implement further staff training to support this. Care Homes for Older People Page 14 of 25 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Service users benefit from a clear and effective complaints procedure and are protected by the homes adult protection procedures and practices Evidence: The home has a clear and effective complaints policy in place. The policy is made available to service users and their families on admission and a copy is also available in the front entrance of the building. There had been no complaints since the previous inspection. Service users we spoke with told us they knew there was a policy for making for making complaints and said that if they had a complaint they would tell the Manager or the Provider. They also told us they had never had to make a complaint but, if they did, they thought it would be dealt with and resolved in a positive way. The home has clear adult protection policies and procedures in place and the Manager was clear that people living in the home needed to be protected from any form of abuse. Examination of training records showed that staff had received training in adult protection issues. The manager was clear about the reporting procedures and knew how and where to report issues if they arose. The Manager had recently completing some training on the Mental Capacity Act and the Deprivation of Liberty. She was now in the process of liaising with Portsmouth Adult Services to provide further training for staff and working towards ensuring that the home was doing all it needed to in relation to these issues for people living there. Care Homes for Older People Page 15 of 25 Evidence: Throughout the inspection we identified no concerns in relation to either complaints or protection. Care Homes for Older People Page 16 of 25 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Service users benefit from living in clean, safe, well-maintained environment. Evidence: The home has a well-maintained appearance and evidence from the maintenance book showed that building issues were highlighted on a regular basis and responded to in a timely manner. Over the past year the home has been improved through regular, planned redecoration of some service user bedrooms and the hallway. Items of furniture and equipments, such as lounge chairs, beds, bedside cabinets, fridge, washing machine, tumble dryer and curtains have been replaced. On advice from the fire authority the home has fitted a new fire door to one room, hinges added to other doors to make them compliant and a new kitchen door fitted. Some carpets throughout the home have been replaced and others have been deep cleaned. The home is clean throughout and the Provider demonstrates a commitment to providing a clean, comfortable and safe environment for people to live in. Infection control policies are in place as well as specific policies for issues such as Legionellas. At the time of the inspection there were Swine Flu protection kits and hand gels available in the home to prevent the spread of infection. The laundry area is well equipped and maintained. The laundry floor has recently been repainted with protective hygienic paint and hand washing facilities were available. Care Homes for Older People Page 17 of 25 Evidence: The home appeared clean and hygienic throughout while still maintaining a comfortable and homely feel. Cleaning schedules are in place and the building is regularly checked by the manager and Provider. Care Homes for Older People Page 18 of 25 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Service users benefit from being supported by adequate numbers of sufficiently trained staff and are protected by the homes recruitment policies and practices Evidence: On the day of the inspection visit it appeared that there were sufficient staff on duty to meet the needs of people living in the home. Staff spoken with said they felt the staffing was adequate and service users told us in discussion and through written surveys that they thought there were always sufficient staff available when they wanted them. One person said staff are very good and they look after us. Theres always someone around when you need them. Staffing levels on the day matched the rota and the rota for the rest of the week showed that staffing levels were the same throughout the week. We looked at the recruitment and training files for four staff working in the home. The recruitment records showed that all necessary pre-employment checks were undertaken prior to people beginning work in the home and that all the information the home was required to keep in respect of members of staff was in place. Staff training records showed that staff were receiving regular training and updates where necessary. The staff we spoke with told us that the training they received was of good quality and relevant to their jobs. Service users spoke highly of staff and told Care Homes for Older People Page 19 of 25 Evidence: us they thought they had the necessary skills to look after them properly. Staff also told that as well as specific training sessions they learned a lot from the Manager who occasionally worked alongside them and supported them in developing their practice. In discussion, the activities coordinator told us she thought the staff working at the home were positive and provided a good service to the people living there. She also told us that she thought the teamworking among the staff team was very good and that they all received good direction and support from the Manager and the Provider. Staff observed on the day of the inspection visit were focused on meeting the needs of service users and their daily routines were arranged around providing support to people throughout the day. Care Homes for Older People Page 20 of 25 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Service users benefit from living in a well managed home that is safe and responsive to their needs. Evidence: The Manager of the home is registered and has demonstrated that she has the skills, knowledge and qualifications to manage the service. Staff and service users spoke highly of the Manager and we received positive feedback about the Manager, the Provider and the way the service was managed from healthcare professionals who completed our surveys. One person wrote to be totally frank this is our best home. The residents appear very well taken care of and the owner is very caring in managing the needs of the residents. A member of staff wrote very homely atmosphere, good teamwork, management and staff have a good rapport with families and service users. From discussion and observation we found that the Managers approach was to be clear with staff about the standards required and to demonstrate how she wanted Care Homes for Older People Page 21 of 25 Evidence: things done. This was followed by regular praise for staff as they got things right and more guidance for staff where improvements were necessary. Staff spoken with told us they appreciated this approach. The home has a quality assurance process in place to identify necessary improvements. Regular checks of the building highlight improvements needed and these are dealt with in a planned and monitored way. Improvements to the service people receive are identified through discussion with service users on an individual basis as well as through service user meetings. Records showed that issues highlighted in this way are also responded to in a planned and timely manner and regularly monitored. To support this process the home sends out regular questionnaires to service users and their families. The Manager told us that the current questionnaires are being redesigned because she feels they are too brief and do not necessarily encourage people to comment on every aspect of the service provided. The home encourages families to manage service users money where they are not able to do it for themselves. Where service users have to spend money it is usually given to them by the home and then recharged back to relatives with receipts. This is to ensure that service users do not have to worry about money and to discourage the need for them to keep money with them while they are in the home. Where service users do want to keep money, they do have lockable storage in their rooms. There had been a requirement from the previous inspection that the home must identify and eliminate any unnecessary risks. The home provides Health and Safety training for all staff and ensures that all staff are aware of their responsibilities within this area. They have safe procedures and storage in place for dealing with potentially hazardous household chemicals. All Health and Safety paperwork is reviewed on a six monthly as well as in between times as issues arise. The records kept in respect of health and safety matters were clear and up-to-date, workplace risk assessments were well managed and we observed no health and safety concerns during the course of the inspection. Care Homes for Older People Page 22 of 25 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, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 23 of 25 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, Care Homes 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 24 of 25 Helpline: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Care Quality Commission (CQC). 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