Inspection on 12/01/06 for Clairmont Residential Home

This inspection was carried out on 12th January 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Clairmont Residential Home 14/10/08

Clairmont Residential Home 23/01/07

Clairmont Residential Home 05/08/05

Clairmont Residential Home 14/12/04

Clairmont Residential Home 12/08/04

Similar services:

Deepdene Care Centre

Ferndale Residential Care Home

David Gresham House

Elizabeth House

Elvy Court Nursing Home

Fontenay Nursing Home

Cornford House

Cherington Nursing Home

Extracts from inspection reports are licensed from CQC, this page was updated on 08/07/2008.

CARE HOMES FOR OLDER PEOPLE Clairmont Residential Home 89-91 Woodside Wigmore Gillingham Kent ME8 0PN Lead Inspector Sue McGrath Announced Inspection 12th January 2006 10:00 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Clairmont Residential Home DS0000028864.V267201.R01.S.doc Version 5.0 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Clairmont Residential Home DS0000028864.V267201.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Clairmont Residential Home Address 89-91 Woodside Wigmore Gillingham Kent ME8 0PN 01634 361468 Telephone number Fax number Email address Provider Web address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Mrs Gwyneth Hayward Mr Godfrey Hayward Care Home 13 Category(ies) of Dementia (13) registration, with number of places Clairmont Residential Home DS0000028864.V267201.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. Future DE(E) service users have single rooms, unless it can be evidenced through a multi disciplinary assessment the appropriateness to share a room with another DE(E) service user. 5th August 2005 Date of last inspection Brief Description of the Service: Clairmont Residential Home is a large detached property situated in a residential area close to a public park and within easy walking distance of a local convenience store and Post Office. The home is on a bus route and within easy reach of Hempstead Valley shopping centre. The nearest town and main line station is Rainham, which is about a mile away. The home has an attractive rear garden part of which is sectioned off for service users, the remaining garden has a swimming pool, service users only access this part of the garden when accompanied by staff. The home provides accommodation to 13 residents with a diagnosis of Dementia on two floors and offers 24-hour care. There is one waking night and one on call on the premises at night. In addition to the team of care staff a cleaner and an activity co-ordinator are employed at the home. Clairmont Residential Home DS0000028864.V267201.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an announced inspection which took place on 12th January 2006.The focus of the inspection was on reviewing progress towards meeting requirements of the last inspection and talking to Residents and staff on duty to monitor ongoing health, safety and wellbeing of the Residents. Records were viewed including care plans and some policies and procedures. Staff training and support was also inspected. Time was spent talking to Residents and one family member. The overall outcome for the residents was that they enjoyed living in a safe and secure environment with a dedicated staff to care for them. What the service does well: What has improved since the last inspection? Several bedrooms have been decorated and plans are in place to decorate the lounge and hallway. Some new carpets are also planned for the spring. Radiator covers are now in place and work is nearly completed with the installation of thermostatic mixer valves. Two extra staff have been employed in the last year. The structure and information held in the care plans had also improved. Clairmont Residential Home DS0000028864.V267201.R01.S.doc Version 5.0 Page 6 What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Clairmont Residential Home DS0000028864.V267201.R01.S.doc Version 5.0 Page 7 DETAILS OF INSPECTOR 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) Scoring of Outcomes Statutory Requirements Identified During the Inspection Clairmont Residential Home DS0000028864.V267201.R01.S.doc Version 5.0 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1- 6 Prospective residents are provided with the information they need to make an informed choice about moving into the home. Residents benefit from a comprehensive assessment of their needs prior to moving into the home to ensure their assessed needs can be met. Residents and families benefit from the opportunity to visit the home prior to admission to assess the quality, facilities and suitability of the service. EVIDENCE: The home’s Statement of Purpose and Service User guide had been incorporated into one document. This document contained all of the information required by regulation. Each resident was provided with a statement of terms and conditions and these were held in the residents file. The home and either by the resident or their representative had signed these. Clairmont Residential Home DS0000028864.V267201.R01.S.doc Version 5.0 Page 9 Discussion with the owner and deputy manager confirmed that all residents had a full assessment undertaken prior to admission and that information was sought from the relatives where possible and the Care Manager. The owner had developed very good working relationships with the Care Managers over the years and this had ensured a good flow of relevant information. The home offers specialist dementia care and has many years of experience in delivering this type of care. Staff had also gained much insight into dementia care and offered care in a very supportive manner. Residents were encouraged to visit prior to admission and move in on a trail basis before they and /or their representatives made a decision to stay. Unplanned admissions were avoided where possible. The amount of time of the trail was dependent on the needs of the resident. Intermediate care was not offered at Clairmont. Clairmont Residential Home DS0000028864.V267201.R01.S.doc Version 5.0 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7-11 Residents benefit from having clear and in-depth care plans that identify their individual needs and give clear guidance to staff. Care plans are regularly updated to ensure changes are recorded and acted upon. Residents’ health care needs are met and service users benefit from having full access to all professional health care services as required. The home handles the issue of illness and ageing sensitively. EVIDENCE: A sample of care plans were viewed and found to be more comprehensive than at the last inspection. Nutritional plans were now in place as discussed previously. The format and style had also improved and this made finding relevant information easier. Reviews were also now recorded. The owner stated that although the home was registered for dementia care none of the Clairmont Residential Home DS0000028864.V267201.R01.S.doc Version 5.0 Page 11 current residents were displaying any challenging behaviour. This was mainly due to the level of care being offered. Residents said that when receiving any personal care they felt comfortable and well supported by staff. Relatives spoken to also stated that they were happy with the level of care and the kindness shown to their loved ones. Two residents were being cared for in bed and evidence was seen that this was being handled well and that appropriate care of tissue viability was being undertaken. Resident’s healthcare needs were being well catered for. The Falls Co-ordinater from the local PCT had visited and falls assessments were being introduced as recommended in the last report. The home had informed families if slippers were suitable or needed replacing. Slightly fewer falls were recorded. The home’s administration of medication was viewed and was found to meet the guidelines of the Royal Pharmaceutical Society of Great Britain. Although staff had some basic training in the administration of medication it will be recommended that staff attend an accredited course. Information on such courses was left with the manager. The home had a comprehensive policy for handling the death of service users, including sudden death, which ensured their death was handled with dignity and propriety. The deputy manager confirmed that service users were able to spend their final days in their own room, surrounded by their personal belongings, unless there were strong medical reasons to prevent this. The home had developed good working relationships with the District Nurse team and felt they received good support from them. Clairmont Residential Home DS0000028864.V267201.R01.S.doc Version 5.0 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13, 14 and 15 Residents are supported to maintain contact with family and friends, which ensures they continue to receive stimulation and emotional support. The residents benefit from the appetising meals and balanced diet offered by the home and those service users requiring specialist diets are well catered for. EVIDENCE: The home employed an activity co-ordinator for six hours per week. Organised activities included bingo, sing songs, skittles and dancing. All activities were recorded for reference. Staff occasionally organised pampering afternoons were nails could be polished, facials and other skin care treatments offered. These sessions were very much enjoyed by those who participated. The home annually organises a Garden Party and Christmas party for both residents and their families. Residents spoken with said they were happy with the level of activities and enjoyed living at the home. Families were actively encouraged to visit regularly and at any reasonable time. Clairmont Residential Home DS0000028864.V267201.R01.S.doc Version 5.0 Page 13 None of the residents wish to attend church however one resident took Holy Communion in the home. Residents spoken with said the food was lovely and all enjoyed the home cooking. Specialist diets could be catered for if required. Clairmont Residential Home DS0000028864.V267201.R01.S.doc Version 5.0 Page 14 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16-18 Residents are protected by a robust complaints system and service users and relatives feel their views are listened to and acted upon. The home has robust adult protection policies and procedures to ensure that residents are protected from abuse. EVIDENCE: The home had a written complaints procedure in place that both staff and the family members spoken to were aware of. Both family members spoken to stated that they had not needed to use the procedure and felt confident that any issues could be resolved with the manager before they got to that level. The home had adopted the Multi Agency Adult Protection Policy for Kent and Medway and staff spoken to were able to demonstrate an awareness and understanding of the policies, although training was not current. The owner stated that all residents were given the opportunity to vote and would be assisted to vote if desired. One resident had a postal vote. Clairmont Residential Home DS0000028864.V267201.R01.S.doc Version 5.0 Page 15 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): Residents benefit from living in a clean, safe, well-maintained environment and have safe access to comfortable indoor and outdoor communal areas. Service users are encouraged to maximise their independence by having access to the range of specialist equipment supplied by the home. EVIDENCE: Discussion took place with owner regarding future planned maintenance and renewal of fabric. It was stated that the lounge area was to be decorated in the spring along with the hall and laundry. Some new carpets were also planned. Four bedrooms were decorated last year. The home has sufficient communal space and a smoking area is provided. Lighting in the communal room was domestic in character and of good quality. Clairmont Residential Home DS0000028864.V267201.R01.S.doc Version 5.0 Page 16 The home had 5 toilets and 4 bathrooms and 1 en-suite room. Each bedroom had a hand basin. An environment risk assessment had been undertaken and all recommendation completed. Discussion took place regarding the sharing of room for people with dementia. The resident who had concerns at the last inspection had been given the option to move rooms but had declined to move. This had been evidenced in the care plans. The home was fresh and clean on the day of the inspection. Clairmont Residential Home DS0000028864.V267201.R01.S.doc Version 5.0 Page 17 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27-30 Systems are in place to ensure residents’ needs are met by a mix of qualified and care staff with a strong commitment to specific and NVQ training. Residents are protected by the home’s robust recruitment procedures. EVIDENCE: The owners had increased the number of staff by two since the last inspection and now had one deputy manager, and thirteen care staff. The proprietor also works between 32 and 48 hours per week as required. The hours worked by these staff indicated that the home was suitably staffed. 79 of the care staff were qualified to NVQ level two with two members achieving level three. The majority of the staff had completed a course in the care of residents with dementia and challenging behaviour. Other courses undertaken in the last year included First Aid and Basic Food Hygiene. Fire awareness training was booked for all staff in March 2006, although most have completed this course previously. The Deputy Manager had recently completed a course to enable her to complete training for Manual Handling and intends to retrain all staff in the very near future. One area of training that could be improved was the medication training and this was discussed with the proprietor. Discussion with staff and the standard of care seen on the day indicated that the staff had the skills to perform their duties well. Several residents complimented them on their capabilities and competences, several also Clairmont Residential Home DS0000028864.V267201.R01.S.doc Version 5.0 Page 18 mentioned how homely and comfortable they felt in the home and that it had been a good decision to live at Clairmont. Residents also commented that there always seemed to be sufficient staff on duty at all times. The home does not use agency staff. The homes recruitment procedure was discussed and found to meet the required standard. All staff had CRB checks in placed. Clairmont Residential Home DS0000028864.V267201.R01.S.doc Version 5.0 Page 19 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31-38 Residents benefit from a clear management and organisational structure, which recognises the expectations of older people needing specialist dementia care. Residents are protected by sound accounting procedures within the home with personal finances safeguarded. Current arrangements are sufficient to protect the health, safety and welfare of residents and staff. EVIDENCE: The deputy manager had recently completed her NVQ Four in management and was working towards her Registered Managers Award. The proprietor was hoping to register her as the manager and registration pack was requested. Clairmont Residential Home DS0000028864.V267201.R01.S.doc Version 5.0 Page 20 The atmosphere amongst the staff in the home was very positive and enhanced the homely atmosphere. Staff worked well as a team and appeared to enjoy working at the home. The home does have a basic quality assurance scheme running but this could improve. Discussion took place about how to improve the system and who to involve. The home had adequate insurance cover in place. Evidence was seen that robust accounting procedures were in place that safeguarded residents’ monies. The procedures of storage and recording of these monies was seen and two accounts where sampled and found to balance exactly. Staff supervision was discussed and found to be done in an ad hoc manner and was given when it appeared to be required. Staff confirmed that this was the actual practise but did say that they felt well supported by the management team. It will be recommended that this system be reviewed and a more formal procedure put in place. Discussion took place regarding types of suitable supervision that could be offered. The manager has started to complete staff appraisals. The radiator covers had been fitted and the majority of the thermostatic mixer valves had also been fitted. The remaining valves were due to be fitted by the end of March 06. All other maintenance checks required to ensure the health, safety and welfare of residents and staff were in place. Clairmont Residential Home DS0000028864.V267201.R01.S.doc Version 5.0 Page 21 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 3 3 3 3 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 X 10 3 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 3 18 3 2 3 3 3 2 3 3 3 STAFFING Standard No Score 27 3 28 4 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 3 3 3 2 3 3 Clairmont Residential Home DS0000028864.V267201.R01.S.doc Version 5.0 Page 22 Are there any outstanding requirements from the last inspection? Yes STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 2. Standard OP25 Regulation 13 (4) (a & b) Requirement The register person shall ensure that-(b)all parts of the home to which service users have access are so far as reasonably practicable free from hazards to their safety;(c)unnecessary risks to the health or safety of service users are identified and so far as possible eliminated. In that preset valves of a type unaffected by changes in water pressure and which have fail safe devises are fitted locally to provide water close to 43 degrees centigrade. (Standard 25.8)The rooms of service users that have a diagnosis of dementia to be prioritised. It is recognised that some work has been completed. Timescale for action 31/03/06 Clairmont Residential Home DS0000028864.V267201.R01.S.doc Version 5.0 Page 23 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 2 3 Refer to Standard OP9 OP36 OP18 Good Practice Recommendations It is recommended that accredited medication training be provided. It is recommended that supervision be more structured. It is recommended that all staff undertake training in Adult Protection Clairmont Residential Home DS0000028864.V267201.R01.S.doc Version 5.0 Page 24 Commission for Social Care Inspection Maidstone Local Office The Oast Hermitage Court Hermitage Lane Maidstone ME16 9NT National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. 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