Inspection on 23/01/07 for Clairmont Residential Home

This inspection was carried out on 23rd January 2007.

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 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

Clairmont Residential Home 14/10/08

Clairmont Residential Home 12/01/06

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 Key Unannounced Inspection 23rd January 2007 09:30 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.V326405.R01.S.doc Version 5.2 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.V326405.R01.S.doc Version 5.2 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.V326405.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 12th January 2006 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.V326405.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was a key unannounced inspection that took place on 23rd January 2007. The key inspections for care home services are part of the new methodology for The Commission For Social Care Inspection, whereby the home provides information through a questionnaire process and further feedback is gained through surveys sent to service users and relatives and information provided from professionals associated with the home, wherever possible. The actual date of the site visit is unannounced. At the site visit, service users and staff were spoken to, records were viewed and a tour of the environment was undertaken. Some judgements have been made through observation only. Overall this was a positive inspection with good outcomes for service users. The home’s fees are from £415 to £425 per week. What the service does well: What has improved since the last inspection? The home’s lounges, dinning room and lower hallway have been decorated and have new carpets fitted. The hallway upstairs, some bedrooms and the bathroom have also had new carpets fitted. The manager has recently been interviewed by the Commission and the process of her registration is being completed. Clairmont Residential Home DS0000028864.V326405.R01.S.doc Version 5.2 Page 6 Staff have received training on the Safe Administration of Medication and Adult Abuse as recommended in the last report. 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. The summary of this inspection report can be made available in other formats on request. Clairmont Residential Home DS0000028864.V326405.R01.S.doc Version 5.2 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.V326405.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 2, 3, 4, 5 and 6 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Prospective residents are currently not provided with up to date written information they need to make an informed choice about moving into the home since the home’s Statement of Purpose and Service User Guide need to be updated. 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 needs to be updated to reflect the change of registration to dementia care. It is strongly advised that the Registered Provider follows the guidance given in Schedule One of the Care Standards Act Clairmont Residential Home DS0000028864.V326405.R01.S.doc Version 5.2 Page 9 2001. The new Statement of Purpose also needs to reflect the change in the staffing structure and personnel. There seemed some confusion as to whether the home had a separate Service User Guide. With that in mind it will be a requirement to update both documents and provide the Commission with completed copies. 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. Discussion with the owner and newly Registered 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. However the home is advised that formal assessments from Care Managers should be obtained prior to admission. The home offered specialist dementia care and had 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 and their families were encouraged to visit prior to admission and moved 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.V326405.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 and 10 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents benefit from having clear care plans that identify their individual needs and give clear guidance to staff Service users can be confident that their care plans are regularly updated to ensure changes are recorded and acted upon. Residents can be confident that their health care needs will be met and that service users benefit from having full access to all professional health care services as required. Residents’ welfare is protected by the home’s policy and procedures with regard to the handling and administration of medication. Service users can be confident that the home handles the issue of illness and ageing sensitively. Clairmont Residential Home DS0000028864.V326405.R01.S.doc Version 5.2 Page 11 EVIDENCE: Several care plans were viewed and were seen to contain relevant information and provide the basis for the care to be delivered. These documents continue to be developed and some areas were discussed with the manager with some improvements suggested. Information from the commissions website was left with the manager regarding various aspects of personal care. The manager stated that although the home was registered for dementia care only one of the current residents was displaying any challenging behaviour. The staff was managing this care very well. All of the residents were registered with a local GP and had access to other professionals such as opticians and chiropodists ensuring health care needs were met. The home’s administration of medication was assessed and found to be of a high standard. All of the staff that administers any medication had completed a formal course in the Safe Administration of Medication at Bexley College. Following this course some minor changes had been made to the home’s medication policy. No errors were found in the relevant paperwork and boxed medication was audited and found to be correct. The home does have any controlled medication at this time. Should any resident require controlled medication in the future the home is advised to ensure it can store this medication safely. All staff signatures were recorded and photos for each resident were in place. The home had also worked hard to obtain written permission from G.P.s to administer homely remedies such as simple cough linctus. The owner may wish to consider if it is appropriate to house the home’s washing machine in the medical room. This raised two concerns, one was the temperature of the room, particularly in summer, and one was that the room was left unlocked. It must be stated that the medication cupboards were locked. The inspector is aware that this machine has always been used in the room and is not making a requirement but does recommend consideration be given in the medium to long term to moving the washing machine. The rooms temperature was monitored and appeared to read the maximum advised for most days. Staff practices seen on the day indicated that residents were well respected at all times and that preferred terms of address were used. Good interaction between staff and residents was observed. Several residents confirmed that the staff looked after them very well. Comments from some residents were ‘the home is always clean and the washing is well done and always returned’ and ‘staff are very good and do everything they can for me’. Clairmont Residential Home DS0000028864.V326405.R01.S.doc Version 5.2 Page 12 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 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.V326405.R01.S.doc Version 5.2 Page 13 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 and 15 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. 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 cares for people with varying degrees of dementia and lifestyles can be challenging for some. With the levels of dementia within the home it was not always easy to ensure full choices were given at all times, however staff were seen to offer choices where possible and where not possible gave full support and consideration. 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 Clairmont Residential Home DS0000028864.V326405.R01.S.doc Version 5.2 Page 14 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.V326405.R01.S.doc Version 5.2 Page 15 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. JUDGEMENT – we looked at outcomes for the following standard(s): 17,18 and 19 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. 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 complaints procedure in place that ensured residents and relative’s complaints were taken seriously and were acted upon with in a recognised timescale. After inspecting the home complaints file it was evident that the home had not received any complaints since the last inspection. 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 as recommended in the last report the majority if staff had completed a training course in Adult Protection. The remaining staff were due to be trained in the very near future. The owner stated that all residents were given the opportunity to vote and would be assisted to vote if desired. Postal votes could be arranged if required. Clairmont Residential Home DS0000028864.V326405.R01.S.doc Version 5.2 Page 16 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. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 20, 21, 24, 25 and 26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents benefit from living in a clean, safe, well-maintained environment and have safe access to comfortable indoor and outdoor communal areas. EVIDENCE: The home has completed extensive internal decoration in the past year with the lounge, dining room and downstairs hallway repainted. New carpets had also been fitted. On the day of the inspection carpets were being laid in the upstairs hallway, two bedrooms and the bathroom. All of the radiators were guarded and the hot water taps regulated by thermostatic valves. The inspector does acknowledge that a considerable amount of work has been completed for the benefit if the residents. New blinds were on order for the conservatory and were to be fitted soon. Clairmont Residential Home DS0000028864.V326405.R01.S.doc Version 5.2 Page 17 Residents had full access to indoor and outdoor rooms; the conservatory was used as the smoking room. The home had 5 toilets and 4 bathrooms and 1 en-suite room. Each bedroom had a hand basin. All of the rooms viewed appeared comfortable and were well personalised. Several residents said they liked their rooms. The shared rooms had privacy screening. The home was very clean and tidy, residents confirmed that the ‘home was always nice and clean’. Clairmont Residential Home DS0000028864.V326405.R01.S.doc Version 5.2 Page 18 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. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Systems are in place to ensure that 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 home employs thirteen care staff who work over a 24-hour rota. The proprietor also works between 32 and 48 hours per week as required. The rotas were viewed and indicated that the home was suitably staffed. Staff themselves stated they felt they had adequate staff and did not feel under pressure. Several residents confirmed they were well supported by staff, ‘There is always someone to help you’ and ‘staff look after me well’ were some of the comments made. Records seen during the inspection confirmed that staff were well trained and the home had a strong commitment to National Vocational Training. Mandatory training was also given a high priority. As recommended in the last report all staff that administered medication were now fully trained and again as recommended in the last report, all staff had either completed Adult Abuse training or were booked on a course due in February. Clairmont Residential Home DS0000028864.V326405.R01.S.doc Version 5.2 Page 19 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 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 recruitment procedures remained robust thus ensuring the safety of the residents. Clairmont Residential Home DS0000028864.V326405.R01.S.doc Version 5.2 Page 20 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. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 32, 33, 34, 35, 36, and 38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. 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. Clairmont Residential Home DS0000028864.V326405.R01.S.doc Version 5.2 Page 21 EVIDENCE: The manager had completed her Registered Managers Award and had recently undertaken an interview with the Commission to become the Registered Manager. This interview was successful and the registration process was being completed. The proprietor is still very much involved with the day-to-day running of the home and the management structures works well. 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. Evidence was seen that robust accounting procedures were in place that safeguarded residents’ monies. Staff supervision was again discussed and still remained slightly haphazard. Discussion took place regarding the differences between staff appraisals and supervision. Staff confirmed 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. It is advised that supervision is planned and recorded. Discussion took place regarding types of suitable supervision that could be offered. The home does have a basic quality assurance scheme running but this could improve as discussed at the last inspection. Sufficient maintenance and safety checks were in place to ensure the health, safety and welfare of residents and staff. It was advised to monitor water temperatures to ensure the new thermostatic valves on the sinks were working. Clairmont Residential Home DS0000028864.V326405.R01.S.doc Version 5.2 Page 22 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 2 3 3 3 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 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 3 3 3 X X 3 3 3 STAFFING Standard No Score 27 3 28 4 29 3 30 4 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 2 3 3 3 x 3 Clairmont Residential Home DS0000028864.V326405.R01.S.doc Version 5.2 Page 23 Are there any outstanding requirements from the last inspection? no 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 Home’s Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1 Standard OP1 Regulation 4 and Schedule 1 Requirement The registered provider must ensure the home’s statement of purpose and service user guide be updated and remain current. Timescale for action 28/02/07 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. Refer to Standard OP9 Good Practice Recommendations It is recommended that in the medium to long term planning consideration be given to moving the washing machine. It is recommended that supervision be more structured. It is recommended that a more robust quality assurance and quality monitoring system is introduced. 2. 3. OP36 OP33 Clairmont Residential Home DS0000028864.V326405.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Maidstone Local Office The Oast Hermitage Court Hermitage Lane Maidstone ME16 9NT National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 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. Extracts may not be used or reproduced without the express permission of CSCI Clairmont Residential Home DS0000028864.V326405.R01.S.doc Version 5.2 Page 25 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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