Inspection on 03/03/09 for Clann House Residential Home

This inspection was carried out on 3rd March 2009.

CSCI found this care home to be providing an Adequate service.

The inspector found there to be outstanding requirements from the previous inspection report. These are things the inspector asked to be changed, but found they had not done. The inspector also made 1 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Clann House Residential Home 30/09/08

Clann House Residential Home 06/05/08

Clann House Residential Home 30/05/07

Similar services:

Fairfields Country Rest Home

Poldhu

Queensmount

Trevaylor Manor

Didsbury Court Rest Home

Stallcombe House

Belma

Hunters Care Centre

Extracts from inspection reports are licensed from CQC, this page was updated on 19/06/2009.

Inspecting for better lives Key inspection report Care homes for older people Name: Address: Clann House Residential Home Clann House Residential Home Clann Lane Lanivet Cornwall PL30 5HD     The quality rating for this care home is:   one star adequate service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Alan Pitts     Date: 0 3 0 3 2 0 0 9 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. 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. 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 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 Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Older People Page 2 of 28 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). 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 CSCI copyright, with the title and date of publication of the document specified. www.csci.org.uk Internet address Care Homes for Older People Page 3 of 28 Information about the care home Name of care home: Address: Clann House Residential Home Clann Lane Clann House Residential Home Lanivet Cornwall PL30 5HD 01208831305 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Conditions of registration: Category(ies) : julie.frape@btconnect.com John Reid Clarkson,Susan Ann Clarkson care home 34 Number of places (if applicable): Under 65 Over 65 0 0 3 dementia mental disorder, excluding learning disability or dementia old age, not falling within any other category Additional conditions: 34 3 0 The maximum number of service users who can be accommodated is 34. The registered person may provide the following category of service only: Care home providing personal care only- Code PC to service users of either gender whose primary care needs on admission to the home are within the following categories: Old age, not falling within any other category- Code OP- maximum 3 places Dementia- Code DEmaximum 34 places Mental disorder, excluding learning disability or dementia- Code MD- maximum 3 places Date of last inspection Brief description of the care home Clann House is situated in three acres of land and gardens, in a quiet rural setting a short distance from the village of Lanivet, near Bodmin. The home is registered to provide accommodation and personal care for up to twenty six older people with a Care Homes for Older People Page 4 of 28 3 0 0 9 2 0 0 8 Brief description of the care home dementia; it is also registered to care for named residents with mental healthcare needs (3), old age (3) and one resident with a learning disability over 65 years. The adapted farmhouse offers comfortable accommodation, with level access around most of the ground floor. The bedrooms offer views of the surrounding countryside. The home offers accommodation on both the ground and first floor, with stair lift provision for those who require it. An extension has been added to the home providing eleven en-suite bedrooms. Communal rooms comprise of three lounges, and a dining room. The dining room comfortably accommodates the residents. There is a central safe courtyard garden. The home has its own car parking with space for approximately 5 to 7 cars. A further extension has been built on to the side of the premises, and provides accommodation for a further 8 people. The accommodation in this new extension is not level access and is suited to people who are more mobile and more self sufficient. Information about the home (Statement of Purpose and Service User Guide) is available from the office, and information is provided in each bedroom. The fees for the home are between 410 and 525 pounds per week; this does not include toiletries, chiropody, hairdressing, clothing or other personal items. Use of the vehicle is charged at 40p per mile. Care Homes for Older People Page 5 of 28 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: one star adequate 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 unannounced inspection took place over approximately 12 hours over two days. Two inspectors, an expert by experience and a pharmacist inspector assisted. We looked at documentation, toured the premises, met with residents and staff, and discussed our findings with the area manager and proposed manager of the home. We also received three surveys completed by staff and six surveys completed by people that live there. Overall, the home has improved significantly since the last inspection. However staffing levels have hindered the continuing improvements, and this is reflected in the overall rating of the home. We were made aware of lots of plans for improvements that had yet to materialize at the time of the inspection. The impression of all assisting with the Care Homes for Older People Page 6 of 28 inspection is best summarized by the words of the expert by experience definitely a home on the up. 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 set out on page 4. The report of this inspection is available from our website www.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 240 7535. Care Homes for Older People Page 8 of 28 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 9 of 28 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. Prospective residents and/or their representatives are provided with comprehensive information to enable them to make an informed choice of home. Residents have their needs assessed prior to moving into the home. This is so that the home can assure them the prospective resident that they are able to meet their individual care needs. Evidence: Copies of the Statement of Purpose and Service User Guide (documents that tell a person about the home) are kept in each of the bedrooms, and are given to prospective people as part of their welcome pack. This pack also includes the Complaints Procedure. The Statement of Purpose and Service User Guide were last reviewed in July 2008. As part of this inspection we looked at the assessments that were carried out prior to a person moving to Clann House. The care documentation of the person most recently Care Homes for Older People Page 10 of 28 Evidence: admitted to the home showed that a proper pre-admission assessment had take place. The area manager planned on carrying out another pre-admission assessment on the day of the inspection. The home does not provide intermediate care, though respite care is offered. Care Homes for Older People Page 11 of 28 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. Many of the people who live at Clann House feel that they are offered a good standard of care. Each resident has a care plan. This is written in plain language, and is easy to understand. Care plans do not provide sufficient direction to care staff. The care records also includes relevant risk assessments. The aims and objectives of the home reinforce the importance of treating residents with respect and dignity. Evidence: Comments received from the people who live at Clann House were very positive, and included: Ive been in a few homes and this is the best, if I have to be in a home this is where I want to be, this is a Flagship in the community, I would recommend this home to my friends, we are lucky to be here, this is a grand place to live and I recommended this home to friends for their relative who stayed here until she died. In talking to the people that live at Clann House we found that call bell response time was said to be within 3 to 4 minutes or less with the attitude of the responding carer to be completely caring, helpful and concerned. Care Homes for Older People Page 12 of 28 Evidence: Many of the people at Clann House have dementia or mental health needs and are not able to always explain their needs or difficulties. It is therefore important that there are written care plans that detail how needs are to be met to ensure that staff know the nature of the care they are to provide. We inspected four care plans. After some initial confusion over what constituted the plan of care it was clear that generally the information people need is provided. However, there are instances were insufficient direction is given to staff (e.g. when a resident is reluctant to accept assistance). There is incomplete information on likes and dislikes and the care plans did not include a social care plan. There needs to be more clarity about the care needed by the individual (e.g. all the residents have a fluid balance chart, but only one or two actually need one, and the entries should clearly show the amounts not just the type of intake). Care should be taken to ensure the care plans detail the residents holistic care and support needs, including promotion of feelings of well being, with evidence of a regular review including maintenance of strengths and abilities. Care plans should also detail the non-pharmacological means used to modify behaviour. We were advised that the home has only recently relaunched the use of the key worker system so reviews of care plans have not been taking place as regularly as they would like. The daily entries use a form that is useful as an aide memoire to staff regarding what they should include in their entries, but in practice limits the amount of information provided by staff. In the case of social activities often not completed at all. The staff station that was used as a second office is still used for storage of care plans, but could not be comfortably used as an office area as it was full of wheelchairs (without footplates attached), a hoover, and other items (including laundry chemicals). Confidential information is also on open display in this area for anyone passing to see. The purpose and future use of this area was discussed with the area manager and deputy manager. Staff sit in the dining area to write their daily entries in the care notes. This area has significant distractions and is also away from where the care plans are stored. The care plans should inform the care given, but these are currently kept separate from the daily notes. Supporting documentation showed that clients have access to relevant professional health care agencies as needed. All the people that live at Clann House are registered with a local GP surgery. Clients preferred names are recorded and used. Clients have access to a telephone for private use. Rooms have been fitted with locks allowing the individual to lock their room whilst ensuring staff access in an emergency. Care Homes for Older People Page 13 of 28 Evidence: We found that medicines were stored securely in locked cupboards and access to the keys was restricted to those people who had received training to administer the medicines. However one of the cupboards was not fixed to the wall in accordance with current regulations. This was being remedied on the second day of the inspection on the 3rd March. We found that when people are prescribed medicines with variable doses that the dose actually given is recorded. Also when people are prescribed medicines to be administered when required there are some records to show how and why the decision to administer has been taken and for other people the staff working at the home were able to tell us clearly how the decision would be taken. We found that where appropriate peole are encouraged to look after their own medicines, but there is no system in place to monitor how these medicines are used as the supply of them had not been recorded. We found that for one person prescribed a nutritional supplement that the records did not show when this had been administered. On looking at this persons care plan it was not clear how frequently these should be given but it does record that their appetite is poor. We also found that not all receipts of medicines received during the month had been recorded meaning that it was not possible to audit if these medicines had been administered correctly. We also found that the dose interval for some medicines containing Paracetamol had been recorded as less than the 4 hours recommended by the manufacturers and other reference sources. This may place people at risk if this happens over a long period. Care Homes for Older People Page 14 of 28 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The records do not fully reflect the social/recreational activities available, nor is there sufficient staff to provide in this area, and improvements are needed. Visitors are welcomed to the home at anytime. Choice is not always shown to be available to residents. Evidence: There is an activity record that identifies the activity and the participants, but offers no information as to whether people enjoyed the event, or not. This record shows that there was one activity provided in January and one in February. We were advised that more is offered, but there was little evidence to support this and the staffing levels are insufficient to offer and provide consistent attention to this important part of peoples lives. The daily entries in the care documentation do not provide information about how the resident spent their day. There is no evidence that the people not listed as participating were given the opportunity to do so. The level of activities was identified as an area of concern in staff comments. Several people are fit and active and able to walk to the nearby village. One resident attends a day centre and also an evening activity in a local school on a weekly basis. Care Homes for Older People Page 15 of 28 Evidence: People appreciated the trips out to local attractions in the homes vehicle and are looking forward to more when the weather improves. There is no appointed Activities Organiser. People did recall the monthly service (including Holy Communion provided by the local vicar), the occasional visiting entertainers, short mat bowls, painting, and keep fit classes. The impression is that there is room for improving the activity opportunities including one to one engagement. The visitors book and comments from residents confirm that contact with loved ones and friends is encouraged. The benefits of the daily entries providing a pen portrait of residents life styles (including times of waking and retiring) was discussed. The current forms used for daily entries limit the amount of information that can be provided. Rooms are personalised with plenty of evidence of personal possessions being brought in. The home maintains a personal property record to reflect this. All the residents spoken with were satisfied that they chose the time of going to bed and getting up, one adding, it is fairly regular so the staff know what I like. The days menu is displayed on the wall of the dining room, and shows that an alternative main meal is available at lunch. There was no indication of an alternative being available at other meals. It is not clear how people are enabled to make a choice as there is no evidence of them being asked. The 3-week rolling menu was written on a loose leaf torn out page, and was dated 2nd to 22nd (no month indicated). There is no record of food provided and choices made. Lunch was seen to be attractively presented and hot when served. Everyone spoken with was satisfied with the food saying: food is lovely, cant fault food and the way it is presented, adequate, I am satisfied, I can recommend the food, I am a vegetarian and get a very good variety of things, I am happy with the food and I get enough, very pleased with the food, and food pretty good on the whole. People were of the opinion that the meals were better when the full time chef was on duty. On the day of the visit the part-time cook had not been satisfied with the meat intended for the cottage pie shown on the menu and had prepared a substitute meal of cold ham, fried egg and chips. Most people cleared their plate, but one diner complained about the chips. Dessert was Black Forest Gateau or tinned fruit with ice cream. Water, blackcurrant, or an orange drink was available. The latter was nigh well tasteless. The chef was said to be aware of peoples preferences and dislikes. Where diners needed assistance with lunch the carer engaged with them and knelt or sat beside them. Care Homes for Older People Page 16 of 28 Evidence: Residents said that a full range of items including cooked food is available for breakfast, but this is not evident from the menu. Tea consists of a variety of sandwiches and perhaps something on toast. Service users were of the opinion that evening snacks were available although none had been sought. One person commented, they wouldnt send you to bed on an empty stomach. No one could recall being asked for their personal favourite item of food, but one said that food had come up at a recent Residents Meeting and the chef had taken notes. Some people choose to take their meals in their bedrooms. Provision is made for people who prefer to have the main meal in the evening and those returning late from trips out. Care Homes for Older People Page 17 of 28 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. The people at Clann House are confident that their concerns will be listened to and acted upon. The people that live at Clann House are protected from abuse by appropriate procedures and ongoing staff training. Evidence: There is an easy read complaints procedure displayed in the entrance to the home. A copy of the complaints procedure is available in each bedroom. Comments from the people that live at Clann House confirmed that they had confidence in the staff and area manager, and knew how to complain. One of the responsibilities a care home has is to protect people from abuse, and the Commission expects homes to be proactive in this matter. There is ongoing safeguarding training taking place, which the area manager said would continue until all staff had received this training. We were advised that the area manager and deputy manager were booked to attend Deprivation of Liberties training later this month. Safeguarding is included as a topic at team meetings. People are protected by the homes adherence to a robust employment procedure. Care Homes for Older People Page 18 of 28 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. The people who live at Clann House benefit from accommodation that for the most part has been designed to meet their needs. The accommodation is clean and odour free. Evidence: There have been no significant changes to the environment since the last inspection that we were advised about. We looked around the home and the rooms seen were all clean and in good order, there were no unpleasant odours. Some of the people had brought items of their own in to decorate their rooms. All of the rooms are of a good size and many have ensuite bathrooms or showers. The most recent extension to the home can provide accommodation for a further eight people. These rooms are down a corridor where there is a door with a keypad; there are a few steps even for rooms on the ground floor. The area manager is aware of the type of people who could be accommodated in these rooms. People who needed more care and support live in other parts of the home. There is a central courtyard around which there are bedrooms the dining room and Care Homes for Older People Page 19 of 28 Evidence: lounge. This means that people are free to wander freely in the rooms and corridors that surround the courtyard, or use the courtyard itself. This part of the home provides for people who may have dementia or memory problems to walk safely and not to be enclosed. The garden area to the side of the house would benefit from further planting and seating facilities. Bedroom door locks have been fitted to provide a facility for residents to lock their doors, whilst allowing staff overriding access in case of emergency. The staff have a master key for all the doors. The main building has been completely rewired in the last 12 months. The kitchen and laundry areas were not inspected at this time though the former was seen to be clean and organised. Care Homes for Older People Page 20 of 28 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The numbers of staff on duty are not sufficient for all care needs or the efficient management of the service. The recruitment procedures are robust to safeguard residents. Training is encouraged and facilitated, but has not progressed since the last inspection. Evidence: Information provided by the Home shows that nine (9) of twenty six (26) care staff have a National Vocational Qualification Level II or above. A new training manager has been appointed by the registered providers, and a training matrix is being implemented so that staff training needs can be better monitored, but this was not in place at the time of the inspection. We were also told this at the previous inspection. New staff undertake a National Training Organisation compliant induction programme. There have been significant staff changes over the last 12 months, which inevitably causes some disruption to staff and managerial systems. There is an area manager assisted by the deputy manager, but the position of registered manager is vacant at the moment. The duty rota and discussion with staff confirms that at the time of the inspection there were 27 people living at Clann House and routinely 4 staff on duty during the day. A resident was seen to need the input of two care staff during the Care Homes for Older People Page 21 of 28 Evidence: inspection, and this clearly has implications for the numbers of staff left available for the other 26 residents. We also received comments from staff and residents about the home being short-staffed. The managers have also been limited in the time available to them for managerial duties as the staff numbers has meant that they have regularly had to work on the floor instead of focusing on management and the homes continuing improvement. Staff comments and records show that the lifestyle of the residents is not being afforded the importance it should with existing staff numbers. The home will benefit and improve further from increased staffing numbers. Examination of personnel files showed that the home is adhering to a robust employment procedure. They have acknowledged the need for assessing the risk if a CRB disclosure includes convictions. Gaps in employment history were discussed and need to be investigated. All encounters seen and heard between staff and residents were appropriate with staff addressing people by their preferred name. Staff were heard to be respectful when talking with service users and seen to be gentle when directing and assisting them. Staff were seen and heard to knock on doors before entering bedrooms. Except for the more recent arrivals, residents were aware there had been considerable changes in both management and staff over the past year saying, all the changes were for the better, new staff have settled in well, staff do not lose their tempers now, and past problems are all sorted. Other comments about the current staff included, I get on fine with the staff, they treat me like a human being, the staff are established now and know what they are doing, they work hard, enough staff now, staff are great, no problems, staff are wonderful, they have a lot to put up with, staff are lovely people, staff very nice to me, and staff alright, they treat me well. Call bell response time was said to be within 3 to 4 minutes or less with the attitude of the responding carer to be completely caring, helpful and concerned. Some residents made comment about the lack of male care staff. Care Homes for Older People Page 22 of 28 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The manager has yet to register with CSCI therefore the legal responsibilities are with the registered provider at this time. The residents will benefit from the appointment of a registered manager. Evidence: The home is managed on a day-to-day basis by the area manager and the homes deputy manager. However, as has already been mentioned their management roles have been compromised by the need to make up staff numbers. Subsequent to the inspection the deputy manager has been appointed as the manager. The appointment of a registered manager is an outstanding requirement from the previous inspection, but the Commission has been advised by the area manager that an application for Registered Manager will be submitted shortly. There are team and resident meetings, but no formal quality assurance system in Care Homes for Older People Page 23 of 28 Evidence: place to ascertain the views of those that use the service and other stakeholders. Financial records were seen to be well recorded and accurate. Financial records are supported by receipts. The home has no involvement in the management of individuals finances, though will look after small amounts of money if requested to do so. Staff supervision has lapsed since the last inspection. We were advised that this was due to a lack of management time available. The premises and equipment within are regularly maintained and checked. There is appropriate insurance in place. Care Homes for Older People Page 24 of 28 Are there any outstanding requirements from the last inspection? Yes R No £ 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 1 31 8 The registered providers must appoint a registered manager. The people that live at Clann House and the staff will benefit from a clear sense of direction and leadership. 01/02/2009 Care Homes for Older People Page 25 of 28 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 1 9 13 Arrangements must be made to ensure that medicines containing Paracetamol are not administered at less than four hourly intervals. This is to prevent the risk of toxicity if administered at shorter intervals. 30/04/2009 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 1 7 The registered provider should ensure that care plans provide for all aspects of client care needs, and give clear direction to staff as to the nature of the intervention needed. The registered provider should ensure that care plans are reviewed at least monthly, with the involvement of the resident where possible. It is recommended that the way the use of nutritional supplements is care planned and recorded be reviewed to improve the nutrional state of the person receiving them The registered provider should ensure that daily records provide a pen portrait of the residents lifestyle, including Page 26 of 28 2 9 3 12 Care Homes for Older People social recreational activities. Records should indicate if an activity was offered and refused, the level of participation, and whether enjoyed or not. 4 12 The registered provider should do more to ensure regular and frequent activities are available and offered to residents. The registered provider should show how people are enabled to make meaningful choices (e.g. meals). The registered providers should do more to ascertain the views of people that use the service and other stakeholders, publishing a summary of the feedback received and any action taken as a result. The registered providers should ensure that staff receive regular and frequent supervision and a record should be kept to demonstrate this. 5 6 15 33 7 36 Care Homes for Older People Page 27 of 28 Helpline: 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 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) Commission for Social Care Inspection (CSCI). 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 CSCI copyright, with the title and date of publication of the document specified. 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