Inspection on 30/08/05 for Clare House Nursing Home

This inspection was carried out on 30th August 2005.

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

Clare House Nursing Home 30/08/07

Clare House Nursing Home 24/07/06

Clare House Nursing Home 12/12/05

Clare House Nursing Home 06/09/04

Clare House Nursing Home 22/04/04

Similar services:

The Shelley

Thorndene

Springfield House

Sutton Lodge Nursing Home

St Helier`s Residential Hotel

St Joseph`s

Ridgemount

Wingham Court

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

CARE HOMES FOR OLDER PEOPLE Clare House Nursing Home 36 Hersham Road, Walton On Thames, Surrey, KT12 1JJ Lead Inspector Fiona Cole Unannounced 30 August 2005 10:00 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 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. Clare House Nursing Home H58 s17598 Clare House v217341 300805 stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Clare House Nursing Home Address 36 Hersham Road, Walton On Thames, Surrey, KT12 1JJ Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) 01932 224881 BUPA Care Homes Limited Patsy Ann Maxwell CRH Care Home 32 Category(ies) of PD(E) Physical dis - over 65, 32 registration, with number of places Clare House Nursing Home H58 s17598 Clare House v217341 300805 stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: 1 32 beds providing nursing care for elderly people from the age of 60 years. 2 Up to 3 beds may be used for physically disabled people from the age of 50 years. 3 2 places for elderly day care (E). Date of last inspection 6-September-2004 Brief Description of the Service: Clare House is an attractive Tudor style home situated in the residential area of Walton-On-Thames. It enjoys the benefit of a pretty secluded garden, which is accessible to all residents. There are three sitting rooms, a conservatory and a large dining room all of which which have a homely atmosphere. An activities centre caters for a offers a variety of interests, and personal hobbies are encouraged. The home is owned by BUPA who are the registered providers. The home offers nursing care to 32 older people. Clare House Nursing Home H58 s17598 Clare House v217341 300805 stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection was the first of the year 2005/2006 and was unannounced which means the staff and residents were not aware of the inspector visiting on the day. The home was being run in an organised manner when the inspector arrived in the morning. Several residents were up and about in various areas of the home and many were receiving personal care to get ready for the day. It was pleasant to be able to meet many residents either in their bedrooms or in the lounges. The inspector was able to speak with several residents and staff and also look at records. There were sufficient staff seen attending to the residents, and all spoken to were very happy living at Clare house and very complimentary about the staff in particular the manager. The interactions between the residents and the staff were very polite and residents were observed to be treated with dignity and respect. The home was well maintained and clean, and the garden attractive with colourful flowers and two gazebos. The inspector wishes to thank all those who have contributed to this report, And every effort has been made for their views to be reflected. What the service does well: The residents are encouraged to form friendships, and meet in the lounges to spend time with each other and their relatives. One resident showed concern for another fellow resident being unwell, and summoned a member of staff for assistance. The food was the favourite topic of conversation as one resident stated “Its like living in a hotel, the food is exquisite, the staff very helpful and I don’t have a care in the world”. Clare House Nursing Home H58 s17598 Clare House v217341 300805 stage 4.doc Version 1.40 Page 6 Another resident said since the engagement of the new manager the home has much improved and the staff all seem settled and happy in their work. The manager operates an open door policy, to both residents and staff, and seen as being a helpful way of managing events, and limiting any problems arising, as they are dealt with immediately. The standard of décor and maintenance were of a high standard and had a homely feel. The furnishings are tasteful and the home has recently had new carpets in the lobby, hall, office and lounge areas. The registered nurse that showed the inspector around, spoke highly of the manager, and stated that her well organised induction programme with the manager helped her settle in to her new job with ease. What has improved since the last inspection? What they could do better: Clare House Nursing Home H58 s17598 Clare House v217341 300805 stage 4.doc Version 1.40 Page 7 Medication records must be accurate at all times and start and end dates on medication bottles recorded and signed by a registered member of staff. 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. Clare House Nursing Home H58 s17598 Clare House v217341 300805 stage 4.doc Version 1.40 Page 8 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 Standards Statutory Requirements Identified During the Inspection Clare House Nursing Home H58 s17598 Clare House v217341 300805 stage 4.doc Version 1.40 Page 9 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 standard(s) 3,4,5. The home has good policies and procedures in place to welcome residents in an organised manner to the home. Residents receive a full and thorough assessment of their needs before they are offered a place. Relatives and/or friends are also involved in the assessment process. EVIDENCE: The inspector looked at records for residents newly admitted. There were plenty of care notes relating to the assessments of needs from hospital staff and community health care staff (district nurses doctors etc.) These notes included how mobile the resident was, any special diets,(likes and dislikes) medication, discharge summary from hospital, and any family involvement. A care plan was then written following the information gathered at the assessments. There are brochures and service users’ guides that are offered to the new residents when the manager visits them in hospital or in their own homes. A photograph album is available to all residents showing pictures of the staff Clare House Nursing Home H58 s17598 Clare House v217341 300805 stage 4.doc Version 1.40 Page 10 members and if any person is unable to visit the home, this can be taken to them. If a prospective resident is unable to visit the home then the family are invited to visit instead so they can feedback their experience and observations to the resident. The rooms are viewed during visits and any personal items that the resident wishes to bring are then considered. The inspector saw several personal items in residents’ bedrooms, during this inspection indicating that this practice was actively encouraged. Clare House Nursing Home H58 s17598 Clare House v217341 300805 stage 4.doc Version 1.40 Page 11 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 standard(s) 7,8. All residents have a comprehensive care plan detailing all their areas of need. The risk assessments also include risks of aspiration. Residents are also in receipt of care from community professionals too. EVIDENCE: Care plans for 3 residents were inspected. All 3 contained very detailed plans of care for each resident. The written information about each assessed need, contained realistic goals. The care plans are updated every month. Also present were all the risk assessments, on pressure sores, falls, and moving and handling. The residents had signed their plans and had taken an active part in the process. Two residents mentioned this information unprompted to the inspector, when they were talking about life at Clare House. The inspector discussed the care plans with one of the registered nurses and the manager and it was evident that they both were very aware of their contents, demonstrating sound knowledge of the residents needs Clare House Nursing Home H58 s17598 Clare House v217341 300805 stage 4.doc Version 1.40 Page 12 Residents are also able to access community health professionals; such as doctors, district nurses, chiropodist, dentist opticians and records are kept of each visit. Clare House Nursing Home H58 s17598 Clare House v217341 300805 stage 4.doc Version 1.40 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12.13,15. Links with the community and with relatives and friends are good. appetising Nutritious food is provided at all times. EVIDENCE: The home assists residents in arranging transport to access the local community. Residents are able to have visitors at any time in private. Communal areas are utilised by residents to entertain their visitors, In one of the three lounges or in the garden areas (weather permitting). Alternatively they can use their own rooms if they require more privacy. Residents are generally unable to manage their own financial affairs in this home; as a consequence relatives and advocates usually manage these, which was seen to be the most appropriate process. Mealtimes were seen by the inspector to be satisfactory and unhurried occasions. During the inspection residents were observed enjoying their midday meal, which was seen to be of high quality and presentation. Clare House Nursing Home H58 s17598 Clare House v217341 300805 stage 4.doc Version 1.40 Page 14 There is always a choice of menu at lunchtime and suppertime and both meals are sufficient in quantity and appearance. The home employs an activities organiser part time and an assistant giving almost full time hours for planned activities. The examples given by residents were “aromatherapy” “seniorexercise” and having musicians coming to the home and play. Feedback obtained from residents said that the hairdresser and the vicar visit regularly, and the home encourages the celebration of birthdays and offers a cake on these occasions. Clare House Nursing Home H58 s17598 Clare House v217341 300805 stage 4.doc Version 1.40 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 inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 16.17.18. Residents are well protected by the companies training policies and procedures with regard to the protection of vulnerable adults. Staff receive training in handling complaints, and this is widely encouraged. EVIDENCE: There have been three complaints since the last inspection. The manager is still investigating these with the assistance of others and will notify CSCI of the outcome in writing as soon as the investigations are concluded. Residents are encouraged to talk to staff and relatives also can talk to the manager or nurse in charge. All residents have a white board in their rooms where they are at liberty to write any complaints. Staff check these on a daily basis. The complaints procedure is easy to follow with clear instructions about who will investigate the complaint right up to senior BUPA level. One resident told the inspector that she was always able to talk to the manager at anytime and thought very highly of her. The home uses the local policy and procedures for managing complaints regarding abuse. All staff have received training in these procedures. The manager holds regular staff meetings and operates an “open-door” policy whereby; staff or residents are able to speak with her if they are experiencing any problems. Clare House Nursing Home H58 s17598 Clare House v217341 300805 stage 4.doc Version 1.40 Page 16 Clare House Nursing Home H58 s17598 Clare House v217341 300805 stage 4.doc Version 1.40 Page 17 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 standard(s) 19 20 21 23 24 25 26 Residents are provided with a high standard of living accommodation. The home remains in very good decorative order and was clean and hygienic. The gardens were exceptionally beautiful with an abundance of brightly coloured flowers and shrubs all well tended. EVIDENCE: The location of the home is suitable for its stated purpose; it is accessible, safe and very well maintained, meeting resident’s individual and collective needs in a comfortable and homely way. Standards of cleanliness and hygiene were high throughout the home and no malodours were evident. The homes communal areas are spacious and are decorated and furnished to a very good standard. No safety hazards were identified within the communal or private space areas. Clare House Nursing Home H58 s17598 Clare House v217341 300805 stage 4.doc Version 1.40 Page 18 Toilet and bathing facilities were equally of a good standard and afforded adequate privacy for all residents. Resident’s rooms are decorated and furnished with good quality furniture and have been personalised by the residents themselves. There is a maintenance man employed for the general daily repairs. There is a good number of dedicated staff employed to clean the home. Clare House Nursing Home H58 s17598 Clare House v217341 300805 stage 4.doc Version 1.40 Page 19 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 considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27 28 29 30 The home employs sufficient staff to run the rota in a manner that allows over the quota on each shift. The administrator manages the reception area and telephone calls, and clearly is efficient and experienced at her job. Staff are given training in many areas and several more staff have been nominated to attend college for NVQ Levels 2 and 3. The home was until recently in line with 50 NVQ qualified; unfortunately as staff have left the numbers have fallen. The manager is fully aware of this and attempting to access more places for staff NVQ’s as appropriate. EVIDENCE: The home does offer a wide range of training, which the staff spoken with appreciated and welcomed. Examples of training covered (as evidenced in the personal training logs and when talking to staff on the day) included: manual handling, basic food hygiene, protection of vulnerable adults, communications equal opportunities, confidentiality infection control and other areas of basic nursing care practices. There are arrangements in place for all staff have regular access to training and a commitment from the organisation to provide staff with NVQ training. Staff are able to work on a one to one basis with residents, and the residents enjoy the personal attention they receive, and appreciate this, as mentioned to the inspector when speaking with individuals. Clare House Nursing Home H58 s17598 Clare House v217341 300805 stage 4.doc Version 1.40 Page 20 The manager is involved in all aspects of recruitment and equally importantly staff induction programmes. Clare House Nursing Home H58 s17598 Clare House v217341 300805 stage 4.doc Version 1.40 Page 21 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 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31 32 33 36 37 38. There is good leadership and consistent direction to staff in this home to ensure the residents receive consistent quality care. The manager is fully aware of the residents needs and as such is able to communicate this through to the staff group. The manager has a good staff team and works well with meeting her responsibilities. The home has relevant health and safety procedures and staff are given training in all aspects of health and safety, to protect the residents and themselves. EVIDENCE: The manager is a qualified nurse and has a wealth of experience, that enables her to maintain high standards and excellent management skills. Clare House Nursing Home H58 s17598 Clare House v217341 300805 stage 4.doc Version 1.40 Page 22 The manager was appointed in June 2004 and has been registered with CSCI for almost a year. She is studying for her Registered Managers Award currently. The following records were examined during this inspection: Residents care plans, resident’s medication records, the staff rota and menus. All of these were in good order. Staff were noted to receive training in matters of health and safety and ample information was available to advise staff on safe practice, including lifting and handling of corrosive materials. No health and safety issues were reported to the inspector. Clare House Nursing Home H58 s17598 Clare House v217341 300805 stage 4.doc Version 1.40 Page 23 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score N/A N/A 3 N/A 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 2 10 3 11 N/A DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION 3 3 3 3 3 3 3 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 3 3 3 3 3 N/A N/A 3 3 3 Clare House Nursing Home H58 s17598 Clare House v217341 300805 stage 4.doc Version 1.40 Page 24 No Are there any outstanding requirements from the last inspection? 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. 1. Standard YA9 Regulation 13(2) Requirement Medication records must be monitored to ensure that profiles correlate. Timescale for action Immediate. 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 Good Practice Recommendations Clare House Nursing Home H58 s17598 Clare House v217341 300805 stage 4.doc Version 1.40 Page 25 Commission for Social Care Inspection The Wharf Abbey Mill Business Park Eashing Surrey GU7 2QN 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. Extracts may not be used or reproduced without the express permission of CSCI Clare House Nursing Home H58 s17598 Clare House v217341 300805 stage 4.doc Version 1.40 Page 26 - 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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