Inspection on 29/04/08 for Claremont Care Home

This inspection was carried out on 29th April 2008.

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

Similar services:

Springfield House

Sutton Lodge Nursing Home

The Shelley

St Helier`s Residential Hotel

St Joseph`s

Ridgemount

Wingham Court

Old Hastings House

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

CARE HOMES FOR OLDER PEOPLE Claremont Care Home 6 Lower Northdown Avenue Cliftonville Margate Kent CT9 2NJ Lead Inspector Wendy Mills Unannounced Inspection 29th April 2008 10:30 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 Claremont Care Home DS0000070398.V361994.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. Claremont Care Home DS0000070398.V361994.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Claremont Care Home Address 6 Lower Northdown Avenue Cliftonville Margate Kent CT9 2NJ 01843 225117 01843 220 333 claremontcarehome@btinternet.com 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) Hope Care Ltd Mr Promise Igbinedion Care Home 17 Category(ies) of Dementia (0), Old age, not falling within any registration, with number other category (0) of places Claremont Care Home DS0000070398.V361994.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The registered person may provide the following category/ies of service only: Care home only (PC) to service users of the following gender: Either Whose primary care needs on admission to the home are within the following categories: Old age, not falling within any other category (OP) Dementia (DE) The maximum number of service users to be accommodated is 17. 2. Date of last inspection N/A Brief Description of the Service: Claremont Care Home is a residential providing care and support home for up to seventeen older people, some of whom may have failing mental capacity. It was taken over by new owners in November 2007 and consequently it is a newly registered with the Commission for Social care Inspection (CSCI). Mr Promise Igbinedion is the registered manager and his company, Hope Care Ltd, is the registered provider. The property is an older detached house that was converted and extended to provide residential accommodation some years ago. It is situated in a residential area of Margate and is within easy walking distance of the main shopping area. The accommodation provides fifteen single bedrooms and one double bedroom that is currently being used as a single room. Many of the rooms have ensuite toilets and wash hand basins and there are specially adapted bathrooms. There is plenty of communal space with two lounges and a spacious dining area. Outside there are pleasant and enclosed gardens to the side and rear. To the front of the home there is a sweep round drive and limited off road parking. There are no restrictions to on street parking near the home. The weekly fees for this service range from £352 to £450. Claremont Care Home DS0000070398.V361994.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was the first inspection of the home since it was registered to new owners in November 2007. We did not tell anyone at the home that we were coming. The visit is called a “Key Unannounced Inspection” and forms part of the inspection process of the Commission for Social Care Inspection (CSCI) under the Regulations of the Care Standards Act 2000. This report has been compiled using information gained during this visit and information supplied prior to the visit from a variety of sources, including notifications of incidents, the views of relatives and health and social care professionals and the home’s Annual Quality Assurance Assessment (AQAA) that is required by the CSCI. The registered provider/manager, the deputy managers and the senior carer all assisted with the inspection. During the visit time was spent with residents and staff, talking to them both in private and informally. On the day of inspection there were fourteen residents in the home and it was possible to speak to all of them, either in their rooms or in the communal areas. In-depth discussion was held with the registered provider/manager, a health care professional was spoken to and later relatives were spoken to on the telephone. A tour of the home was made and documentation, including staff files and care plans, was examined. Direct and indirect observations were made throughout the visit. The home meets the National Minimum Standards. The residents and their relatives say that they are well cared for. They say they are able to make choices and that there is a good level of activities in the home. The residents, their relatives, staff at the home, the deputy managers and the manager are all thanked for the welcome they gave and their help throughout this visit. Relatives, advocates and health and social care professionals are thanked for the information they gave us. The overall outcome for users of this service is good. Claremont Care Home DS0000070398.V361994.R01.S.doc Version 5.2 Page 6 What the service does well: What has improved since the last inspection? 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. Claremont Care Home DS0000070398.V361994.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 Claremont Care Home DS0000070398.V361994.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&3 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. The home provides the residents, their relatives and supporters with the information they need to help them make a decision about their choice of home. Residents are properly assessed before a place at the home is offered. This ensures that only people whose needs can be met are cared for in the home. EVIDENCE: The home has a very comprehensive Statement of Purpose that clearly states the purpose of the home and gives good information about the organisational structure and the staff. Written contracts are in place. Claremont Care Home DS0000070398.V361994.R01.S.doc Version 5.2 Page 9 The home produces a quarterly newsletter. The April newsletter was on display in the hall with a written invitation to “Please take one”. The newsletter was well written, nicely illustrated with photographs and gave good information about what is going on in the home and what recent courses staff have attended. A sample of care plans was examined as well as the care plan for a new resident due to be admitted to the home on the afternoon of the inspection. The care plans have been reviewed and all contain good assessment of needs. There is a new and very comprehensive pre-admission assessment form. This means that staff have enough information to meet the needs of new residents coming into the home. Discussion with the registered manager showed that there is a thorough pre-admission assessment process. Relatives praised the home for the way it keeps them informed. They particularly mentioned the newsletter and social occasions. The home does not provide intermediate care. Claremont Care Home DS0000070398.V361994.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 & 10 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home promotes the health and well-being of the residents. EVIDENCE: Policies and procedures for the protection of the privacy and dignity of the residents are in place. Staff were observed to treat the residents with kindness and respect. The residents and their relatives said that the staff are always helpful, kind and caring. Care plans have been reviewed and contain life histories, choices and relatives comments. There is a written plan of support for each resident. Care plans are important documents. This is because they form one of the means by which the residents and their supporters can tell that they will receive their Claremont Care Home DS0000070398.V361994.R01.S.doc Version 5.2 Page 11 care in the manner of their choice. Also, the plans are a source of reference information for the care workers who need to ensure that they assist people in a consistent and appropriate manner. Three care plans were selected at random for detailed examination. They were noted to be well written and to identify needs and choices of the residents. The plans are reviewed regularly or when needs change. The new owners have worked hard to encourage residents, relatives and friends to become more involved in the home. They have established regular social occasions for residents, their families and staff. There are also more formal meetings for residents and their relatives to talk with the registered manager and staff. Relatives have been involved in care planning and some have written sections on past interests and likes and dislikes. A visiting health care professional said that, on the occasions she has visited the home the staff have always been helpful and ready to take advice. All residents are registered with local General Practitioners (GPs). The registered manager said he is working to build good relationships with local health and social care professionals. Staff said that GPs and District Nurses are very good about coming out when needed. Other health and social care professionals such as chiropodists and care managers visit as necessary. Staff said that, should a resident need to attend a hospital appointment, a member of staff is allocated to accompany them. Medication policies and procedures have been reviewed and the manager has met with the pharmacist to agree efficient processes for ordering and return of medicines. A monitored dose system is used in the home. This means that medicines are supplied in monthly blister packs with the dose already in place when it comes from the pharmacy. The pharmacy also provides labelling for the Medicines Administration Record (MAR). Medicines are stored safely and securely and the medication trolley is very neat and well organised. MAR charts were in order. It is sometimes necessary to start a course of medicine halfway through a month. When this happens, staff write the instructions on the MAR chart. It is important that when this occurs, the member of staff making the entry ensures that it is signed, countersigned and dated. Three members of staff have recently received training in the management and administration of medicines. Claremont Care Home DS0000070398.V361994.R01.S.doc Version 5.2 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14, & 15 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. The home promotes the independence and autonomy of the residents. EVIDENCE: One member of staff has recently been employed for two extra sessions each week so that she can organise activities for the residents. There are a variety of activities including group music and movement and art and craft sessions. There are also individual activities such as puzzles and crosswords. Several of the residents spoken to said that they liked to spend time in their rooms reading, listening to the radio or watching TV. Others said they like the company of other residents. Entertainers visit the home once a week and there is a visiting chaplain. A hairdresser visits the home fortnightly. Outings are planned for when the better weather arrives. Claremont Care Home DS0000070398.V361994.R01.S.doc Version 5.2 Page 13 At present there are no male residents or residents from ethnic or religious minorities in the home. However, the registered manager was an advisor on equality and diversity for a large NHS Trust prior to acquiring Claremont. He spoke knowledgeably about the diverse needs of people. Staff training in equality and diversity is due to take place within the next three months. The providers have introduced quarterly social occasions for residents, their family and friends and staff. Sometimes these are combined with a formal meeting to find out what the relatives and residents think of the service and to see if they have any ideas for improvements. The last social occasion was a cheese and wine evening to celebrate Easter. There is also a quarterly newsletter that tells the residents and their supporters what is going on. Food services at the home are good. The dining room has plenty of space and the tables are properly laid with linen tablecloths and napkins for mealtimes. Most residents said that they like to go to the dining room for lunch, as it is a social occasion. The cook said that there is plenty of fresh meat and vegetables and that menus are planned in conjunction with the providers. Meat and vegetables are purchased locally. Residents said that they enjoy their meals and that the food is “pretty good”. Special diets are catered for and there is good nutritional monitoring with monthly weighing, risk assessments and additional food supplements if necessary. Claremont Care Home DS0000070398.V361994.R01.S.doc Version 5.2 Page 14 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): 16 & 18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. There are sound policies and procedures the handling of complaints and the protection of residents. This means that the home listens to the concerns and comments of the residents, their supporters and staff and acts appropriately. EVIDENCE: There are sound, written policies for the handling of concerns, comments and complaints. We received one anonymous complaint. We asked the registered manager to look into the concerns expressed. He did so immediately and provided us with a satisfactory response within the timescales staffed in the policy. The elements of this complaint were also reviewed during this inspection. Staff have received Protection of Vulnerable Adults (POVA) training. Those spoken to clearly understood their responsibility to report any concerns. They all knew the correct way in which to do this. . Claremont Care Home DS0000070398.V361994.R01.S.doc Version 5.2 Page 15 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 20, 22, 24, 25 & 26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The environment is pleasant, clean and safe. This gives the resident a homely place in which to live. EVIDENCE: Since the new owners took over the home last November there has been a significant amount of improvements to the environment. New carpet has been laid to the landings and corridors, doorframes have been painted in bright colours to help residents recognise where their rooms are, a new special bath with hoist has been fitted and the central heating boiler has been attended to. Claremont Care Home DS0000070398.V361994.R01.S.doc Version 5.2 Page 16 The dining room has been made more homely and tables are now laid with linen cloths and napkins. There is an on-going development programme and the home has a maintenance person upon whom they can call at short notice. The registered manage is clear about the further improvements that need to be carried out and there is an improvement plan for the environment that has been prioritised. The home has plenty of communal space with two good-sized lounges, one quiet and one with TV, and a dining area. Bedrooms are personalised and some residents have brought some of their own furniture from home. Currently all residents are accommodated in single rooms. This means that the maximum number of residents at the present time is sixteen. Outside there is some parking to the front and a sweep round drive to allow vehicles to get close to the home to pick up passengers. To the rear of the home there are pleasant and enclosed gardens that are accessible from the ground floor. The accommodation is arranged on two floors with bedrooms on each level. At present there is no lift to the first floor. All the residents on the first floor can still manage the stairs but for some this is now becoming much more difficult. The registered manager said that a stair lift is scheduled to be fitted next week. All areas of the home were clean, homely and free from offensive odours on the day of inspection. There are sound infection control systems in place and staff have received infection control training. There are plenty of disposable gloves in dispensers in the bathrooms and toilets and the red bag system is used for soiled laundry. Health and safety documentation was seen to be in good order and a health and safety check is carried out every night. The hoist was noted to have been recently serviced. Claremont Care Home DS0000070398.V361994.R01.S.doc Version 5.2 Page 17 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 & 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Staff training, staff morale and recruitment practices are good. Staffing levels are sufficient to meet the needs of the residents but more back up is needed to cover unforeseen circumstances. EVIDENCE: There were fourteen residents in the home on the day of inspection. Three care staff, two carers and either a senior carer or a deputy manager, are on shift between 8aam and 8pm. In addition there is a cook and cleaners. The registered manager said that this is sufficient to meet the needs of the residents. He said he is currently recruiting more care staff so that there will be better back up should there be any unforeseen circumstances such as staff sickness. This will also give the option to put more staff on shift should the dependency levels of the residents increase. Since taking over the home the owners have worked hard to promote and increase staff training. One deputy manager already has a National Vocational Claremont Care Home DS0000070398.V361994.R01.S.doc Version 5.2 Page 18 Qualification (NVQ) at level four. The other deputy and senior carer are currently working towards the NVQ level three and three carers are working towards NVQ at level two. Staff spoke very positively about the ambiance in the home since the new owners took over. They said that there is openness and honesty and they feel free to speak their minds. There is a very stable staff team. Only one member of staff has left since the new owners took over and this was to embark on nurse training. Direct and indirect observation showed that the staff approached the residents with respect and kindness. Relatives said that the staff are always respectful and kind. Examination of staff files showed that all necessary pre-employment checks have been made for staff. These include Criminal records Bureau (CRB) checks, POVA first checks, sound references and health checks. This is important because it ensures that only staff who have the qualities, such as diligence, kindness and honesty, that make them suitable to work in a care home are employed. Claremont Care Home DS0000070398.V361994.R01.S.doc Version 5.2 Page 19 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 32, 33, 34, 35, 36 & 38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is well managed. This means that it is run in the best interests of the residents EVIDENCE: Direct and indirect observation of interaction of staff with the registered manager/provider showed good working relationships. There was openness in their conversation and it is clear that staff are prepared to speak their minds and put forward ideas. The staff said that they are listened to and valued the various meetings that have been organised. Claremont Care Home DS0000070398.V361994.R01.S.doc Version 5.2 Page 20 The registered manager has reviewed all documentation in the home. He has updated many policies and procedures including health and safety policies and procedures. He said he is gradually updating all policies and procedures but has had to prioritise this work. This is clearly a “work in progress”. All documentation requested during this visit was to hand and in order. The registered manager/provider is well qualified to run a care home. He is a registered general nurse (RGN) who has maintained his continuing professional development and registration with the Nursing and Midwifery Council (NMC). He also has a Masters degree in Business Administration (MBA) and many years experience at management level in the NHS, including time spent in the role of “modern matron”. In addition, prior to taking in the home, he was an advisor on equality and diversity issues for a large NHS Trust. The home does not hold any personal monies for the residents. Any need for money, for example, payment for hairdressing, is paid by the home and later an invoice is sent to the relative or representative of the resident. Records and receipts are kept for all expenditure. There are sound quality assurance systems in place. There are social and formal occasions where residents, relatives, friends, and staff can meet with the providers to discuss any concerns or ideas that they wish to express. Relatives said that they were pleased to be given the opportunity to have more contact with the home and to have their ideas valued. The registered manager is currently developing a template for a formal questionnaire that he intends to send out annually to residents and their supporters. Claremont Care Home DS0000070398.V361994.R01.S.doc Version 5.2 Page 21 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 4 X 4 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 4 13 4 14 4 15 4 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 3 X 3 3 3 3 3 STAFFING Standard No Score 27 3 28 3 29 3 30 4 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 3 3 3 3 X X Claremont Care Home DS0000070398.V361994.R01.S.doc Version 5.2 Page 22 Are there any outstanding requirements from the last inspection? N/A 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. Standard Regulation Requirement Timescale for action 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 All handwritten entries on the Medicines Administration Record (MAR) to be signed, dated and countersigned. Claremont Care Home DS0000070398.V361994.R01.S.doc Version 5.2 Page 23 Commission for Social Care Inspection Maidstone 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 Claremont Care Home DS0000070398.V361994.R01.S.doc Version 5.2 Page 24 - 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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