CARE HOMES FOR OLDER PEOPLE
Claremont House Lovent Drive Leighton Buzzard Bedfordshire LU7 8LR Lead Inspector
Andrea James Unannounced Inspection 5th January 2006 10:00 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information
Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Claremont House DS0000014889.V268705.R01.S.doc Version 5.1 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 House DS0000014889.V268705.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION
Name of service Claremont House Address Lovent Drive Leighton Buzzard Bedfordshire LU7 8LR 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) 01525 852628 01525 217242 Mr Derek Abreu Mr Derek Abreu Care Home 13 Category(ies) of Dementia - over 65 years of age (13), Old age, registration, with number not falling within any other category (13), of places Physical disability over 65 years of age (13) Claremont House DS0000014889.V268705.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION
Conditions of registration: Date of last inspection 3rd November 2005 Brief Description of the Service: Claremont residential home is a detached property, which is situated in a pleasant residential area close to Leighton Buzzard town centre. The home provides care for 13 older people over the age of 65 years. The resident’s bedrooms were personalised to meet individual tastes and all bedrooms had en- suite facilities. The home had adequate parking facilities to the front of the building. Claremont House DS0000014889.V268705.R01.S.doc Version 5.1 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This was an unannounced inspection, which took place three months after the last inspection. This was to ensure two inspections are carried out on the home within the inspection year. The inspection took place on the 5th of January 2006 and lasted for 3.5 hours. The main method of inspection used was “case tracking” which involved selecting a sample of service users and tracking their care through reviewing their records, discussion with them, the care staff and observation of care practices. This report only covers areas that had outstanding requirements/ recommendations or where standards were not assessed and should therefore be read in conjunction with the previous report to gain a full understanding of the homes overall performance. What the service does well:
The Manager and Deputy Manager provide effective leadership within the home promoting good standards of care and support for staff. Clear indication is provided regarding the standards expected and there is an open and positive atmosphere in the home. The home had made great efforts to ensure the residents have the opportunity to engage in a variety of activities whilst respecting their individual preferences. Service users, relatives and staff spoken to all spoke positively about the home’s ability to provide a “first class” service. Words such as “ brilliant and fantastic” were used to describe the service the home provided. One relative said the care offered superseded all expectations. Through observation the service users appeared happy and relaxed and the staff and relatives demonstrated positive communication dialogues. The home appeared to deal sensitively to those service users who were dying. Claremont House DS0000014889.V268705.R01.S.doc Version 5.1 Page 6 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. Claremont House DS0000014889.V268705.R01.S.doc Version 5.1 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 House DS0000014889.V268705.R01.S.doc Version 5.1 Page 8 Choice of Home
The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): These standards were not assessed on this inspection but the key standards were assessed and met at the last inspection (see previous report). EVIDENCE: Claremont House DS0000014889.V268705.R01.S.doc Version 5.1 Page 9 Health and Personal Care
The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7.9.11 The care plans within the home were satisfactory to demonstrate the social and health care needs of all service users were being met. The medication processes were also satisfactory and improvements had been made to the recording of service users wishes in the event of their death as a result service users health and personal needs were met. EVIDENCE: The home had made improvements to their recording in regards to ensuring a cross reference of all health care professionals are documented in the service users care plans. All care plans demonstrated regular update in excess of monthly when required. The home had satisfactory medication procedures and the medication trolley was made safe. Claremont House DS0000014889.V268705.R01.S.doc Version 5.1 Page 10 The home had good death and dying procedures and on the day of the inspection a recent deceased service user’s records were inspected which showed that the home acted considerately and professionally throughout. Relatives of a dying service user also praised the home for their co-operation and love offered to their mother in her last hours. Claremont House DS0000014889.V268705.R01.S.doc Version 5.1 Page 11 Daily Life and Social Activities
The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12.13.14. Good processes were in place that ensured service users received a wide variety of daily activities, nutritious meals, opportunity to make choices and contact with families and friends. As a result service users daily lives and social needs were well catered for. EVIDENCE: The home had made great efforts to make sure the service users received a variety of activities that met with their needs and choices. Service users spoken to said they had regular exercise sessions, dominos, cards, and parties and were also able to visit the outside community. A weekly activities programme was on display in a pictorial and written format. Service users spoke positively about the recent Christmas party where all the relatives and friends were able to participate. Service users were offered choice of newspapers and those wishing to watch television were able to do so. Residents talked about being given choices and not being made to join in, which was important to them. Some care plans indicated, “offer all activities but respect her wishes” and “has had a lay in today with breakfast in bed”. The home also has a formal activity evaluation for residents to highlight their likes or dislikes.
Claremont House DS0000014889.V268705.R01.S.doc Version 5.1 Page 12 Complaints and Protection
The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16 The home had good complaints procedures in place to ensure service users and relatives could complain should they wish to do so as a result service users were confident that their issues would be listened to. EVIDENCE: The home has a complaints procedure displayed in a frame in the hallway. This clearly indicates the complaints procedure including time frames for response, and the Commission for Social Care Inspection contact details, and residents spoken to were aware of the process if they wished to make a complaint. Claremont House DS0000014889.V268705.R01.S.doc Version 5.1 Page 13 Environment
The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): These standards were not inspected on this occasion but the key standards were inspected and met at the last inspection (See previous report). EVIDENCE: Claremont House DS0000014889.V268705.R01.S.doc Version 5.1 Page 14 Staffing
The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27 and 29. Staffing was available in sufficient numbers, with good skills and experience to satisfactorily meet the needs of the service users. The home also had good recruitment procedures in place that would protect the welfare of the service users. EVIDENCE: The rotas indicated that sufficient numbers of staff were available to meet the needs of the service users. The service users and relatives spoken to said the staff were nice and caring and they wouldn’t change anything they did. The staff files inspected indicated that good recruitment procedures were in place. Staff spoken to said they were happy to work in the home and considered it to be one of the best. They said they received regular supervisions ad staff meetings. Claremont House DS0000014889.V268705.R01.S.doc Version 5.1 Page 15 Management and Administration
The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): These standards were assessed and met at the last inspection (See previous report). EVIDENCE: Claremont House DS0000014889.V268705.R01.S.doc Version 5.1 Page 16 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 X X X X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 X 9 3 10 X 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 X COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 X X X X X X X X X STAFFING Standard No Score 27 3 28 X 29 3 30 X MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score X X X X X X X X Claremont House DS0000014889.V268705.R01.S.doc Version 5.1 Page 17 Are there any outstanding requirements from the last inspection? No STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care 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 OP37 Good Practice Recommendations There is a need to ensure there is a system in place that enables the policies for the home to be reviewed regularly, identified as belonging to the home, dated and signed. Arrangements should be made to ensure a shaft lift is installed in meeting with the assessed needs of the service users. 2. OP22 Claremont House DS0000014889.V268705.R01.S.doc Version 5.1 Page 18 Commission for Social Care Inspection Bedfordshire & Luton Area Office Clifton House 4a Goldington Road Bedford MK40 3NF National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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