Inspection on 01/08/07 for Claremont Nursing Home

This inspection was carried out on 1st August 2007.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Excellent. 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

Claremont Nursing Home 14/06/10

Claremont Nursing Home 30/07/09

Claremont Nursing Home 31/08/06

Claremont Nursing Home 11/11/05

Claremont Nursing Home 26/04/05

Claremont Nursing Home 20/10/04

Claremont Nursing Home 20/05/04

Similar services:

The Vicarage

Fairfields Country Rest Home

7 Hyde Road

5 Seafield Road

Trevaylor Manor

12 Orchard Mews

Stallcombe House

Stepping Stones

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

CARE HOMES FOR OLDER PEOPLE Claremont Nursing Home 5 Nelson Gardens Stoke Plymouth Devon PL1 5RH Lead Inspector Doug Endean Unannounced Inspection 10:00 1 and 2 August 2007 st nd 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 Nursing Home DS0000003579.V337140.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 Nursing Home DS0000003579.V337140.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Claremont Nursing Home Address 5 Nelson Gardens Stoke Plymouth Devon PL1 5RH 01752 606799 01752 606799 claremontpl1@btconnect.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) St Nicholas Homes Limited Mr Ian Johnston Care Home 32 Category(ies) of Dementia (3), Dementia - over 65 years of age registration, with number (32), Mental disorder, excluding learning of places disability or dementia (3), Mental Disorder, excluding learning disability or dementia - over 65 years of age (32), Physical disability (3), Physical disability over 65 years of age (32) Claremont Nursing Home DS0000003579.V337140.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. 4. 5. 6. Registered for maximum of 3 DE Registered for maximum of 32 DE(E) Service Users 65 years and over Registered for maximum of 3 MD Registered for maximum of 32 MD(E) Service Users 65 years and over Registered for maximum 3 PD Registered for maximum 32 PD(E) Service Users 65 years and over Date of last inspection 31/08/2006 Brief Description of the Service: Claremont Nursing Home is situated in Stoke, a suburb of the City of Plymouth, which is a short distance away by road. It is a large property, as part of a terrace, built on four floors each of which provides accommodation for the people who live there. Nelson Gardens is a private road, there is some allocated off road parking at the front of the building accessed directly from the road. The home is registered to care primarily for up to thirty-two (32) Service Users who have a mental health problem or dementia and are over the age of retirement. There is also capacity for the home to admit up to three (3) Service Users under the age of 65 years who have dementia. The ground floor provides the day space for the Service Users by way of a large lounge/diner to the rear of the ground floor and a further lounge room in the middle of the building on the ground floor. The minimum weekly fee is £502 rising according to the needs of individual people using the service. Claremont Nursing Home DS0000003579.V337140.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This key inspection took place on the 1st and 2nd August and lasted a total of ten hours. In that time we discussed the management of the home with the Registered Manager, looked at the premises, spoke to three staff and one person who lives at the home. We also spoke to five relatives. We read the notes of three people who live in the nursing home following the way they are cared for by observing the care delivered using a “Short Observational Framework for Inspection” and talking to staff. One of the people who lives at the home was interviewed asking questions about her experiences of the care provided. There was one completed service users questionnaire and three that had been completed by relatives. The home provided a lot of information about its service on the Annual Quality Assurance Assessment. What the service does well: What has improved since the last inspection? Assessments of the people who live in the home has continued to improve. This has meant improved care planning and delivery. It has also improved the communication between shifts as the computerised handover notes have been introduced. Claremont Nursing Home DS0000003579.V337140.R01.S.doc Version 5.2 Page 6 The emphasis on training continues to be a priority of the Registered Managers and using the skills of the staff such as having a person trained in first aid on every shift. The environment continues to be invested in on a rolling basis. Wet rooms, bedrooms and the shaft lift have all been improved. The business plan is being followed to achieve an environment that matches the standard of care. 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 Nursing Home DS0000003579.V337140.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 Nursing Home DS0000003579.V337140.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): The homes performance was assessed against Standard 3. Standard 6 does not apply. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The pre-admission process that the home use brings together a lot of very good information about each person that is referred to the home, to ensure that people’s needs will be fully catered for. EVIDENCE: We read the notes of three of the people who live at Claremont Nursing Home. Each on had a completed pre-admission assessment form. The form recorded a lot of good information about the way the person had been prior to their admission to the home. It gave the Manager enough information to make a decision about the homes ability to care for the person. The notes also held information that had been given to the Manager by other people, such as a Social Worker or Nurse, to help him in deciding if the home would be able to Claremont Nursing Home DS0000003579.V337140.R01.S.doc Version 5.2 Page 9 care for the person. The sort of information that was written down was about the general health of the person, if they had problems walking or going to the toilet. It also told the Manager about the behaviour of the person and what their memory was like. Claremont Nursing Home DS0000003579.V337140.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): The homes performance was assessed against Standards 7, 8, 9 & 10. Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. The home has excellent ways of checking the needs of people who might be admitted to the home. They go on to make regular checks on them, involving other people from the health care system, and plan the care people get to keep them as healthy as possible. EVIDENCE: We read in detail the notes of three people who live in the nursing home. The notes began with a photograph of the person they were about. There was a completed pre-assessment form and other information from health and social services staff that had known the people before they moved into the home. The staff had then gathered lots more information about the people such as what they needed to do for them and what they could still do for themselves i.e. if they could wash and dress or did they need some help. They also wrote down about what help they needed to move about the home, and if a hoist was Claremont Nursing Home DS0000003579.V337140.R01.S.doc Version 5.2 Page 11 needed, which one and how many people were to help in using the hoist. There was information about how fragile their skin was and what needed to be done to prevent it from being damaged such as using pads to manage problems with toileting and special mattresses when in bed. The home does not discriminate against people who want to live at the home on the grounds of disability and have adapted the building to improve access such as temporary ramps at the front door and rear exit to the garden. The home has mainly white British people living in it and one white European. They admit on the grounds of need and not race, colour or religion although these would be considered in order to ensure individualised social and nursing care. The home employs an Occupational Therapist who has looked at how people eat, what cutlery they can manage best and also how best to present their meals. She found that if some people had their meat pureed/chopped they were able to eat their vegetables without being pureed. We spoke to several people who live in the home about the food they are served. They were all happy with the quality of meals that are provided and the size of the portions. We watched some people being helped with their main meal of the day. The staff took their time between each serving, offered encouragement, and also provided a drink as the meal was eaten. Some of the people fed themselves. They were given all the time they needed, and some encouragement if they became distracted. When the meals were finished the staff made a record of the amount of food and drink that had been taken. We used a “Short Observational Framework for Inspection” to record the way the people responded to the staff, visitors, and other people who live in the home. The home has a national nutritional assessment and scale that is used and the results are recorded on computer that is ‘backed up’ regularly. It is easy to identify any changes of eating and drinking habits, and weight using this information. The home does involve other healthcare professionals in caring for the people who live there. The Manager has proved to be a strong advocate for the people in getting some National Health Service departments to provide the care they specialise in promptly. We have been told that he has also given a lot of support to the relatives during these times. The Community Psychiatric Nurse has also told us that the home does give good care to the people who live in it. As we walked around the home we saw that there was pieces of special equipment there to use so that people were safely lifted and their skin was protected from damage. During the inspection the staff were seen using some of the equipment correctly. The Deputy Manager showed us how the home dealt with all the medication that comes in and is given to the people who live there. We saw that all the medication that is brought into the home was written down and stored properly, some in a fridge, at the right temperature. When it is given to the person it has been prescribed for, their identity is checked using a photograph, Claremont Nursing Home DS0000003579.V337140.R01.S.doc Version 5.2 Page 12 and the medication given is signed for on a “medication administration record” sheet. The medication that is no longer in use is taken away from the home to be destroyed. All of the people in the home have a homely remedy sheet that has been signed in agreement by the General Practitioner. Claremont Nursing Home DS0000003579.V337140.R01.S.doc Version 5.2 Page 13 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): The homes performance was assessed against Standards 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 excellent variety of activities provided by the home are well planned and delivered. The way the nutritional needs of people living at the home are met is excellent. The quality and presentation of the food is excellent given the consideration to people’s needs and choice. EVIDENCE: The home employs a qualified Occupational Therapist who has carried out a risk assessment of the activities that the people living at the home attend. They have the chance to join in things that happen in the home and also in the local community such as trips to the local park for a picnic or individual visits to local shops or just outside for a walk. The homes regular newsletter announced in July 2007 that they now have the use of a mini bus and driver and trips would begin to such places as the Hoe and Barbican in Plymouth. In the home they have activities that are both practical and therapeutic such as Claremont Nursing Home DS0000003579.V337140.R01.S.doc Version 5.2 Page 14 painting, sing-along and being entertained by a visiting theatre group. The planned events are displayed on the notice board in the reception area and in the newsletter. There were photographs showing how the theatre group involved everyone in their production. The hairdresser also comes to the home the hair of the men and the woman at a very reasonable price from £5 to £16 for a perm. Meal times are not rushed and people are encouraged to manage themselves to help maintain their independence and dignity. We saw dinner being served and ate in the dining room and also in the comfort of the lounge where some people chose to sit. Drinks were served throughout the day and there is a cool drinks machine in the front lounge for people to have cool or chilled water at anytime. Visiting can take place at any reasonable time of the day and several people came to the home during the two days that we were there to see relatives. They were welcomed and made to feel comfortable wherever they choose to sit. Some people used the garden area for visiting as the weather was good and there were comfortable chairs, a table and umbrella to sit at. There is a gentle ramp from the rear lounge down to the garden and people were walking in and out all day. The Manager helps to keep the staff, relatives and other advocates informed about that is happening at the home in different ways. Visitors are free to ask questions either when at the home or by telephone. The home sends a monthly newsletter to them that tells them interesting things about what’s happening and there is also the Family liaison group every quarter. It is through these ways that the home finds out more about the people they care for. The relatives of some people have produced books telling the history of their relative in various forms such as a mix of written information and photographs or just a photographic history. We spoke to five people visiting the home and each said how satisfied they were with the home and the standard of care that they provide. They also felt that the staff keeps them informed of the care that is provided and any changes that take place. One visitor said that she now rests easy when at home because she knows her relative is well cared for. Another was very positive also in her comments saying that the staff does whatever you might ask straight away and she felt that the home is excellent. We also received one completed service users questionnaire and three service users questionnaires completed by relatives on their behalf. Each one had positive remarks to make about the home and one did say that although not all activities were appropriate for his relative she was not excluded from observing what’s going on. The same person wrote that there are period that his relative does not eat and the staff do encourage them to eat and also supplement the diet with a nutritional drink. The home does not manage the financial affairs of any of the people who live there. They do not keep any of their pocket money on the premises either. Claremont Nursing Home DS0000003579.V337140.R01.S.doc Version 5.2 Page 15 There is a bank account with named individuals who receive interest from it. Some of the people have solicitors or relatives who manage their affairs and invoices are sent to them for any money that has been spent, such as trips, hairdressing or toiletries. As we walked about the home we saw that many of the people have decorated their rooms with personal items of furniture, ornaments and photographs. The home does invite them to make their rooms as comfortable as possible in this way. The way the home manages the food the people eat has been recorded in this and the previous section. However, they do have information about the likes and dislikes of each person so that a meal will be of something they would have chosen if they are not able to express there actual choice due to the problems caused by their dementia. Should someone show through their actions that the food they are served is not to their liking an alternative will be provided. The dietary needs/equipment assessment sheet is very thorough and has been used on everyone living at the home. The homes kitchen is in the lower ground floor. It is suitable for the task and has many stainless steel surfaces and equipment. However, the home were successful in obtaining a grant from a government initiative to be used to fully refurbish the kitchen and work is about to commence on this with a temporary kitchen being set up whilst the work is carried out. Claremont Nursing Home DS0000003579.V337140.R01.S.doc Version 5.2 Page 16 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): The homes performance was assessed against Standards 16 & 18. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home has good procedures for handling complaints or allegations of any form of abuse in a through and professional way. The home has given staff suitable training to recognise and report any abuse. EVIDENCE: The complaints procedure is displayed in the front entrance and is also held in the service users guide. It is structured as required having and has a time scale for there response. It has the contact details of the Commission for Social Care Inspection who may be contacted about complaints. We have not had any complaints to look into since the last key inspection one year ago. The staff at the home has training that brings their attention to the issue of abuse. This is first introduced at induction and then added to with National Vocational Qualification training. The home also sends all of the staff to Protection of Vulnerable Adults training given by the local authority and we saw proof of this. The home also has its own accident reporting training so that the staff knows how to report accurately on the correct record sheet. This information is Claremont Nursing Home DS0000003579.V337140.R01.S.doc Version 5.2 Page 17 extracted and used on a quarterly basis in the homes audit of accidents that we saw. It is used to guide care planning and environmental changes. Claremont Nursing Home DS0000003579.V337140.R01.S.doc Version 5.2 Page 18 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): The homes performance was assessed against Standards 19, 20, 21, 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 home is well presented being nicely decorated and well maintained. The equipment provided in the home is appropriate for the job, hoisting, bathing, etc and is maintained to a satisfactory standard. EVIDENCE: The home is located in the suburb of Stoke, which is near Plymouth city. There is level access to the local streets and small shopping area of Stoke close to the home. Cars can be parked on the street in front of the home or in one of a small number of spaces off the road in front of the home. Claremont Nursing Home DS0000003579.V337140.R01.S.doc Version 5.2 Page 19 There are removable ramps at the front door to improve access into, and out of, the home, as there are a small number of steps at the front entrance. There is a fully enclosed well-kept garden at the back of the home that can be got to from the lounge by a gentle ramp for safety. The garden is level and gives a safe area to use good weather. There is comfortable seating, a garden table and an umbrella for anyone to use. In the home there are 19 single bedrooms and 6 doubles, and all are of good size and shape. A nurse call system is connected everywhere in the home including the bedrooms. The bedrooms are on every floor of the home and there is a shaft lift to all floors. The lift has safety features to prevent people who live in the home using it without staff and becoming trapped or lost. It also has a multipoint infer red door closure system to prevent the door closing on anyone. The bedrooms are furnished and many people have brought along there own belongings for their comfort. Most of the beds in the home are adjustable in height but some service users do have divan beds for their comfort. Floor coverings vary from one room to another to meet individual need. All rooms are centrally heated and the radiators are guarded to prevent scalding. Windows are mainly double glazed and restricted to prevent them opening beyond 100mm. We saw that although all areas are satisfactorily decorated some areas did have minor damage to the paintwork and one carpet was in need of repair. The repair was carried out during the course of the inspection. The manager told us that the home is going through a full program of refurbishment. We were shown a number of bedrooms that had been refurbished to a very high standard. The communal areas were also being further up graded again to again raise their appearance with new floor coverings and ceiling blinds. The communal areas are of good size and comfortably furnished, some people having their own special seating. There is a good level of natural lighting from windows in the walls and ceiling. The Parker bath on the lower ground floor has a thermostatic mixer valve and the manager said that all baths have this devise fitted. All the sinks in people’s bedrooms have a thermostatic mixer valve fitted. There was a record also of the temperature of the water for each bath that is drawn. The home also has newly developed “wet rooms” that get used a lot as the people who live in the home find them easier to manage. This helps to promote their independence and dignity. There are disabled toilets and a mechanical disinfecting sluice on the lower ground floor. There are disabled toilet facilities close to service users bedrooms and also next to the lounge on the ground floor. The administrator has well appointed and equipped new office on the ground floor giving people who live or visit the home easy access to her. The Registered Manager also has a new office on the ground floor next too the administrator, which is in the early stage of development. Claremont Nursing Home DS0000003579.V337140.R01.S.doc Version 5.2 Page 20 The home employs its own Maintenance man who carries out much of the dayto-day maintenance work. He has also produced some risk assessments of the home that are of a high standard and have photographs to show how some work is carried out. Where needed contracts are in place for specialist maintenance such as the hoists, shaft lift and the fire system. We saw proof that these items had been regularly serviced and dates were provided in the information sent to us as part of the inspection process. The home has a laundry located on the lower ground floor. It has two commercial sized washing machines and one has a sluicing cycle. There is also a full-sized commercial cloth dryer. The laundry is manned by full time laundry assistants who wash and iron the clothes for people who live in the home and place them in baskets with their names on for delivery to their bedrooms. Claremont Nursing Home DS0000003579.V337140.R01.S.doc Version 5.2 Page 21 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): The homes performance was assessed against Standards 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. The homes recruitment procedure is satisfactory. The staff training, from induction to foundation, is excellent, being appropriate, well planned and well recorded. Staff are competent to do their jobs as a result of this. EVIDENCE: The home provides nursing care to mainly older people who have a form of dementia. There is always a nurse on duty in charge of the home by day and by night. At the present time in addition to the registered nurse there are five or six care staff during the day and two care staff during the night. The Registered Manager is also a Registered Nurse and he works mainly during the week during office hours. This means there are actually two registered nurses on duty during office hours on weekdays. Due to the need to keep record keeping and assessments up-to-date second hands on registered nurse is always on duty on Tuesdays and Wednesdays. We verified this by looking at the homes duty rotas. The home has some training in first aid on duty at all times. Claremont Nursing Home DS0000003579.V337140.R01.S.doc Version 5.2 Page 22 The home also employs an Administrator who handles enquiries and the homes finances among other duties. The Maintenance man works full time maintaining the fabric of the home and some equipment. He also keeps the risk assessment of the premises up-to-date. There are also cleaners and laundry staff as well as catering staff that together keep the ancillary side of the home operating well. There is also an Occupational Therapist employed by the home that has made a valuable contribution to the overall assessment of the people who live at the home and the services that they receive. The trained staff are responsible for maintaining there pin number. To do this they must comply with the training requirement of continual updating. In particular the manager and a registered nurse have been involved in a national dementia conference for the last two years. The manager is a qualified moving and handling trainer and he keeps the staff up-to-date with this and other training in the home. The Annual Quality Assurance Assessment document provides information about the origins of the staff employed at the home. It showed that the staff group is made up of a multinational, multicultural group of people. We saw how well the staff group works together during the inspection. The home has a formal recruitment procedure that has been professionally prepared. Three staff files were reviewed in detail. Each file was complete and all had Criminal Records Bureau’s disclosure information, POVA first on a recent employee, application forms, and a contract of employment. The social care staff had undertaken a period of induction before working unsupervised. The manager explained the induction training that involves the staff having a comprehensive induction training record that has been developed by an external training institution. The pack was seen and includes a handbook for each staff member with details of employment, disciplinary procedures, Health & Safety information, first aid, moving and handling and the grievance procedure. A training matrix gave information about further training that is undertaken including dementia care and challenging behaviour. A short, but very powerful DVD is also shown to all staff about dementia and its effect on people and their carers. We were shown this during the inspection. A registered nurse was interviewed who has recently joined the home. She said that she felt her induction was satisfactory and began with a tour of the home then fire and moving and handling training on her first day of duty. Her staff file was read and it included all the documentation required including a completed application form, identification, references, contract of employment and a Criminal Records Bureau result. There was also a completed appraisal form. We also spoke to a member of the care staff who has worked at the home for several years. She said that the Registered Manager has made a big difference Claremont Nursing Home DS0000003579.V337140.R01.S.doc Version 5.2 Page 23 to the way the home is run. She said that he has given training that has prepared all the staff well so that they work to a good standard. She said that this was tested during his recent time off when “all the staff just clicked together and worked well”. She said, “He is the best manager I have ever had”. She also said that the home has better staffing levels and the training is much better. She has had moving and handling, dementia care, first aid, health & safety and fire training in the last year. She has also commenced her National Vocational Qualification in care. This was verified when her staff file was read that was complete with training information and normal documentation identifying her. The Administrator has also received training in Business Administration and Equality & Diversity. Claremont Nursing Home DS0000003579.V337140.R01.S.doc Version 5.2 Page 24 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): The homes performance was assessed against Standards 31, 33, 35 & 38. Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. The home is very well managed and this is reflected in the continuingly improved standards of care, recordings, training, maintenance and appearance of the home. EVIDENCE: The home is being managed in a very professional way by a Registered Nurse who has worked hard to raise all of the standards to the height that they now are. He has now completed the Commission for Social Care Inspection application process and is the homes Registered Manager. He has shown through his skills and enthusiasm that his team can achieve high standards of Claremont Nursing Home DS0000003579.V337140.R01.S.doc Version 5.2 Page 25 care in a pleasant environment that is well maintained, safe and attractive. The Registered Manager has produced audit tools that look at the activities of the home and if standards are being met, what may be the cause of a standard not being met, and what needs to be done to resolve the situation. The Accident audit was an example of this. The information from accident records are continually recorded and a quarterly audit is done that identifies any trends such as times of the day that accidents occur or particular areas of the home that experience most accidents. The information is then presented in a report form and acted upon. These records were seen and felt by the inspector to be excellent audit information that has a practical use in the home. He has also introduced a handover sheet on the computer that is used to handover from shift to shift. It is also used to update people after time off. The information is stored and backed up regularly as a history of events that are handed over and can be called upon if needed. There is also an improved level of communication between the home and relatives via the family liaison group that he developed. The home provided a completed Annual Quality Assurance Assessment. This document has given us a lot of information about the homes own assessment on how it functions against the national minimum standards. It also told us about the people and staff who are at the home. There are clear lines of accountability within the home and the external management. The Registered Persons meet’s regularly with the Registered Manager and gives their support to the ongoing improvements at the home. We saw how the Administrator manages any pocket monies held for the service users. No money is held at the home but is in named accounts receiving interest at the bank. The records of any expenditure clear, easy to understand and were found to be accurate. Advocates receive an invoice for any money that is owed from purchases that have been made on the behalf of someone living at the home. The Registered Manager showed during this inspection that the health, safety and welfare of the service users and staff have been protected. He has done this through good training and good management of the resources made available to him. He has encouraged his staff to use their individual skills and talents to assess, plan and deliver a high standard of care or maintenance. He is aware of the legislation involved in running a care home and has taken the steps to improve his own knowledge in care and management. The home now has good and excellent procedures in place and also there is the enthusiasm to continue to improve. We saw a detailed risk assessment of the building that included photographs of equipment and areas of the home to help in describing the risk’s perceived and the way that they are addressed. We also saw the way accidents are recorded and audited, maintenance records are handled and staff and patient’s records are complied and held securely. Claremont Nursing Home DS0000003579.V337140.R01.S.doc Version 5.2 Page 26 Claremont Nursing Home DS0000003579.V337140.R01.S.doc Version 5.2 Page 27 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 4 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 4 8 4 9 3 10 4 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 4 14 3 15 4 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 3 3 X X 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 4 X 4 X 3 X X 3 Claremont Nursing Home DS0000003579.V337140.R01.S.doc Version 5.2 Page 28 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 OP28 Good Practice Recommendations The Registered Manager should continue to have staff train up to at least National Vocational Qualification at level 2 in care to achieve at least 50 of the social care staff with this qualification. The refurbishment of the home should continue with a priority given to the replacement of a damaged carpet. 2 OP19 Claremont Nursing Home DS0000003579.V337140.R01.S.doc Version 5.2 Page 29 Commission for Social Care Inspection Ashburton Office Unit D1 Linhay Business Park Ashburton TQ13 7UP 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 Nursing Home DS0000003579.V337140.R01.S.doc Version 5.2 Page 30 - 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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