Inspection on 12/07/05 for Clarence House And The Granary

This inspection was carried out on 12th July 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 found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Clarence House And The Granary 24/07/06

Clarence House And The Granary 27/09/05

Clarence House And The Granary 10/01/05

Clarence House And The Granary 07/05/04

Clarence House And The Granary 13/01/03

Similar services:

Hillside

Applegarth

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Jubilee Villa Care Home

Thornham Grove

Beech Lodge

8 Thorndale Road (Homefield College)

Hunter`s Lodge

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

CARE HOMES FOR OLDER PEOPLE Clarence House and the Granary 53 West Street Horncastle Lincs LN9 5JE Lead Inspector Ken Hague Unannounced 12 July 2005 @ 9am 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. Clarence House and the Granary C53 C04 S2348 Clarence House V238109 12-7-05 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Clarence House and the Granary Address 53 West Street Horncastle Lincs LN9 5JE 01507 524466 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) Prime Life Limited Mrs Christine Papworth PC Care Home Only 21 Category(ies) of LD(E) - Learning Disability over 65 years - 3 registration, with number LD - Learning Disability -18 of places Clarence House and the Granary C53 C04 S2348 Clarence House V238109 12-7-05 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: N/A Date of last inspection 10 January 2005 Brief Description of the Service: Clarence House is a listed, 3-storey town house set in its own gardens in the market town of Horncastle, near to a crossroads that is controlled by traffic lights and the home is situated within a quarter of a mile of all the amenities within the town. Clarence House offers 10 single rooms and one double room, which has access to a separate lounge/kitchen. The main building has been adapted to provide residential care for 21 people with a learning disability. Access to the first floor can be gained by using either the main staircase or via a stair lift; access to the second floor is gained by stairs only. Adjacent to and across a courtyard from the main building is another 3-storey building, known as The Granary, this is also a conversion and provides accommodation for 8 people. This is a self-contained unit with its own kitchen, dining room, lounge and utility area; the main laundry area is situated in Clarence House. All bedrooms in The Granary are for single occupation and are situated on the first and second floors, access to these rooms is by stairs only. There is a separated, self-contained bed sitting complex adjoining The Granary. The courtyard provides limited car parking spaces and the walled gardens are accessible to service users and include a patio area. The home is owned by Prime Life Ltd and the day to day management of the home is the responsibility of a Registered Manager. Clarence House and the Granary C53 C04 S2348 Clarence House V238109 12-7-05 Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection took place over a five hour period. The care records for three service users were inspected in detail. Three service users were spoken to informally. The deputy manager and a second member of staff were formally interviewed. A tour of the care home was made as part of this inspection. The Inspector observed service users taking part in activities during this inspection. He observed dinner being served prior to him leaving the care home. 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. Clarence House and the Granary C53 C04 S2348 Clarence House V238109 12-7-05 Stage 4.doc Version 1.40 Page 6 The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Clarence House and the Granary C53 C04 S2348 Clarence House V238109 12-7-05 Stage 4.doc Version 1.40 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 Standards Statutory Requirements Identified During the Inspection Clarence House and the Granary C53 C04 S2348 Clarence House V238109 12-7-05 Stage 4.doc Version 1.40 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 standard(s) 1,2,3 The home provides potential service users with information which allows them to make an informed choice about coming to stay at the care home. Service users are issued with a written contract and a statement of the terms and conditions for their stay at the home. No service user is admitted to the home until a detailed assessment has been carried out. EVIDENCE: The home has a statement of purpose which is given to all new potential service users. This is a consistent document used by all Prime Life Ltd homes. The statement of purpose states that all new service users will be fully assessed before being admitted to the home. The interviews with staff confirmed this to be the case. The three sampled files all contained an initial assessment made prior to the individual service user being admitted to the home. The three files sampled as part of this inspection all contained signed and dated copies of the terms and conditions for the individual service users stay at Clarence House. Clarence House and the Granary C53 C04 S2348 Clarence House V238109 12-7-05 Stage 4.doc Version 1.40 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 standard(s) 7,8,10 Not all individual service users files contain a full care plan identifying the total needs of the service users and how these needs are to be met by the resources of the home. The failure to clearly identify and record service users needs and health care needs could put place service users at risk. EVIDENCE: The three service users files studied in detail during this inspection were all filed inconsistently. The care records were difficult to follow and even after reading one file for 40 minutes it was difficult to establish the total needs of that service user. One service users file contained a care plan from his last placement, but no care plan for his present stay, a second file contained an assessment carried out prior to their admission, but there was no care plan on their file. Staff were able to describe in detail care needs and health needs of the three individual service users. There was no evidence of care plans being reviewed. One service user admitted to the home in June had no CPA assessment. The discharge notes from hospital stated the CPA would follow when a key worker returned to work. This document was still missing in July 2005. The service user subject to a section 117 on the 1983 Mental Health Act was due to have the service reviewed in February 2005. The deputy manager said this review had taken place, but there was no evidence this on the file. Clarence House and the Granary C53 C04 S2348 Clarence House V238109 12-7-05 Stage 4.doc Version 1.40 Page 10 All staff interviewed were unaware of the significance of the service user mean under section 117 of the 1983 Mental Health Act. The observations made during the day for this inspection was that staff treated service users with courtesy and respect. They were seen to knock on doors before entering. They were seen to speak courteously to service users when discussing their activities and care needs. Staff were observed to listen carefully to service users point of view during discussions. Clarence House and the Granary C53 C04 S2348 Clarence House V238109 12-7-05 Stage 4.doc Version 1.40 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 standard(s) 12,13,14&15 Service users are encouraged to take part in activities of their choice, some activities are taken within the local community. They are enabled to take part in religious activities should they wish to attend church. The home makes all friends and family welcome. Service users are actively involved in the decision making process of the home. The home offers a wholesome and appealing menu and special diets are catered for. EVIDENCE: The care plan files contain details of the individual likes and dislikes in relation to the provision of food. One file stated the service user is a vegetarian and gave a list of her choices of food. Another file stated the service user wishes to have a sensible diet to avoid becoming overweight. A third service users file stated” I like fruit, vegetables, milk, cheese, egg chiken and fish and chips, I also enjoy chocolate”. All three files inspected contained a list of the choices of activities of individual service users. One stated “I relax listen to my music, I like playing pool and enjoy holidays. I like to go bowling and go to the pub for a drink, when Im in the home I like to watch TV”. The deputy manager confirmed that service users are encouraged to attend day centres and local colleges. Service users stated that they were very happy with the food and confirmed choice was offered. All the service users were preparing food and planning activities for a party that was to be held on the night of this inspection for a member of staff who was leaving the home. Clarence House and the Granary C53 C04 S2348 Clarence House V238109 12-7-05 Stage 4.doc Version 1.40 Page 12 One service user had completed a sheet of paper saying “I shall miss you because when I am sad you make me happy ”. Clarence House and the Granary C53 C04 S2348 Clarence House V238109 12-7-05 Stage 4.doc Version 1.40 Page 13 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. The home has a complaints policy in place which meets the National Minimum Standards. There are policies and procedures in place to ensure that staff take appropriate action in the event of any suspicion of an abusive situation. Staff have been provided with training in the identification and management of abuse. EVIDENCE: The staff stated that they have been provided with training in the identification and management of abuse. The deputy manager stated that all staff have taken part in fire training and drill. The home has a Prime Life Limited abuse policy and a copy of the Lincolnshire County Council’s Vulnerable Abuse procedures in the homes procedure manual. Service users have regular meetings which are recorded. The minutes of these meetings were seen at this inspection. Service users are invited to make comments regarding the services being provided by the home. Service users were seen to confidently approach staff and take part in detailed discussions regarding their provision of care. The home and the Commission for Social Care Inspection have not received any complaints since the last inspection in January 2005. The accident book was inspected and all incidents were being recorded appropriately and signed by the registered manager. Clarence House and the Granary C53 C04 S2348 Clarence House V238109 12-7-05 Stage 4.doc Version 1.40 Page 14 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) 19,26 The standard of decoration and furnishing of the care home is good. It provides a comfortable atmosphere in which service users live. The home is well maintained and all areas of the home was clean and free from any offensive odour. EVIDENCE: There was evidence found of maintenance work being carried out in the care home. A new carpet had been fitted in a bedroom area. A new lounge carpet was in place ready to be fitted within the next week. Repairs have been carried out to the fire escape as requested at the last inspection. Downpipes had been replaced outside one area of the care home. A tour of the care home confirmed all areas were clean tidy and free from any offensive odours. Clarence House and the Granary C53 C04 S2348 Clarence House V238109 12-7-05 Stage 4.doc Version 1.40 Page 15 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) 27,29&30 There is a stable staff group, which provides sufficient care hours to ensure that all of service users needs can be met. The registered manager has followed the recruitment policy of Prime Life Ltd. The home has failed to provide staff with specialised training in the last seven months. EVIDENCE: The staffing rota has been changed since the last inspection. Staff hours have been increased as a result of the service user requiring 60 hours per week oneto-one supervision. Service users stated they were happy with present staffing levels. Staff confirmed in informal interviews that there was sufficient hours provided to ensure they could complete their tasks appropriately. The inspection of the individual file for a new member of staff provided evidence that the recruitment policy of the company was being followed. All of the information set out in the Care Home Regulations schedule 2 had been obtained prior to this person be offered employment. The formal interviews with staff provided evidence that only one course of specialised training has been offered in the last seven months. This course was not recorded in the staff training files. There was no written staff training plan in place on the day this inspection. Clarence House and the Granary C53 C04 S2348 Clarence House V238109 12-7-05 Stage 4.doc Version 1.40 Page 16 Clarence House and the Granary C53 C04 S2348 Clarence House V238109 12-7-05 Stage 4.doc Version 1.40 Page 17 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) 31,33,38 The home is run in the best interest of service users. All staff are following the health and safety policy of the care home. There are policies and procedures in place to ensure that all service users are protected from any potential harmful situation. EVIDENCE: There was only one health and safety issue identified at this inspection. This related to a carpet recently been fitted at the top of the stairs and a joint was seen to be damaged and repaired with tape. The deputy manager contacted the maintenance section during the inspection. It was agreed this carpet would be repaired within 24 hours. The inspection of the policy and procedures manual provided evidence that the home has policies in place for the protection of service users from any potential abuse. There is a health and safety policy in place and in infection control policy. Staff confirmed that they were aware of these policies during the formal interviews. Clarence House and the Granary C53 C04 S2348 Clarence House V238109 12-7-05 Stage 4.doc Version 1.40 Page 18 The home is managed by an experienced registered manager. Staff stated that she is very supportive and approachable. They confirmed that appraisals and supervisions are being carried out in accordance with the National Minimum Standards. Service users stated that they feel able to raise any issues with any member of staff or the registered manager. Staff stated that service users meetings are held at the home. The records and minutes of these meetings were seen during this inspection. Clarence House and the Granary C53 C04 S2348 Clarence House V238109 12-7-05 Stage 4.doc Version 1.40 Page 19 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 3 3 3 x x x HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 x 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION 3 x x x x x x 3 STAFFING Standard No Score 27 3 28 x 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 x 3 x x x x 3 Clarence House and the Granary C53 C04 S2348 Clarence House V238109 12-7-05 Stage 4.doc Version 1.40 Page 20 yes 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 7 Regulation 15-1 Requirement The registered person must complete a care plan for each new service user which includes a risk assessment Timescale for action 31 August 05 2. 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. 2. Refer to Standard 18 Good Practice Recommendations The home is recommended to review its staffing levels to ensure that the 60 hours 1:1 supervision identified on the service users care plan is being provided. Clarence House and the Granary C53 C04 S2348 Clarence House V238109 12-7-05 Stage 4.doc Version 1.40 Page 21 Commission for Social Care Inspection Unity House, The Point Weaver Road, off Whisby Road Lincoln LN6 3QN 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 Clarence House and the Granary C53 C04 S2348 Clarence House V238109 12-7-05 Stage 4.doc Version 1.40 Page 22 - 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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