Inspection on 27/09/05 for Clarence House And The Granary

This inspection was carried out on 27th September 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Clarence House And The Granary 24/07/06

Clarence House And The Granary 12/07/05

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 Mr Ken Hague Unannounced Inspection 27th September 2005 08:00 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 Clarence House And The Granary DS0000002348.V251006.R01.S.doc Version 5.0 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. Clarence House And The Granary DS0000002348.V251006.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Clarence House And The Granary Address 53 West Street Horncastle Lincs LN9 5JE 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) 01507 524466 Prime Life Limited Mrs Christine Papworth Care Home 21 Category(ies) of Learning disability (18), Learning disability over registration, with number 65 years of age (3) of places Clarence House And The Granary DS0000002348.V251006.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 12/07/05 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. 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 separate, 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 DS0000002348.V251006.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection took place between 7.45am and 1.00pm. The main method of inspection used is called case tracking which involved selecting three residents and tracking the care they receive through the checking of their records, discussion with them, the care staff and observation of care practices. A tour of the premises was conducted and care records were inspected. One member of staff and five service users were interviewed. What the service does well: What has improved since the last inspection? The registered manager has reviewed the care plans since last inspection when they did not meet the National Minimum Standards. They have now been improved and contain all the information set out in the National Minimum Standards. Training opportunities have been increased to all staff. The registered manager continues to review the care records. An individual residents care file shown to the inspector exceeded the National Minimum Standards in the quality of recording. It is aim of the home to bring all care records up to this standard. Clarence House And The Granary DS0000002348.V251006.R01.S.doc Version 5.0 Page 6 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. Clarence House And The Granary DS0000002348.V251006.R01.S.doc Version 5.0 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 Clarence House And The Granary DS0000002348.V251006.R01.S.doc Version 5.0 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): 2&3 There are satisfactory procedures for the introduction and assessment of people to the service, ensuring that care needs are met. Residents and relatives are happy with the care provided and feel that their needs are being met. EVIDENCE: The home has a statement of purpose which is given to all new potential service users. This is a universal 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. This information was used to formulate the initial care plan and risk assessments. The three files sampled as part of this inspection all contained signed and dated copies of the terms and conditions for the individual service user stay at Clarence House. Clarence House And The Granary DS0000002348.V251006.R01.S.doc Version 5.0 Page 9 Clarence House And The Granary DS0000002348.V251006.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8 & 9 Care plans contain sufficient information to ensure that the care needs of service users are met during their stay, this included evidence of the involvement of service users or their representatives in the writing of individual care plans. Risk assessments are of a good quality and are being reviewed to ensure they contain an up-to-date management strategy for any risk identified. Medication is being administrated in accordance with the company’s procedures. EVIDENCE: The files of three service users who were being case tracked as part of this inspection demonstrated an improvement in the standard of care records since the last inspection. The care records are filed in a consistent manner. The files contained an initial assessment, which included a detailed risk assessment. The care plan and risk assessments were easy to read and set out the individual needs of each resident. All three files contained details of dental care, eye care and where appropriate, chiropody. The file of one resident contained a risk assessment relating to the administration of medication. The risk assessment demonstrated that the resident could not self-medicate. There was an agreement on the care records that staff would administer medication this Clarence House And The Granary DS0000002348.V251006.R01.S.doc Version 5.0 Page 11 was signed and dated by the individual resident. The care plans were being reviewed in accordance with the National Minimum Standards. A resident stated “I was involved in the writing of my care plan and a have taken part in reviews with members of staff.” The care plans contained the choices and wishes of individual residents. One care plan stated this resident does not wish any contact from his family. A management strategy was detailed to ensure that he was protected from unwanted contact with his family. This decision is reviewed with the resident each month to ensure that if he changed his mind contact can be re-established. Clarence House And The Granary DS0000002348.V251006.R01.S.doc Version 5.0 Page 12 Clarence House And The Granary DS0000002348.V251006.R01.S.doc Version 5.0 Page 13 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13 & 15 A wide range of activities are available for residents to participate in, ensuring that they have an enjoyable and stimulating lifestyle. Catering arrangements reflect resident’s preferences and choice. Friends and family members are encouraged to visit the home. EVIDENCE: The care plan files contain details of individual’s resident likes and dislikes in relation to menu. A file stated this resident is a vegetarian and gave a list of her choices of food. Evidence was found of a second resident being advised on planning a healthy diet with her personal goal being to lose weight. A third resident’s file stated “I like fruit, vegetables, milk, cheese, eggs, chicken and fish and chips. I also enjoy chocolate”. All three files inspected contained a list of the activities of the individual service users. A group of five residents took part in a discussion regarding their activities. One resident stated we go out into the community almost daily to take part in activities. We visit local restaurants, pubs and go bowling. The file of two residents contained details of home visits and holidays which the residents took with their individual families. One of these residents had a long discussion with the Inspector and confirmed that the details in his file were accurate in terms of his home Clarence House And The Granary DS0000002348.V251006.R01.S.doc Version 5.0 Page 14 contact. Two residents described their work placements which were in a local business in the village area. They said “they are very proud to obtained work experience”. Clarence House And The Granary DS0000002348.V251006.R01.S.doc Version 5.0 Page 15 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16,&18 Service users are enabled to make their views known, including having access to a complaints policy which meets the National Minimum Standard. 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: Staff discussions and the inspection of the records provided evidence that training in the identification and management of abuse had been provided. The registered manager stated that all staff have taken part in fire training and a fire drill. The home has a Prime Life Ltd abuse policy and a copy of Lincolnshire County Council’s Vulnerable Abuse Procedures in the homes procedure manual. Residents confirmed that they have regular meetings with the staff of the home which are recorded. Residents are invited to make comments regarding the service being provided by the home. Residents 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 July 2005. Clarence House And The Granary DS0000002348.V251006.R01.S.doc Version 5.0 Page 16 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): 19,23 & 26 The standard of the environment within this home is good, providing service users with a comfortable and homely place to stay. The home is well maintained. All areas of the home were clean and smelt fresh. EVIDENCE: A tour was made of a care home. All areas were found to be clean, tidy and free from any odour. A bedroom was on viewed at a resident’s request. It was found to contain all equipment and facilities set out in a National Minimum Standards. The residence stated, “I love my bedroom, I have all my own things inside this room, my videos, hi-fi equipment and a large collection of family photographs”. Clarence House And The Granary DS0000002348.V251006.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27,28,29 & 30 Staff are recruited in accordance with the homes recruitment procedure. All staff are competent to carry out their individual roles. The home provides appropriate training for staff to ensure their development needs are met. The homes staffing rota ensures appropriate numbers of staff are on duty at all times. EVIDENCE: The company has a comprehensive training programme which includes induction and NVQ training. Staff records showed that they had received regular supervision and appraisal sessions. Staff stated personal development is discussed at each supervision session. The inspection of two staff member’s files confirmed that the recruitment policy of the home was being followed. The Prime Life Ltd recruitment policy meets the National Minimum Standards. Residents stated that they get on well with all staff, they found them kind and helpful. In the opinion of the residents spoken to during this inspection, there are always sufficient staff on duty to meet resident’s needs. Staff confirmed they are given advance notice of their future shifts. They confirmed that staffing levels are not reduced at any time and that the staffing rota is always met. Clarence House And The Granary DS0000002348.V251006.R01.S.doc Version 5.0 Page 18 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): 31,33,& 38 The home is well run, with good leadership and guidance from the registered manager who has worked for many years in the provision of community care. The health and safety and welfare of residents is promoted. EVIDENCE: Residents stated “staff are very approachable. They regularly discuss with us our opinions regarding the services being provided by the care home. Staff treat us as individuals”. Residents confirmed that they are satisfied their individual care needs were being met. There were no health and safety issues identified at this inspection. A staff member interviewed stated “the registered manager is very supportive and encourages individuals to develop their own personal skills”. Clarence House And The Granary DS0000002348.V251006.R01.S.doc Version 5.0 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 Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 3 3 3 x x x HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 x 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 x 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 3 18 3 3 x x x 3 x x 3 STAFFING Standard No Score 27 3 28 3 29 3 30 x MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 x 3 x x x x 3 Clarence House And The Granary DS0000002348.V251006.R01.S.doc Version 5.0 Page 20 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. 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. Refer to Standard Good Practice Recommendations Clarence House And The Granary DS0000002348.V251006.R01.S.doc Version 5.0 Page 21 Commission for Social Care Inspection Lincoln Area Office 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. 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