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Inspection on 01/07/05 for Clarence Park Nursing Home

Also see our care home review for Clarence Park Nursing Home for more information

This inspection was carried out on 1st 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 made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

What has improved since the last inspection?

The standard of documentation has improved since the last inspection. Residents` needs are comprehensively assessed on admission. Care plans give staff clear guidance to meet these assessed needs. Staff have worked hard to improve the medication systems. The vast majority of these were well maintained, and reflected good practice. Since the last inspection, a new chef has been appointed to work in the home. Residents and staff said that the standard of food served has improved. They said that they were given a good choice, and the meals were to their liking.

What the care home could do better:

The home has very comprehensive systems in place to monitor the quality of service offered. These are most effective, and show that staff in the home are committed to continuous improvement. Three requirements were made at this inspection. Mrs Lawrence and her staff had already identified these problems. Action was underway to address them.

CARE HOMES FOR OLDER PEOPLE Clarence Park Nursing Home 9 Clarence Road North Weston Super Mare North Somerset BS23 4AT Lead Inspector Alison Murray Announced Ist July, 2005 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 Park Nursing Home D53 - D02 S40907 Clarence Park V222270 280605 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Clarence Park Nursing Home Address 9 Clarence Road North, Weston Super Mare, Somerset BS23 4AT 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) 01934 629374 01934 626207 Notaro Homes Ltd Ms Sharmaine Marie Lawrence Care Home with nursing 50 Category(ies) of Old age (50) registration, with number of places Clarence Park Nursing Home D53 - D02 S40907 Clarence Park V222270 280605 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: 1 May accommodate up to 35 patients aged 50 years and over requiring nursing care 2. Manager must be a RN on parts 1 or 12 of the NMC register 3. Staffing levels detailed in the letter to Mr N Notaro from the CSCI dated 7th September, 2004 apply. Date of last inspection 25 November, 2004 Brief Description of the Service: Clarence Park provides care and support to older people who have nursing needs. It comprises of two houses joined together and extended close to the seafront in Weston super Mare and opposite Clarence Park. Local shops and amenities are close by and the town centre is just under a mile away. Inside, the home is well laid out, level throughout with ramps and lifts giving access to the upper floors. Twenty one of the single, and all four of the shared bedrooms have en suite facilites. With a small garden at the front, the rear has been laid as patio around a central water feature. Clarence Park Nursing Home D53 - D02 S40907 Clarence Park V222270 280605 Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was a very positive announced inspection. Two inspectors spent a total of 16 hours in the home. In the morning, one inspector spoke with residents, visitors and staff in the communal areas of the home. The other reviewed care records. In the afternoon, they swapped roles, with one spending time in the office, inspecting staff records, and the other meeting residents, visitors and staff in private. Comment cards were received from two residents and four staff members. What the service does well: What has improved since the last inspection? The standard of documentation has improved since the last inspection. Residents’ needs are comprehensively assessed on admission. Care plans give staff clear guidance to meet these assessed needs. Staff have worked hard to improve the medication systems. The vast majority of these were well maintained, and reflected good practice. Clarence Park Nursing Home D53 - D02 S40907 Clarence Park V222270 280605 Stage 4.doc Version 1.30 Page 6 Since the last inspection, a new chef has been appointed to work in the home. Residents and staff said that the standard of food served has improved. They said that they were given a good choice, and the meals were to their liking. 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 Park Nursing Home D53 - D02 S40907 Clarence Park V222270 280605 Stage 4.doc Version 1.30 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 Park Nursing Home D53 - D02 S40907 Clarence Park V222270 280605 Stage 4.doc Version 1.30 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) 3 and 5. Clarence Park does not provide intermediate care. Residents’ needs are effectively assessed before they are admitted to the home. They are given good information about the range of services offered. EVIDENCE: Mrs Lawrence said that she always visits prospective residents before their admission to Clarence Park. She uses this opportunity to assess their needs, and tell them about the home. Care records reviewed contained evidence of a comprehensive pre admission assessment. Recently admitted residents confirmed that they were given good information about the range of services offered at the home. One lady said that she had originally been admitted to the home for a respite stay. She said that she had since decided to stay there permanently. Clarence Park Nursing Home D53 - D02 S40907 Clarence Park V222270 280605 Stage 4.doc Version 1.30 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, 9 and 10 The standard of care documentation is good. Residents’ health and personal care needs are well met. There is a friendly atmosphere in the home, with a good rapport between residents and staff. EVIDENCE: The standard of care documentation was good. Care plans were written for each area of identified need. They provided staff with clear guidance to meet residents’ needs. This guidance was based on current good practice, and confirmed the involvement of other health professionals. Wound and catheter care plans were particularly well completed. Staff demonstrated a sound awareness of residents’ needs. Residents felt comfortable that staff had the knowledge and skills to look after them. A large number of residents were aware of the content of their care plans. One lady said that staff had asked the GP to refer her to a specialist. A visitor said that he was kept informed of any changes in his relative’s condition. Many residents were consulted individually, and others observed in the communal areas of the home. All were neatly dressed, and attention had been Clarence Park Nursing Home D53 - D02 S40907 Clarence Park V222270 280605 Stage 4.doc Version 1.30 Page 10 paid to their hair and nail care. One resident was being nursed in bed. She looked comfortable, and had been provided with a suitable pressure relief mattress. This lady had specialist communication needs. She had been given a most effective communication device, and was happy to chat to the inspector. Conversations with staff and residents indicated that the home had recently ‘run out’ of incontinence pads and cleaning wipes. The nursing staff said that they had identified this as a training issue. Continence products are supplied to named residents following an individual assessment. They felt that care staff were not using the correct allocated pads. They have now spoken to the PCT nurse specialist, and obtained a training pack. They plan to give all care staff a ‘refresher course’ in continence care. There was a calm, relaxed atmosphere in the home. The residents said that the staff were ‘lovely’, with several naming specific favourites. They gave numerous examples of staff members going out of their way to be helpful. The medication administration records were generally well maintained, and drugs securely stored. It was noted that on one occasion, staff had not given two residents their prescribed controlled release medication on the appropriate day. This was rectified the following day, and new systems put in place to ensure it does not happen again. Clarence Park Nursing Home D53 - D02 S40907 Clarence Park V222270 280605 Stage 4.doc Version 1.30 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 and 15 The programme of planned and informal activities offered at Clarence Park is very good. It meets the needs and expectations of the residents. Family and friends are made welcome. Residents enjoy the meals provided, although staff should review the way they serve desserts. EVIDENCE: Residents at Clarence Park are offered the opportunity to take part in a wide range of activities. There is a planned programme, and other activities are added through the month. These include ‘Flexercise’ classes, raffles, and theme days. On the morning of the inspection, a visiting musician entertained a large and appreciative audience of residents and visitors. A number of residents said that they enjoyed trips out in the home minibus; others said that they liked the outings to the local pub. One of the staff has put forward a proposal to take on the role of activities organiser within the home. This is currently at the discussion phase, but her ideas look very good, and deserve serious consideration. Residents said that their family and friends were able to visit at any time. Relatives confirmed that they were always made welcome. Clarence Park Nursing Home D53 - D02 S40907 Clarence Park V222270 280605 Stage 4.doc Version 1.30 Page 12 All the residents consulted said that the standard of food provided at Clarence Park was good. The lunchtime meal of fish looked and smelt appetising. The majority of residents chose to take their meal in one of the two dining rooms. In one of these dining rooms, staff were observed to bring the dessert of hot sponge and cream, on the same trolley as the fish. This meant that it was cold when served to the residents. Resident said that this was often the case. Clarence Park Nursing Home D53 - D02 S40907 Clarence Park V222270 280605 Stage 4.doc Version 1.30 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 and 18 The complaint procedure in the home is satisfactory. Staff demonstrate a good awareness of adult protection issues. EVIDENCE: There are comprehensive policies and procedures in place. Residents and relatives all confirmed that they knew how to use these procedures if the need should arise. Several commented that they felt comfortable raising informal concerns with Mrs Lawrence. They added that these had always been ‘Sorted out’ very promptly, and there had been no need to make a formal complaint. Clarence Park Nursing Home D53 - D02 S40907 Clarence Park V222270 280605 Stage 4.doc Version 1.30 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) 21,22, 23, 24, 25 and 26. Clarence Park offers very good all round accommodation. The standard of housekeeping is commendable. EVIDENCE: Over the past two years, there has been considerable investment in the fabric and décor of Clarence Park. The communal areas, and refurbished rooms are decorated and furnished to a very high standard. Work is continuing to refurbish other rooms as they become available. All the residents consulted said that they liked their room. Many had chosen to bring small items of furniture and pictures to give their room a personal touch. There is a comprehensive risk assessment of the building. This did not identify that two first floor windows need to be fitted with opening restrictors. The standard of housekeeping was commendable. Residents confirmed that this was always the care. Clarence Park Nursing Home D53 - D02 S40907 Clarence Park V222270 280605 Stage 4.doc Version 1.30 Page 15 Many of the residents said that they enjoyed using the courtyard garden. They commented that it was a lovely place to sit, and very good for entertaining visiting family and friends. Clarence Park Nursing Home D53 - D02 S40907 Clarence Park V222270 280605 Stage 4.doc Version 1.30 Page 16 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, 28, 29 and 30 Robust recruitment procedures ensure suitable staff are employed to work in the home. A comprehensive training programme equips staff with the skills and knowledge to meet the needs of the residents. EVIDENCE: The duty rota provided evidence that the home consistently meets the staffing notice imposed as a condition of registration. Conversations with residents and observation during the inspection suggested that these staffing levels are appropriate. A staff member expressed frustration that it was not always possible to spend time talking to residents. Mrs Lawrence had already identified this. She plans to appoint additional staff to make beds, and ‘tidy up’. She hopes that this will free up care staff to spend more time with the residents. The sample of staff records reviewed confirmed a thorough and robust recruitment procedure. During the inspection, a new staff member was working a supervised induction shift. Staff were observed to give her good support. The maintenance person ensured that she was aware of fire safety requirements. Staff said that they were given good access to training courses. The training programme confirmed a range of ‘in house’ and external training courses for all grades of staff. Clarence Park Nursing Home D53 - D02 S40907 Clarence Park V222270 280605 Stage 4.doc Version 1.30 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, 32, 33, 35, 36, 37 and 38 The home is effectively and efficiently managed. Systems are in place to enable staff, residents and visitors to comment on the way the home is run. EVIDENCE: Mrs Lawrence has been the manager of Clarence Park for approximately two years. She is enrolled on the Registered Manager’s Award Course. Staff said that she demands high standards but is fair and supportive. Residents and relatives commented that she is very approachable. Observation and conversations with staff and residents confirmed effective management of the home. Regular staff and resident meetings are held. Minutes of these confirmed that they were able to comment about the day-today running of the home. Although a formal programme of staff supervision had been started, Mrs Lawrence said that this had ‘lapsed’ recently. She plans to restart this in the near future. Clarence Park Nursing Home D53 - D02 S40907 Clarence Park V222270 280605 Stage 4.doc Version 1.30 Page 18 Records reviewed were well maintained and up to date. Procedures to safeguard residents’ money were seen to be effective. A review of the health and safety systems confirmed good practice. Clarence Park Nursing Home D53 - D02 S40907 Clarence Park V222270 280605 Stage 4.doc Version 1.30 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 x x 3 x 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 2 9 2 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 x 15 2 COMPLAINTS AND PROTECTION 3 3 3 3 3 3 2 3 STAFFING Standard No Score 27 3 28 3 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 x 3 3 3 3 x 3 2 3 3 Clarence Park Nursing Home D53 - D02 S40907 Clarence Park V222270 280605 Stage 4.doc Version 1.30 Page 20 No 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. 2. 3. Standard OP9 OP26 OP36 Regulation 13.2 13.4 18.2 Requirement Prescribed medications must be given on the appropriate day Opening restrictors must be fitted to identified windows The programme of staff supervision must be re-started. Timescale for action 01/07/05 01/08/05 01/08/05 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. 3. Refer to Standard OP8 OP12 OP15 Good Practice Recommendations Staff should receive a training update on the use of incontinence products. The home should appoint an activities co-ordinator The procedures related to serving meals should be reviewed. Clarence Park Nursing Home D53 - D02 S40907 Clarence Park V222270 280605 Stage 4.doc Version 1.30 Page 21 Commission for Social Care Inspection Riverside Chambers Castle Street Tangier Taunton TA1 4AL 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 Park Nursing Home D53 - D02 S40907 Clarence Park V222270 280605 Stage 4.doc Version 1.30 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. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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