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Inspection on 05/12/05 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 5th December 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?

Residents felt that since the appointment of a new chef, the standard of food provided at Clarence Park has improved significantly. All the requirements and recommendations made at the last inspection were met within the agreed timescales.

What the care home could do better:

Although morale was good, there are high levels of staff turnover. Residents said that they found it frustrating that `you get to know people and their ways, then they leave, and you have to go through it all with a new person`. The use of a `communications book` compromises residents` confidentiality. Mrs Lawrence agreed to remove it from a communal area straight away. She plans to review its ongoing use. A specific risk assessment must be carried out before bedrails are used, to ensure that these are appropriate.

CARE HOMES FOR OLDER PEOPLE Clarence Park Nursing Home 7 / 9 Clarence Road North Weston Super Mare North Somerset BS23 4AT Lead Inspector Alison Murray Unannounced Inspection 5th December 2005 09:30 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 Park Nursing Home DS0000040907.V268824.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 Park Nursing Home DS0000040907.V268824.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Clarence Park Nursing Home Address 7 / 9 Clarence Road North Weston Super Mare North Somerset BS23 4AT 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) 01934 629374 01934 626207 Notaro Homes Ltd Ms Sharmaine Marie Lawrence Care Home 50 Category(ies) of Old age, not falling within any other category registration, with number (50) of places Clarence Park Nursing Home DS0000040907.V268824.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. May accommodate up to 35 Patients aged 50 years and over requiring nursing care. Manager must be a RN on parts 1 or 12 of the NMC register Staffing levels detailed in the letter to Mr N Notaro from the CSCI dated 7th September 2004 apply. Date of last inspection 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 facilities. With a small garden at the front, the rear has been laid as patio around a central water feature. Clarence Park Nursing Home DS0000040907.V268824.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was a positive unannounced inspection. Two inspectors spent a total of 11 hours in the home. Although some care and staff records were reviewed, the main focus of the inspection was the day-to-day experience of the residents. Twenty of the 36 residents were consulted individually; others were observed in the communal areas of the home. Four staff members and one regular visitor spoke to the inspectors. What the service does well: What has improved since the last inspection? Residents felt that since the appointment of a new chef, the standard of food provided at Clarence Park has improved significantly. All the requirements and recommendations made at the last inspection were met within the agreed timescales. Clarence Park Nursing Home DS0000040907.V268824.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 Park Nursing Home DS0000040907.V268824.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 Park Nursing Home DS0000040907.V268824.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): 1, 2, 3, 4 and 5. Standard 6 does not apply. Prospective residents are given good information about the home. Their needs are comprehensively assessed before admission. The staff are given training if required, to ensure that they can meet these needs. EVIDENCE: Since the last inspection the written information about the home has been updated. It gives prospective residents and their relatives good information about the range of services offered at Clarence Park. Recently admitted residents were very frail. They were not able to recall how they came to be in the home. Their care records contained evidence of a comprehensive pre admission assessment. A visitor told how she been encouraged to look around the home before she chose to place her relative there. One of the current residents has complex communications needs. Staff training records confirmed that Mrs Lawrence arranged specialist training for staff before this person was admitted to the home. The care plan, and observation Clarence Park Nursing Home DS0000040907.V268824.R01.S.doc Version 5.0 Page 9 of staff as they worked with the resident confirmed that this training was effective. Clarence Park Nursing Home DS0000040907.V268824.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, 10 and 11 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. Staff demonstrated a sound awareness of residents’ needs. Residents felt comfortable that staff had the knowledge and skills to look after them. Bedrails were used for a number of residents. Although their use was documented in the care records, there was no specific assessment of the risk they posed. Records suggested that these had been implicated in several accidents. None of the residents sustained serious injuries. Clarence Park Nursing Home DS0000040907.V268824.R01.S.doc Version 5.0 Page 11 Many residents were consulted individually, and others observed in the communal areas of the home. All were neatly dressed, and attention had been paid to their hair and nail 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. During the course of the day, the inspectors observed many caring exchanges between staff and residents. There was also lots of laughter, as staff and residents gently teased each other. In conversation, two of the residents commented ‘we’ve got the staff well trained!’ The medication administration records were well maintained, and drugs securely stored. The lunchtime medicine round was observed. The medicine administration procedures demonstrated good practice. Clarence Park Nursing Home DS0000040907.V268824.R01.S.doc Version 5.0 Page 12 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): 13, 14 and 15 Residents are able to keep contact with family and friends. Staff encourage them to become involved in the life of the home. Residents enjoy the meals provided. They feel that the chef knows their likes and dislikes. EVIDENCE: Since the last inspection, an activities organiser has been appointed to work in the home. When the inspection took place, she was acting as escort to a resident, so the inspectors were unable to speak to her in detail. Mrs Lawrence said that she keeps a record of activities provided in the home. During the inspection there was a steady stream of visitors coming and going. Staff greeted regular visitors by name, and escorted those who were unfamiliar with the home to the relevant resident. Those consulted during the inspection said that they were always made welcome, and encouraged to take part in the life of the home. All the residents consulted said that the standard of meals provided had improved since the last inspection. They said that the new chef is very good, with several offering details of favourite meals. They said that they had a good Clarence Park Nursing Home DS0000040907.V268824.R01.S.doc Version 5.0 Page 13 choice of meal, but that if they did not like the menu suggestions, they could have something else. The kitchen assistant said that she goes around the residents every morning, to find out what they want to eat that day. She said that she is able to pass on their choices and suggestions directly to the chef. The lunchtime meal looked and smelt appetising. Residents were offered a choice of sauces and condiments. Staff were on hand to discretely assist residents if necessary. Clarence Park Nursing Home DS0000040907.V268824.R01.S.doc Version 5.0 Page 14 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 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. Recently Mrs Lawrence received an allegation of abuse against a member of staff. She referred this to the adult protection team through the appropriate channels. She co-operated fully with the subsequent investigation. Since then, she had given all staff additional training and supervision to ensure that they are aware of adult protection issues, and whistle blowing procedures. Clarence Park Nursing Home DS0000040907.V268824.R01.S.doc Version 5.0 Page 15 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, 25 and 26 Clarence Park offers very good all round accommodation. The standard of housekeeping was 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. Since the last inspection, work has been competed to fit opening restrictors to all windows. The inspection took place on a cold day. The home felt pleasantly warm, but none of the radiators were excessively hot to touch. Clarence Park Nursing Home DS0000040907.V268824.R01.S.doc Version 5.0 Page 16 The standard of housekeeping was commendable. Residents confirmed that this was always the care. Staff demonstrated a good awareness of infection control procedures. They were observed to remove gloves and aprons, and wash their hands after attending to a resident. Alcohol gel dispensers were in place around the home; all bedrooms visited were supplied with anti-bacterial soap in dispensers, and paper towels. Clarence Park Nursing Home DS0000040907.V268824.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, 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. Staff turnover is relatively high, and affects continuity of care. EVIDENCE: Some of the residents said that they felt that the staff ‘work too hard’. They said ‘they always seem so busy’. Despite this, the inspectors felt that the staffing levels were appropriate to the needs of the residents. When the inspectors arrived at 10:30, virtually all the residents were up and dressed. Staff were seen to chat with them in the communal areas of the home. Call bells were answered promptly. Residents said that this was usually the case. A review of the duty rota confirmed that the home consistently meets the staffing notice agreed with CSCI. Staff records contained evidence of a thorough recruitment process. All the necessary checks, references and permissions were in place before staff started work in the home. Training records confirmed a comprehensive induction programme, and a commitment to ongoing training. It was clear from conversations with residents and staff, that staff turnover levels are relatively high. Residents said that they found it frustrating that ‘you get to know people and their ways, then they leave, and you have to go Clarence Park Nursing Home DS0000040907.V268824.R01.S.doc Version 5.0 Page 18 through it all with a new person’. Mrs Lawrence said that a number of overseas staff had reached the end of their contract, and chosen to return to their home country. Others had gone on to higher education, with a number now doing their nurse training. Some people had gone to work in other care homes. Mrs Lawrence said that some of these individuals had now returned to Clarence Park. Clarence Park Nursing Home DS0000040907.V268824.R01.S.doc Version 5.0 Page 19 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): 36 and 37 Regular staff supervision sessions are effectively used to review and improve care practice. Residents confidentiality is compromised by informal communication systems in the home. EVIDENCE: Staff records, and notices displayed in the nurses’ office confirmed that staff receive regular supervision. As a result of an allegation made recently, all staff had been given group, and individual supervision about adult protection procedures, and the whistle bowing policy. At present, staff use a ‘communication book’ to pass messages between shifts. This book was kept on a table in the lobby to one of the lounges, where other residents or visitors could have read it. Some of the comments made related to Clarence Park Nursing Home DS0000040907.V268824.R01.S.doc Version 5.0 Page 20 specific residents. This is not good practice. Mrs Lawrence agreed to remove the book straight away. Clarence Park Nursing Home DS0000040907.V268824.R01.S.doc Version 5.0 Page 21 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 3 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 X 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X X X X 3 4 STAFFING Standard No Score 27 2 28 X 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score X X X X X 3 2 x Clarence Park Nursing Home DS0000040907.V268824.R01.S.doc Version 5.0 Page 22 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 OP7 Regulation 13.-(4) Requirement A risk assessment must be carried out and documented in the care records if bed rails are used. Staff must ensure that written information relating to residents is stored securely Timescale for action 05/01/06 2 OP36 17.-(1) 05/12/05 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 Refer to Standard OP27 OP27 Good Practice Recommendations Staffing levels should be kept under review. The management team should attempt to identify and address factors contributing to staff turnover Clarence Park Nursing Home DS0000040907.V268824.R01.S.doc Version 5.0 Page 23 Commission for Social Care Inspection Somerset Records Management Unit Ground Floor Riverside Chambers Castle Street 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 DS0000040907.V268824.R01.S.doc Version 5.0 Page 24 - 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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