Inspection on 19/05/05 for Clarendon House

This inspection was carried out on 19th May 2005.

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

Clarendon House 20/11/07

Clarendon House 09/05/06

Clarendon House 24/11/05

Clarendon House 09/03/05

Clarendon House 24/11/04

Clarendon House 26/05/04

Similar services:

Chirnside House

Keer Sands Residential Home

Ruskin Lodge

Bushell House

Langrigg House

Parkside

Dystlegh Grange

Thornton Lodge

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

CARE HOMES FOR OLDER PEOPLE Clarendon House Carrwood Road Bramhall Stockport Cheshire, SK7 3LR Lead Inspector Kathleen Mcall Unannounced 19th May 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. Clarendon House F54 F04 s8548 Clarendon Hse un v227979 190505 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Clarendon House Address Carrwood Road Bramhall Stockport Cheshire SK7 3LR 0161 488 4107 0161 488 4107 NA Davenport Manor Nursing Home Limited 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) Paula Beckley Care Home 32 Category(ies) of OP - Old Age registration, with number of places Clarendon House F54 F04 s8548 Clarendon Hse un v227979 190505 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: 1 Service users to include up to 32 OP. Date of last inspection 24th November 2004 Brief Description of the Service: Clarendon House is a residential care home that is registered to provide accomodation for up to thirty two older people. It is one of three residential care homes owned by the Davenport Manor Nursing Group, these include, Little Manor residential care home and Davenport Manor residential care home. The registered providers are Kiran Patel and Mr Dilip Patel. The registered manager is Miss Paula Beckley, who has held the postion since November 2003. Clarendon House is a large Tudor (style) residence that is situated on Carwood Road, Bramhall. The home is set back off the road with substantial gardens surrounding the property with access to Bramhall Park. There are no bus routes that run directly to the home. The nearest shops are situated on Bramhall Road or in Bramhall village, which is approximately a five minute drive away from the home. The home has twenty single rooms, ten of which have ensuite facilities and six double rooms which have no ensuite facilities. All rooms have a washbasin. There are two lounges and two dining rooms. There is a passenger lift to assist residents to their bedrooms on the first floor. The home is suitable for wheelchair users. Clarendon House F54 F04 s8548 Clarendon Hse un v227979 190505 Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced inspection, which took place over the course of a day. The registered manager was not available at the time of the inspection. Two senior carers on duty at the time of the inspection assisted the inspector with the inspection. Care plans, assessment documentation, contracts and medication records and their storage were examined. The inspector spoke with a number of residents in the home and had a discussion with a relative who was visiting the home at the time of the inspection, and several members of staff on duty. Two relatives comment cards were returned, both indicated some dissatisfaction with the laundry arrangements at the home and did not feel that they were always kept informed of important matters affecting their relatives. Since the last inspection a complaint had been made about the staffing arrangements at the home, the cleanliness of the home, temperatures within the home and the delivery of care. The complaint was upheld in part, with requirements made for improvement. A further complaint was made at the time of this inspection concerning domestic and laundry arrangements at the home and standards of hygiene at the home. At the time of writing this report the complaint was under investigation. What the service does well: What has improved since the last inspection? Comfortable seating had been provided in both lounges since the last inspection. Several bedrooms had been redecorated and recarpeted to a comfortable standard. Clarendon House F54 F04 s8548 Clarendon Hse un v227979 190505 Stage 4.doc Version 1.30 Page 6 The registered proprietors had reviewed the homes contract and were in the process of replacing existing contracts with the new one. 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. Clarendon House F54 F04 s8548 Clarendon Hse un v227979 190505 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 Clarendon House F54 F04 s8548 Clarendon Hse un v227979 190505 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) 2 and 3. Service users had been issued with a written and their care needs were fully assessed before admission. EVIDENCE: The registered proprietors had recently revised the Service User contract and at the time of the inspection the home was in the process of replacing existing service users contracts with new contracts. Service users recently admitted to the home had a written contract which detailed the terms and conditions of their stay. Service users were assessed prior to their admission to the home; no service users were admitted to the home without having had their care needs assessed. Assessments were obtained from social workers if they had been involved in the admission. Service users were assured that their care needs could be met by the home prior to their admission. Those service users recently admitted to the home told the inspector that they were happy with the way in which the home met Clarendon House F54 F04 s8548 Clarendon Hse un v227979 190505 Stage 4.doc Version 1.30 Page 9 their needs. One service user said that ‘the home was very good, if you want to see a dentist they sort this out for you’. Clarendon House F54 F04 s8548 Clarendon Hse un v227979 190505 Stage 4.doc Version 1.30 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 standard(s) 7, 9 and 10. Care plans were poor and did not accurately reflect how service users cares needs were being met. Medication practice was unsatisfactory. EVIDENCE: All service users had a care plan. Whilst there had been some improvement in the standard of care plans since the last inspection, this tended to be in respect of those service users recently admitted to the home. The standard of these care plans was good, however for the majority care plans remained poor. Care plans did not include all areas where assistance was given ie medication. Risk assessments were stored separately from care plans, as were records held in respect of service users weight gain and losses and visits from GP’s. Whilst care plans did reflect the assessed risk, risk assessments did not consider what actions were required to address identified risks and merely stated what the identified risk was. The storage and administration of medication within the home was unsatisfactory, the medication trolley was not secured when not in use and the storage of inhalers and eye drops was not acceptable. The controlled drugs register was not accurately maintained. Clarendon House F54 F04 s8548 Clarendon Hse un v227979 190505 Stage 4.doc Version 1.30 Page 11 Several service users told the inspector that the staff at Clarendon were ‘very good’ and ‘very caring’ and that they always treated them respectfully. One service user told the inspector that she didn’t like all the staff, she felt they didn’t like her and ‘that was ok’, but this didn’t cause her any problems and that she was still happy with her care. Clarendon House F54 F04 s8548 Clarendon Hse un v227979 190505 Stage 4.doc Version 1.30 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 standard(s) 12, 13 and 15. The day-to-day routine of the home was relaxed and informal enabling service users to exercise choice and control. Mealtime arrangements were well managed and satisfied service users expectations. EVIDENCE: The home had an activities programme that was flexible and changeable depending on what service users wanted to do. On the day of the inspection service users were having their nails painted and others were watching TV. One service user told the inspector that the activity arrangements at the home suited her. The day-to-day routine of the home was relaxed and flexible with some service users preferring to spend time in their rooms and others using the lounge facilities. A service user told the inspector that she could get up and go to bed when she wanted and that she was able make choices about how she spent her day and what she wanted to eat. Visitors were made welcome at the home and service users kept in touch with family and friends. Service users confirmed that they could have visitors at all times, but that meal times were best avoided. Clarendon House F54 F04 s8548 Clarendon Hse un v227979 190505 Stage 4.doc Version 1.30 Page 13 A number of service users commented how good the food was and that a wide selection was available. Clarendon House F54 F04 s8548 Clarendon Hse un v227979 190505 Stage 4.doc Version 1.30 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 standard(s) 16 and 18. Whilst service users felt confident with the complaints procedure, complainants did not share this view. Staff did not respond appropriately to suspicions of abuse at the home. EVIDENCE: The home had a complaints policy and procedure. Two complaints about the home had been made to the commission since the last inspection and were being followed up at the time of the inspection. These matters have been addressed in separate letters to the home. Service users told the inspector that they knew who to complain to if they had a problem and believed that they would be listened to and that their problem would be resolved. The home had a procedure for responding to allegations of abuse. A number of care staff had looked at issues around adult protection and abusive care practices in residential care homes as part of their National Vocational Qualification training. However staff would benefit from completing training in Adult Protection and increase their awareness of the correct reporting procedures to follow when potential abuse is suspected. Clarendon House F54 F04 s8548 Clarendon Hse un v227979 190505 Stage 4.doc Version 1.30 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 standard(s) 19, 21, 22, 24 and 26. Service users did not live in a clean and well-maintained environment and bathing facilities were grossly inadequate. EVIDENCE: The damaged ceiling that had been observed on a previous inspection had been repaired however the home has since had another leak and damage to the first floor area of the home was again observed. The home did not provide sufficient assisted bathing areas for service users care needs. One bathroom has been out of commission for some considerable time awaiting the installation of an assisted shower. The home has replaced all comfortable chairs in the lounge areas used by service users, thus raising the overall standard and appearance of both the lounges. Since the last inspection a number of bedrooms had been redecorated and recarpeted to a comfortable and satisfactory standard. However the curtains Clarendon House F54 F04 s8548 Clarendon Hse un v227979 190505 Stage 4.doc Version 1.30 Page 16 in a number of other bedrooms were observed to be hanging off their rails giving the home an unkempt appearance. The standards in bedrooms varied considerably with some rooms appearing well maintained and others not so. Not all rooms had a lockable piece of furniture for service users to store personal belongings. At the time of the inspection the home did not have a domestic assistant on duty, in recent months the home had experienced difficulties in recruiting domestic and laundry staff. This was apparent at the time of the inspection, as standards of cleanliness at the home were unsatisfactory. Bedroom numbers 17 and 24 had an odour, however the communal areas of the home were clean and free from unpleasant odours. Clarendon House F54 F04 s8548 Clarendon Hse un v227979 190505 Stage 4.doc Version 1.30 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 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. The home was insufficiently staffed to undertake specific domestic and laundry. EVIDENCE: At the time of the inspection it was observed that the home did not have any domestic assistants on duty, cleaning tasks had been left. The cleaner on duty had been redeployed to assist in the kitchen. The home did not have a dedicated laundry person on the staff rota. Laundry tasks were the responsibility of carers when they could fit these in their working schedule. The concern with this arrangement was that care staff were taken away from caring tasks and meeting the needs of service users whilst completing laundry tasks. However a sufficient number of care staff was observed to be on duty at the time of the inspection. One service user told the inspector that care staff were ‘very good, excellent in fact’ and another service user described care staff as being ‘good fun’. There was a good banter and rapport between staff and service users. Care staff had undertaken training in the ‘Safe Handling of Medicines’, annual fire safety training and health and safety training were planned with future dates. Clarendon House F54 F04 s8548 Clarendon Hse un v227979 190505 Stage 4.doc Version 1.30 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 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) 38. The health, safety and welfare of service users and staff appeared to be promoted by the home. EVIDENCE: Future training was planned for fire safety and health and safety at the home. The home maintained records in respect of fire safety at the home. Lifting equipment was maintained. Clarendon House F54 F04 s8548 Clarendon Hse un v227979 190505 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 3 3 x x N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 x 9 2 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 x 15 3 COMPLAINTS AND PROTECTION 2 x 1 2 x 2 x 2 STAFFING Standard No Score 27 2 28 x 29 x 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x 2 x x x x x x x 3 Clarendon House F54 F04 s8548 Clarendon Hse un v227979 190505 Stage 4.doc Version 1.30 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 OP 7 Regulation 15 Requirement The registered person must ensure that care plans illustrate how the service users needs in health and welfare are met. (Timescale of 24.01.05 not met.). The registered person must develop risk assessment held in respect of service users, to include actions and measures taken to minimise the risk. The registered person must ensure that the receipt and administration of controlled drugs are recorded accurately and that any corrections are made by dated marginal note or footnote. (Timescale of 24.11.04 not met.) The registered person must ensure that when not in use the medication trolley is securely thethered to a wall or placed in a locked room. The registered person must make arrangements for all staff to attend training in Adult Protection. The registered person must ensure that all allegations and incidents of abuse are followed Timescale for action 19th August 2005. 2. OP 7 13 19th August 2005. 3. OP 9. 13(2) 19th May 2005. 4. OP 9 13(2) 19th May 2005. 5. OP 18. 13(6) 19th December 2005. 19th May 2005. Page 21 6. OP 18 Schedule 3 Clarendon House F54 F04 s8548 Clarendon Hse un v227979 190505 Stage 4.doc Version 1.30 7. OP 19 23(2)(b) 8. OP 21 23(2)(j) 9. OP 24. 16(2)(c) 10. OP 24 16(2)(m) 11. OP 26 23 12. OP 27 18(1)(a) up promptly and that accurate records of such incidents are maintained. The registered person must arrange for the damaged ceilings to the first floor of the home to be repaired. The registered person must provide further assisted bathing facilities to meet the needs of service users resident at the home. (Timescale of 08.09.03 not met.) The registered person must ensure that curtains fitted in rooms occupied by service users are repaired and re- fitted to curtain rails. The registered person must ensure that a lockable piece of furniture is provided in room 5 and in any other room that requires such. The registered person must ensure that the home is kept clean and bedrooms 17 and 24 are kept free from odours. The registered person must ensure that domestic and laundry staff are employed in sufficient numbers to keep the home clean. 19th July 2005. 19th May 2005. 19th June 2005. 19th June 2005. 19th May 2005. 19th May 2005. 13. RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard OP 22 Good Practice Recommendations The registered person should consider providing grab rail to assist service users when mobilising in the basement area of the home. Clarendon House F54 F04 s8548 Clarendon Hse un v227979 190505 Stage 4.doc Version 1.30 Page 22 Commission for Social Care Inspection 2nd Floor, Heritage Wharf Portland Place Ashton-under-Lyne OL7 OQD 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 Clarendon House F54 F04 s8548 Clarendon Hse un v227979 190505 Stage 4.doc Version 1.30 Page 23 - 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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