Inspection on 18/11/08 for Clarendon Mews
Also see our care home review for Clarendon Mews for more information
This inspection was carried out on 18th November 2008.
CSCI found this care home to be providing an Adequate service.
The inspector found there to be outstanding requirements from the previous inspection report. These are things the inspector asked to be changed, but found they had not done. The inspector also made 7 statutory requirements (actions the home must comply with) as a result of this inspection.
Other inspections for this house
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
An agency cook was seen at inspection. The food was well presented and individuals who tasted it said that they enjoyed it. A choice of two hot meals was offered and a third alternative of sandwiches was also offered to anyone who requested this. The meals and pudding was served hot. The inspector sampled the food being served. The kitchen was clean and well presented. Staff were seen at lunchtime helping to assist individuals who needed help in this way. The meal time was a pleasant experience. One of the concerns raised to the inspector prior to visiting was that part of the home used by individuals was unheated and cold. The heating in all parts of the home was now working and the home was warm at inspection. Families who spoke with the inspector felt that they were made to feel welcome and visited often. One newer relative said that it was too early to comment.
What the care home could do better:
Information affecting the well being of individuals has not always been sent into the Commission. It is a legal requirement to complete Regulation 37 forms and an assessment of the accident and incidents as they arise must follow. A Regulation 37 form is completed for any deaths, illnesses or other events that has a poor outcome for any individual at the home. Such incidents would include a temporary loss of heating to parts of the home. Two people were case tracked. One of the individuals had a disability affecting one side of their body. They were able to speak and express them self. The care plan stated that they liked to be in bed at 6.30pm and up at 7am. It also stated that they needed the help of one staff member to help them to eat their meals. The inspector observed the individual having their meal. The meal was eaten by the individual in bed, a family member was present. Staff had previously had problems with the family and appeared over bossy towards the individual at meal time and tried to persuade them to be fed by the staff member. This individual insisted on taking their meal independent of any help. They asked to be sat up right in bed to do so. Staff assisted the individual to be moved into an upright position. In doing so however they had to manually move the bed which did not have wheels on it. This is a health and safety issue for both staff and the individual being moved. The individual chose not to get out of bed. The meal was given to them placed on a pillow without any protection to the individuals skin from the hot food, no apron or serviette was offered to wipe their mouth afterwords. The meal kept sliding to one side. There was no place guard around it. There was no table available for the individual to rest the plate on. Visibility in the room was poor. (It was a dark day and an energy saving light bulb was used to light the room). This is a situation for management to review. There was no bed rail risk assessment in the care plan or the provision of bed rail protectors for the bed rails if used. The staff at the home should contact the District Nurses for advice and help in this matter. They should also speak with and explain the use of bed rails to the individual and close family member and gain their consent. A key worker system is operated at the care home. However this person was new and would have benefited from a staff member taking a special interest in them to ensure that their needs were being met. This would also help them to settle in and feel more comfortable when needing or asking for help. The individual told the inspector that they were afraid of falling and this was one of the reasons that she did not want to be out of bed. They also thought that the Doctor was visiting on that day. Another person case tracked had a key worker. Neither the individual or the family members who spoke with the inspector were able to say who the key worker was. It is recommended that the role of the key worker is reviewed if it is to be of benefit to the individual who lives at the care home. Clutter in two bedrooms was seen. Both rooms contained equipment that was no longer used for the individuals. The inspector was told that the night staff were now trained to give medications. In this way individuals at night in pain can be given their medicines when they need it without waiting for someone to come in specially during the night or having to wait for the morn ing shift. Both bedrooms had medication in them in the form of prescribed creams. The medications were not stored in a safe manner. Creams were left available to anyone who wanders around the home giving them easy access to it as well as putting themselves or others at risk. A relative confirmed that individual residents do wander into bedrooms and their relative has snacks and small items of food that the family bring in for them placed on top of their wardrobe because of this. This was seen on inspection. Oral medications of the individual residents case tracked and a few others were seen and checked. Some people did not have a photograph on their medicine record. Itwould help any newer staff to recognize individuals more easily if assisting with medicines. This was discussed with the new manager who said that photographs of individuals was in progress. Staff need to consider how they approach and meet the needs of individuals and to ensure that individual needs are accurately reflected in the care plan. In this way privacy and dignity will be demonstrated as met. On the day of inspection no activities were seen to be done with or between individuals living at the home. The staff were able to show activities that had been bought for staff to do with individuals such as board games with large pictures and prints on them. One person`s relatives who was case tracked said that they chose not to take part in many activities. It is important however to provide people with activities that will prevent loss of abilities. Many of the